The results of Ramstedt's operation in a district general hospital.

From 1970 to 1979 78 pyloromyotomies were performed for congenital hypertrophic pyloric stenosis in the Royal United Hospital in Bath. Fourteen surgeons were involved. Fifty-eight operations were performed using local anaesthesia, and in this group a significantly smaller number of infants vomited postoperatively compared with those given general anaesthesia. There were no deaths, but a relatively high proportion of complications were encountered. These complications were related to the infrequent performance of the operation by the surgeons concerned rather than to the choice of anaesthetic. Pyloromyotomy should be carried out by surgeons with a special interest in the condition. Local anaesthesia offers an advantages by limiting postoperative vomiting.