Impact of Premedication on Preoperative Anxiety in Females with Gynecological Diseases

Abstract

Objective: to study preoperative psychoemotional, autonomic, and hematodynamic responses in patients to develop criteria for evaluating the efficiency of premedication.Subjects and methods. Sixty gynecological patients (mean age 38.5±1.1 years), who were being prepared for elective surgery, were examined. According to the results of an integrative anxiety test, the patients were divided into 3 groups in relation to the level of personality anxiety. The three-stage study was conducted to evaluate systemic circulation by the results of impedance rheography and by the state of the autonom-ic nervous system, as evidenced by variational pulsometry.Results. Preoperatively, the patients showed varying personality anxiety that further formed the psychoemotional features of their response to an impending operation. Situational anxiety components, such as a phobic element and emotional discomfort, should be also regarded as an informative criterion for the adequacy of premedication. Psychoemotional and autonomic changes were more pronounced in Group 3 patients who were prone to the development of decompensation of adaptive mechanisms due to their personality typological traits.Conclusion. Premedication involving only narcotic analgesics and antihistamines does not limit the overac-tivation of the sympathetic part of the autonomic nervous system on the eve of the forthcoming operation.

Keywords

• premedication
• anxietyp preoperative period