Introduction. Surgical interventions are accompanied by acute stress reactions, which are staged and cause functional changes, primarily in the nervous, cardiovascular, endocrine systems. The study of biochemical stress markers in blood provides valuable information about the state of patient’s state under conditions of surgical aggression. Aim: To investigate the biochemical manifestations of stress reactions in blood of dental patients with different individual psychological characteristics during planned surgical treatments in the maxillofacial department. Materials and methods. The level of neuroticism was determined in 64 patients at the Department of Maxillofacial Surgery of Lviv Regional Clinical Hospital, by testing according to the well-known Eysenck method. The level of reactive anxiety and depressive manifestations in patients was determined using the Hospital Anxiety and Depression Scale (HADS). Before the surgery (before premedication) and five hours after its completion, the content of cortisol, prolactin and interleukin-1β was examined in the peripheral venous blood of the patients. Results and discussion. Before premedication, the highest levels of cortisol and prolactin in the peripheral venous blood of patients with high neuroticism and anxiety, which could not be eliminated by antistress therapy in the stage of preoperative preparation, were found. In the pre-surgery period, all patients, regardless of their level of neuroticism, had a low level of interleukin 1-β in blood – 8.5 ± 3.6 pg/ml (p = 0.2547). Despite the satisfactory anaesthetic support of the surgical interventions, all patients had increased cortisol in blood, due to the development of an acute inflammatory reaction induced by surgical trauma. In the postsurgical period, there was also a statistically significant increase of interleukin 1-β in the blood in all patients – up to 19.7 ± 4.6 pg/ml. There is a close relationship (χ2 = 17.89, p < 0.01) between the anxious state of the patients and the increase in the concentration of prolactin in their blood. Conclusions. Under conditions of surgical stress in dental patients before analgesia, similar changes occur at biochemical level – the blood cortisol and prolactin levels increase, the intensity of this process being more pronounced in emotionally labile patients (with a high level of neuroticism). There is a close relationship between the psycho-emotional state of patients (their level of anxiety) and the dynamics of prolactin concentration in blood, while the concentration of cortisol in blood is affected by phlogogenic factors caused by surgical trauma.
Keywords:- anxiety
- cortisol
- dental patients.
- neuroticism
- prolactin premedication
- surgical stress