Skin surgery under local anesthesia leads to stress-induced alterations of psychological, physical, and immune functions
Identifieur interne : 000D63 ( PascalFrancis/Checkpoint ); précédent : 000D62; suivant : 000D64Skin surgery under local anesthesia leads to stress-induced alterations of psychological, physical, and immune functions
Auteurs : M. Augustin [Allemagne] ; I. Zschocke [Allemagne] ; N. Godau [Allemagne] ; A. Buske-Kirschbaum [Allemagne] ; M. Peschen [Allemagne] ; B. Sommer [Allemagne] ; G. Sattler [Allemagne]Source :
- Dermatologic surgery [ 1076-0512 ] ; 1999.
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- Pascal (Inist)
- Wicri :
English descriptors
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Abstract
BACKGROUND. Although excision of nevi under local anesthesia is a frequent and harmless operation, it apparently causes increased stress in many patients. However, thus far no studies have focused on the question of whether there are measurable effects on psychological, physiological, and immunological parameters. OBJECTIVE. To assess the perioperative stress reactions of patients undergoing skin surgery under local anesthesia for nevo-cellular nevi. METHODS. Fifty consecutive patients with pigmented nevi were examined at five points of measurement: 1 week and 30 minutes before the operation, during the operation, 30 minutes and 1 week after the operation. Somatic parameters included blood pressure, pulse, respiratory rate, and the level of pain. Lymphocyte subpopulations, white blood cell count, and cortisol in saliva were determined. Anxiety and general psychological distress were evaluated with validated questionnaires. RESULTS. There was a significant increase in anxiety at the time of surgery. In parallel, the physiological parameters as well as the CD56+ lymphocytes changed significantly. Preoperation anxiety and intraoperation pain were significantly higher in women (P <.001), but did not depend on age. CONCLUSION. There appears to be an interaction between physiological and emotional components in the operative stress reaction under local anesthesia. In patients with skin cancer, the perioperative stress may lead to transient impairment of immune function.
Affiliations:
- Allemagne
- Bade-Wurtemberg, District de Darmstadt, District de Fribourg-en-Brisgau, Hesse (Land), Rhénanie-Palatinat
- Darmstadt, Fribourg-en-Brisgau, Trèves (Allemagne)
- Université de Trèves
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Peschen</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Dermatology, University Clinics of Freiburg</s1><s2>Freiburg</s2><s3>DEU</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>Allemagne</country><placeName><region type="land" nuts="1">Bade-Wurtemberg</region><region type="district" nuts="2">District de Fribourg-en-Brisgau</region><settlement type="city">Fribourg-en-Brisgau</settlement></placeName></affiliation></author><author><name sortKey="Sommer, B" sort="Sommer, B" uniqKey="Sommer B" first="B." last="Sommer">B. Sommer</name><affiliation wicri:level="3"><inist:fA14 i1="03"><s1>Clinic of Dermatology</s1><s2>Darmstadt</s2><s3>DEU</s3><sZ>6 aut.</sZ><sZ>7 aut.</sZ></inist:fA14><country>Allemagne</country><placeName><region type="land" nuts="1">Hesse (Land)</region><region type="district" nuts="2">District de Darmstadt</region><settlement type="city">Darmstadt</settlement></placeName></affiliation><affiliation wicri:level="3"><inist:fA14 i1="04"><s1>Rosenparkklinik</s1><s2>Darmstadt</s2><s3>DEU</s3><sZ>6 aut.</sZ><sZ>7 aut.</sZ></inist:fA14><country>Allemagne</country><placeName><region type="land" nuts="1">Hesse (Land)</region><region type="district" nuts="2">District de Darmstadt</region><settlement type="city">Darmstadt</settlement></placeName></affiliation></author><author><name sortKey="Sattler, G" sort="Sattler, G" uniqKey="Sattler G" first="G." last="Sattler">G. Sattler</name><affiliation wicri:level="3"><inist:fA14 i1="03"><s1>Clinic of Dermatology</s1><s2>Darmstadt</s2><s3>DEU</s3><sZ>6 aut.</sZ><sZ>7 aut.