The endocrine-metabolic response to postoperative pain.

A short review is given on the role of pain as a release mechanism of the endocrine-metabolic response to surgery. It is concluded that: (1) the stress-response is mainly released through afferent neurogenic stimuli from the surgical area; (2) pain may be an additional release mechanism but quantitatively of minor importance compared to other afferent stimuli; (3) neurogenic blockade and analgesia with local anaesthetics prevents a major part of the stress-response to surgery; (4) systemically administered opiates may lessen the postoerative endocrine-metabolic response, but further studies are needed before any definite conclusion can be drawn; and (5) epidural administration of opiates has no major influence on the postoperative stress-responses.