Despite the widespread use of intrathecal opioids, there is still neither clear evidence, nor a consensus among anaesthetists, regarding the optimal dose of intrathecal opioids for postoperative pain relief. This review examines some of the key aspects of the use of intrathecal opioids for acute postoperative analgesia.

An accurate assessment of cardiovascular function is fundamental when assessing fitness for anaesthesia and surgery. Cardiac investigations enable anaesthetists and surgeons to risk stratify patients and plan for post operative care.

A pregnant woman may require surgery at any stage. This patient poses both clinical and ethical challenges for the anaesthetist, not only during the moments of childbirth and labour, but perhaps more importantly when we encounter these individuals during nonobstetric surgery. The immense variations in physiology and anatomy, and therefore pharmacology, need to be taken into account when forming a management plan. This includes staffing, training, equipment, drugs and above all, an insight into the difficulties that may arise when anaesthetising a pregnant patient.

Daragh Lehane is a perioperative fellow at the Alfred Hospital in Melbourne, Australia. Daragh is our first Australian trainee to author a Perioperative Medicine Tutorial of the Month - expect to see more from down under as our new Australia & New Zealand arm, TRIPOM ANZ, is starting to grow. This presents valuable opportunities to gain international perspectives on perioperative teaching and practices through a global network of trainees interested in perioperative medicine.

Introduction
Mechanical Ventilation (MV) is a cornerstone of intraoperative anaesthetic practice but is surprisingly poorly understood.It’s clear that one size doesn’t fit all, and simply accepting default settings is rarely appropriate.On the other hand, striving to achieve physiological ideals (derived in awake upright patients not undergoing intra-abdominal surgery) can result in volu-, baro-, atelecta-, and bio-trauma (to name a few) and exacerbates existing lung pathologies.