</sZ></inist:fA14><country>Allemagne</country><placeName><region type="land" nuts="1">Hesse (Land)</region><region type="district" nuts="2">District de Darmstadt</region><settlement type="city">Darmstadt</settlement></placeName></affiliation><affiliation wicri:level="3"><inist:fA14 i1="04"><s1>Rosenparkklinik</s1><s2>Darmstadt</s2><s3>DEU</s3><sZ>6 aut.</sZ><sZ>7 aut.</sZ></inist:fA14><country>Allemagne</country><placeName><region type="land" nuts="1">Hesse (Land)</region><region type="district" nuts="2">District de Darmstadt</region><settlement type="city">Darmstadt</settlement></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">00-0032372</idno><date when="1999">1999</date><idno type="stanalyst">PASCAL 00-0032372 INIST</idno><idno type="RBID">Pascal:00-0032372</idno><idno type="wicri:Area/PascalFrancis/Corpus">000F64</idno><idno type="wicri:Area/PascalFrancis/Curation">000005</idno><idno type="wicri:Area/PascalFrancis/Checkpoint">000D63</idno><idno type="wicri:explorRef" wicri:stream="PascalFrancis" wicri:step="Checkpoint">000D63</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Skin surgery under local anesthesia leads to stress-induced alterations of psychological, physical, and immune functions</title><author><name sortKey="Augustin, M" sort="Augustin, M" uniqKey="Augustin M" first="M." last="Augustin">M. Augustin</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Dermatology, University Clinics of Freiburg</s1><s2>Freiburg</s2><s3>DEU</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>Allemagne</country><placeName><region type="land" nuts="1">Bade-Wurtemberg</region><region type="district" nuts="2">District de Fribourg-en-Brisgau</region><settlement type="city">Fribourg-en-Brisgau</settlement></placeName></affiliation></author><author><name sortKey="Zschocke, I" sort="Zschocke, I" uniqKey="Zschocke I" first="I." last="Zschocke">I. Zschocke</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Dermatology, University Clinics of Freiburg</s1><s2>Freiburg</s2><s3>DEU</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>Allemagne</country><placeName><region type="land" nuts="1">Bade-Wurtemberg</region><region type="district" nuts="2">District de Fribourg-en-Brisgau</region><settlement type="city">Fribourg-en-Brisgau</settlement></placeName></affiliation></author><author><name sortKey="Godau, N" sort="Godau, N" uniqKey="Godau N" first="N." last="Godau">N. Godau</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Dermatology, University Clinics of Freiburg</s1><s2>Freiburg</s2><s3>DEU</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>Allemagne</country><placeName><region type="land" nuts="1">Bade-Wurtemberg</region><region type="district" nuts="2">District de Fribourg-en-Brisgau</region><settlement type="city">Fribourg-en-Brisgau</settlement></placeName></affiliation></author><author><name sortKey="Buske Kirschbaum, A" sort="Buske Kirschbaum, A" uniqKey="Buske Kirschbaum A" first="A." last="Buske-Kirschbaum">A. Buske-Kirschbaum</name><affiliation wicri:level="4"><inist:fA14 i1="02"><s1>Department of Psychology, University of Trier</s1><s2>Trier</s2><s3>DEU</s3><sZ>4 aut.</sZ></inist:fA14><country>Allemagne</country><wicri:noRegion>Trier</wicri:noRegion><placeName><settlement type="city">Trèves (Allemagne)</settlement><region type="land" nuts="1">Rhénanie-Palatinat</region></placeName><orgName type="university">Université de Trèves</orgName></affiliation></author><author><name sortKey="Peschen, M" sort="Peschen, M" uniqKey="Peschen M" first="M." last="Peschen">M. Peschen</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Dermatology, University Clinics of Freiburg</s1><s2>Freiburg</s2><s3>DEU</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>Allemagne</country><placeName><region type="land" nuts="1">Bade-Wurtemberg</region><region type="district" nuts="2">District de Fribourg-en-Brisgau</region><settlement type="city">Fribourg-en-Brisgau</settlement></placeName></affiliation></author><author><name sortKey="Sommer, B" sort="Sommer, B" uniqKey="Sommer B" first="B." last="Sommer">B. Sommer</name><affiliation wicri:level="3"><inist:fA14 i1="03"><s1>Clinic of Dermatology</s1><s2>Darmstadt</s2><s3>DEU</s3><sZ>6 aut.