Pain management by intercostal block was superior during the first 24h after surgery whereas on the second day after surgery pain control was significantly better achieved by the epidural catheter in relaxed position. A combination of both forms of anaesthesia seems to be an ideal pain management in patients undergoing thoracic surgery.

We have investigated two patients with multiple myeloma who had a prolonged thrombin clotting time and absent clot retraction but no haemorrhagic diathesis. Coagulation and platelet function studies, as well as electron microscopy of the fibrin clot, indicate abnormal fibrin polymerization; adherence of myeloma protein to very thin fibrin strands results in a rigid translucent clot which fails to retract. This abnormality is not necessarily associated with a haemorrhagic diathesis.

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