In Reply:—

We were aware of the article by Anderson et al. , which appeared in Pediatric Anaesthesia  at the time our manuscript was accepted with revisions by the Editor of Anesthesiology. We noted that there was considerable variation in the intervals between the start of the dead space purge of the pump and catheter and the onset of coma in their patients. Could this be related to the dermatomal level of the spinal catheter tip? This level is described in our report, whereas it is missing in their article. We received no reply to this query after we e-mailed Anderson et al.  at their address listed for correspondence. Thus, their article was not included in our references, which were limited to those that were strictly relevant to our case description.