| Abstract
| - The purpose of this study was to investigate the effect of differentpain-relief methods (regional and systemic) following thoracotomies on thecardiovascular system, pulmonary gas exchange, various endocrine parametersand subjective perception. A further aspect was to evaluate the benefits ofinterpleural analgesia as a new regional technique against alreadyestablished regional techniques, such as intercostal nerve block andthoracic epidural block. All postoperative pain methods led to asignificant time-dependent reduction of the adrenaline concentrations inplasma while the noradrenaline concentrations did not change significantly.There were no statistical differences in catecholamine concentrations amongthe different study groups, although the mean concentrations of adrenalinein patients having a thoracic epidural block for pain relief were lower incomparison to the findings in other groups. The plasma concentrations ofthe "stress metabolites", such as glucose, free fatty acids and lactate, aswell as the haemodynamic (mean arterial pressure, heart rate) and pulmonaryparameters (blood gas analyses), showed no significant differences amonggroups. In contrast to the other pain-relieving methods, interpleuralanalgesia did not lead to sufficient pain relief in that 7 out of 10patients needed supplementary systemic opioid therapy. Therefore,interpleural analgesia for pain relief following thoracotomies cannot berecommended.
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