[Preoperative stress. Study of the mental behavior and parameters of physiological stress in non-premedicated patients during the preoperative period].

In 29 male patients undergoing arterial bypass operations of the lower limb, psychological and physiological stress parameters were investigated. They received no premedication. We found an increase of heart rate (HR), arterial blood pressure (BP), plasma cortisol (Cort), free fatty acids (FFA), ventricular ectopic beats (VEB) and supra-ventricular ectopic beats (SVEB) (registered with a 24 hour ECG). The physiological dynamics were different, depending on the results of the psychological tests (MMQ and ESB): Repressor had higher HR and increased significantly more than sensitizer. Depressive patients had higher Cort levels the day before surgery compared to hopeful ones, but remained at these levels, whereas hopeful patients had a significant increase of Cort immediately before operation. They had also higher BP's and HR's. Patients with sthenic affections increased significantly more with FFA levels than asthenic ones. Anxious and asthenic patients had significantly more VEB than non anxious and sthenic ones. These results can well be interpreted in terms of dynamic psychophysiological stress reactions. We propose the use of psychological and physiological stress parameters for investigations of methods for the reduction of preoperative stress.