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Early postoperative syndrome in oncological patients is accompanied by a pronounced increase of plasma 13-endorphin irrespectively on the type of surgery. By contrast, chronic pain syndrome in incurable patients is characterized by a decrease of [3-endorphin in the plasma and cerebrospinal fluid. In patients with early postoperative syndrome, efficient epidural morphine analgesia and central epidural electrical neurostimulation reduce plasma 13-endorphin. By contrast, in incurable patients with chronic pain syndrome, the content ofl3-endorphin in the plasma and cerebrospinal fluid increases under the effect of efficient spinal morphine analgesia (epidural or subarachnoidal). Changes in the plasma content of 13-endorphin directly depend on the type of pain syndrome, its intensity, and efficiency of analgesia, and may serve as a criterion of analgesia.

Introduction:Because of the reports of improved myocardial performance, cardiopulmonary bypass (CPB) with systemic normothermia is being increasingly used in many institutions recently [1]. During hypothermic CPB anaesthetic requirements are reduced by hypothermia itself [2]. However, during normothermic CPB, anaesthetic requirements should not be changed, thus the anaesthetic requirements may be higher than that during hypothermic CPB. To investigate the difference in anaesthetic requirements, we performed a prospective, randomized study of bispectral index (BIS) changes in patients with either normothermic or hypothermic CPB. Method: Patients scheduled for elective coronary artery bypass graft surgery were randomly allocated to a normothermic group (GN; n ϭ 20) or hypothermic group (GH; n ϭ 20). Anaesthesia was maintained with isoflurane (0.5-1.2% volume) and supplemented with fentanyl (0.1-0.3 g kg Ϫ 1 min Ϫ1 ). The fentanyl infusion rate and the concentration of isoflurane were not changed from the period 15 min before starting CPB and throughout CPB. ln GH, hypothermia was induced with a target rectal temperature of 30°C. The anaesthesiologist in charge was blinded to BIS. Change in BIS, mean arterial pressure (MAP), and nasopharyngeal temperature were recorded at the following times: (1) pre-CPB; after induction when vital signs were stable, (2) CPB 10; 10 min after start of CPB, (3) CPB 60; 60 min after start of CPB, (4) CPB off; 30 min after weaning from CPB. Results: There was no difference in patients' demographic data, duration of CPB or MAP nor in isoflurane concentration or fentanyl requirement between the two groups. In the follow-up, no patients could recall anything from the operation. 096Depression and anxiety after cardiac surgery: second year follow up Introduction: Depression and anxiety play important roles in the immediate postoperative period of patients after cardiac surgery [1]. The aim of our study was to investigate long-term influence of these mood disorders. Method: Following Ethic Committee approval 193 patients were prospectively studied between May 2000 and July 2001. Depression and anxiety scores were measured by pure mail survey before surgery, 6 weeks, 6 months, one and two years after discharge from the hospital. Beck depression Inventory Test, based on cognitive behaviour theory and Spielberger state-trait anxiety inventory test (STAIs and STAIt) were used. The following factors were considered and compared with the follow-up scores: age, gender, type of surgery, marital state, education, preoperative disorders. Additional data collected were: neuropsychiatric disorders, hospitalization, cardiovascular and non-cardiovascular events and death after discharge. Statistical analysis was performed with simple and multiple logistic regressions. Results: 98 patients responded. During the last year 3 patients died, the overall 2nd year (July 2003) mortality of the study group was 8.2%. The mean BDI score was 8.9 (range: 0-30), 29 patients had mild depressive symptoms (BDI: 10-20), and...