The influence of medical information on the perioperative course of stressin cardiac surgery patients

Cardiac surgery correlates with increased perioperative stress and anxiety. We tested whether preoperative extensive oral information in combination w ith more personal attention by the surgeon is associated with any effect on patients' perioperative stress, anxiety, and well-being. Sixty patients aw aiting open heart surgery were divided into two groups. Group I consisted o f 30 patients who received routine medical information through an informati ve pamphlet. In Group II (n = 30 patients), additional, extensive oral medi cal information and more personal attention by the surgeon was provided bef ore surgery. Salivary cortisol, plasma cortisol, state anxiety, and patient s' well-being were measured perioperatively. Extensive preoperative oral in formation in combination with more personal attention by the physician did not have any significant influence on the perioperative psychoendocrinologi c course of stress. During transport to the operating room, salivary cortis ol increased significantly (P < 0.001) in both groups (ranges are 95% confi dence intervals) (Group I, 23.2 nmol/L [17.1-31.5]; Group II, 14.6 nmol/L [ 9.9-21.3]) versus the first day in the hospital (Group I, 8.4 nmol/L [6.2-1 1.4]; Group II, 6.7 nmol/L [5.3-8.6]). After the induction of anesthesia, p lasma cortisol decreased significantly (P < 0.001) in both groups (Group 1, 170.1 nmol/L [143.6-201.4]; Group II, 172.0 nmol/L [142.2-208.1]) versus p reoperative levels. After surgery, well-being decreased (P = 0.003) in all patients, and patients' state anxiety was reduced (P = 0.001) after surgery . Our data demonstrate a lack of effect of extensive oral medical informati on that was presented as part of clinical routine on the perioperative psyc hoendocrinologic course of stress. High levels of stress during transport t o the operating room were detected.