Forty-five patients underwent enflurane anaesthesia and surgery. Anaesthesia alone evoked little change in the plasma concentrations of ACTH, cortisol or antidiuretic hormone (ADH), but there were significant increases during surgery. The plasma concentrations of aldosterone increased during anaesthesia alone, and a further increase was noted during surgery. Neither enflurane anaesthesia nor surgery significantly influenced plasma concentrations of renin activity and thyroxine. A significant decrease in the plasma triiodothyronine concentrations was detected during anaesthesia alone, and a further decrease was found during and following surgery. Enflurane anaesthesia did not affect the plasma concentration of luteinizing hormone (LH) in male subjects throughout surgery, but a significant decrease in female patients was detected to the first day after operation. The plasma concentrations of testosterone decreased during anaesthesia alone and surgery, and a further decrease was noted on the first day after operation.

Ketamine has been considered to be contraindicated for schizophrenic patients because it may induce psychological emergence reactions and psychiatric deterioration. Total intravenous anaesthesia (TIVA) with ketamine combined with droperidol and fentanyl (DFK) has been used in 14 schizophrenic patients undergoing various surgical procedures. Two patients died post-operatively of concomitant severe disease rather than from schizophrenia related pathophysiology or anaesthetic complication. One patient showed transient mild anxiety in the early post-operative period soon relieved by the patient's routine medication. However, no patient developed exacerbations of psychosis or psychological emergence reactions during the first post-operative month. The cardiovascular state during and after DFK remained stable in all cases. It is concluded that ketamine when combined with droperidol and fentanyl is a satisfactory anaesthetic for patients with schizophrenia.

Forty-five patients underwent enflurane anaesthesia and surgery. Anaesthesia alone evoked little change in the plasma concentrations of A C I H , cortisol or antidiuretic hormone (ADH), but there were significant increases during surgery. 'l'he plasma levels of aldosterone rose during anaesthesia alone, and a further increase was noted during surgery. Neither enflurane anaesthesia nor surgery significantly influenced plasma concentrations of renin activity and thyroxine. A significant decrease in the plasnia triiodothyronine levels was detected during anaesthesia alone, and a further decrease was found during and following surgery. Enflurane anaesthesia did not afIect the plasma level ofluteinizing hormone (LH) in male subjects throughout surgery, but a significant decrease was detected in female patients on the first postoperative day. The plasma concentrations of testosterone decreased during anaesthesia alone and surgery, and a further decrease was noted on the first postoperative day.Ann. Surg. 169, 16.

The clinical evaluation of continuous administration of epidural morphine was undertaken using an infusion pump (Act‐A‐Pump 1000). Eleven patients who had undergone abdominal surgical procedures were treated with this therapeutic modality for postoperative pain control, and two cancer patients for chronic pain relief. The results were satisfactory and the advantages over repeated epidural injections are discussed.

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