To quantify the effects of postoperative pain relief on surgical stress response, 16 patients undergoing cholecystectomy were allocated randomly to double-blind treatment with either fentanyl by patient controlled analgesia (PCA) with the Prominject plus saline given s.c. by nurses on demand (PCA group) or saline by the infusion pump plus morphine 10 mg/70 kg s.c. by nurses on demand (control). Pain intensity (VAS) and plasma catecholamine, cortisol and glucose concentrations were measured 2-hourly for 12 h after operation. PCA improved postoperative pain intensity (P less than 0.05) and reduced plasma cortisol (P less than 0.05), but not glucose and catecholamine concentrations compared with the control group. Thus improved postoperative pain relief per se by PCA with systemic opioids had no major influence on the catabolic response to abdominal surgery.

After the intake of approximately 24 g wheat bran daily for 5 weeks, 25 trainee nurses showed no changes in the serum levels of cholesterol, triglyceride, calcium or total 3α‐hydroxycholanic acid. On the other hand, the study revealed a reduced intestinal transit time with good correlation to an increased frequency of bowel movements. Average body weight fell significantly, by 0.4 kg. The daily caloric intake remained constant throughout the study period, whereas the calcium intake was significantly increased. Among the serum parameters and the dietary constituents, good correlation was found only between serum cholesterol and the dietary cholesterol content. In addition, an inverse relationship was demonstrated between the serum levels of cholesterol and total 3α‐hydroxycholanic acid. The significance of this observation is as yet unknown.