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A randomized study was done to evaluate operation stress of reconstructive surgical procedures in the pelvic and femoral regions in regional anaesthesia compared to general anaesthesia. Spinal anaesthesia showed more favourable parameters of plasma catecholamines and plasmacortisol. In blood pressure and heart rate there was no significant difference between both anaesthetic groups. According to these (preliminary) results the authors consider spinal anaesthesia a more adequate method of intraoperative anesthesia.

The use of neuroleptanalgesia in acute myocardial infarction offers the possibility of reducing pain and emotional stress. The influence of such treatment on hemodynamic parameters (heart rate, cardiac output, stroke volume, peripheral resistance, systemic blood pressure, and pulmonary pressure) and on the plasma level of adrenaline and noradrenaline has been studied in 6 patients with acute myocardial infarction. This results demonstrate that during neuroleptanalgesia the already elevated levels of noradrenaline and adrenaline further increase. This increase was most pronounced in the patients with the highest initial levels of catecholamines. Since the peripheral resistance and systolic and diastolic blood pressures decrease concomitantly, it is concluded that the increase in levels of noradrenaline and adrenaline further increase. This increase was most pronounced in the plasma catecholamines is due to a reaction of the sympathetic nervous system to the alpha-adrenergic receptor blocking activity of droperidol causing vasodilation. The data indicate that pain, emotional stress, and anxiety in the acute phase of myocardial infarction do not play the expected essential role for the activation of the sympathetic nervous system generally observed in acute myocardial infarction. Additionally, the data demonstrate that drugs producing a vasodilation can have a deteriorating effect on the hemodynamic situation and that a reduction of the afterload by vasodilating drugs can result in a further increase in the release of catecholamines.

The influence of neuroleptanalgesia and halothane-N2O-anaesthesia on the activity of the sympathetic nervous system was studied continuously in the intra- and postoperative period in 2 groups of 10 patients undergoing abdominal operations. In the neuroleptanalgesia-group the noradrenaline level in plasma rose continuously during the course of the operation and this increase was highly significant. The adrenaline level in plasma increased as well, however this increase did not depend on the duration of the operation. In the halothane-N2O-group only a small increase of both adrenaline and noradrenaline in plasma could be demonstrated intraoperatively. One hour after the end of the operation the plasma levels of adrenaline and noradrenaline were elevated in both groups. The noradrenaline level was even higher after neuroleptanalgesia. Four hours after the end of surgery the levels of adrenaline and noradrenaline started to decrease, but were still above the preanaesthetic level. The increase of the concentration of catecholamines in plasma indicating an activation of the sympathetic nervous system was not associated with a corresponding increase in heart rate and blood pressure intra- as well as postoperatively in either group. Only in the neuroleptanalgesia-group was there a small, but insignificant increase of the systolic and diastolic pressure postoperatively.