This study was undertaken to assess stress hormones response after awake videoassisted thoracoscopic surgery (VATS). Plasma levels of adrenal-corticotropic hormone (ACTH), cortisol, epinephrine, norepinephrine, and glucose were assessed at baseline, 3 h postoperatively (T1), and on postoperative mornings 2 (T2) and 3 (T3) in 21 patients undergoing awake VATS with epidural anesthesia for non-malignant conditions (ns11) or equivalent procedures performed with general anesthesia. Epinephrine level

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... peaked in both groups at T1, although significant change from baseline values occurred in the control group only wmedian-D: 6 ngyl (IQR: 4-6), Ps0.005x. Cortisol level was lower in the study group at T1 (15.5 mgydl vs. 23.0 mgydl, Ps0.001) and T2 (15.2 mgydl vs. 19.2 mgydl, Ps0.002). In the control group, peak cortisol level proved not to be related to changes in ACTH (Rs0.23, Ps0.46). At T2, glucose (137 mgydl vs. 98 mgydl, Ps0.01) and Creactive protein (Ps0.04) were higher in the control group. No other clinically relevant between-groups differences were found in aspecific acute-response factors. Overall, these preliminary findings suggest attenuated stress response after awake VATS in comparison with equivalent procedure performed under general anesthesia and one-lung ventilation. ᮊ