</sZ><sZ>7 aut.</sZ></inist:fA14><country>Allemagne</country><placeName><region type="land" nuts="1">Hesse (Land)</region><region type="district" nuts="2">District de Darmstadt</region><settlement type="city">Darmstadt</settlement></placeName></affiliation><affiliation wicri:level="3"><inist:fA14 i1="04"><s1>Rosenparkklinik</s1><s2>Darmstadt</s2><s3>DEU</s3><sZ>6 aut.</sZ><sZ>7 aut.</sZ></inist:fA14><country>Allemagne</country><placeName><region type="land" nuts="1">Hesse (Land)</region><region type="district" nuts="2">District de Darmstadt</region><settlement type="city">Darmstadt</settlement></placeName></affiliation></author><author><name sortKey="Sattler, G" sort="Sattler, G" uniqKey="Sattler G" first="G." last="Sattler">G. Sattler</name><affiliation wicri:level="3"><inist:fA14 i1="03"><s1>Clinic of Dermatology</s1><s2>Darmstadt</s2><s3>DEU</s3><sZ>6 aut.</sZ><sZ>7 aut.</sZ></inist:fA14><country>Allemagne</country><placeName><region type="land" nuts="1">Hesse (Land)</region><region type="district" nuts="2">District de Darmstadt</region><settlement type="city">Darmstadt</settlement></placeName></affiliation><affiliation wicri:level="3"><inist:fA14 i1="04"><s1>Rosenparkklinik</s1><s2>Darmstadt</s2><s3>DEU</s3><sZ>6 aut.</sZ><sZ>7 aut.</sZ></inist:fA14><country>Allemagne</country><placeName><region type="land" nuts="1">Hesse (Land)</region><region type="district" nuts="2">District de Darmstadt</region><settlement type="city">Darmstadt</settlement></placeName></affiliation></author></analytic><series><title level="j" type="main">Dermatologic surgery</title><title level="j" type="abbreviated">Dermatol. surg.</title><idno type="ISSN">1076-0512</idno><imprint><date when="1999">1999</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Dermatologic surgery</title><title level="j" type="abbreviated">Dermatol. surg.</title><idno type="ISSN">1076-0512</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Anxiety</term><term>Emotional disorder</term><term>Human</term><term>Immunity</term><term>Local anesthesia</term><term>Psychosomatics</term><term>Skin</term><term>Statistical study</term><term>Stress</term><term>Surgery</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Peau</term><term>Chirurgie</term><term>Anesthésie locale</term><term>Stress</term><term>Immunité</term><term>Angoisse anxiété</term><term>Trouble émotion</term><term>Psychosomatique</term><term>Homme</term><term>Etude statistique</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Chirurgie</term><term>Homme</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">BACKGROUND. Although excision of nevi under local anesthesia is a frequent and harmless operation, it apparently causes increased stress in many patients. However, thus far no studies have focused on the question of whether there are measurable effects on psychological, physiological, and immunological parameters. OBJECTIVE. To assess the perioperative stress reactions of patients undergoing skin surgery under local anesthesia for nevo-cellular nevi. METHODS. Fifty consecutive patients with pigmented nevi were examined at five points of measurement: 1 week and 30 minutes before the operation, during the operation, 30 minutes and 1 week after the operation. Somatic parameters included blood pressure, pulse, respiratory rate, and the level of pain. Lymphocyte subpopulations, white blood cell count, and cortisol in saliva were determined. Anxiety and general psychological distress were evaluated with validated questionnaires. RESULTS. There was a significant increase in anxiety at the time of surgery. In parallel, the physiological parameters as well as the CD56<sup>+</sup> lymphocytes changed significantly. Preoperation anxiety and intraoperation pain were significantly higher in women (P <.001), but did not depend on age. CONCLUSION. There appears to be an interaction between physiological and emotional components in the operative stress reaction under local anesthesia. In patients with skin cancer, the perioperative stress may lead to transient impairment of immune function.</div></front></TEI><inist><standard h6="B"><pA><fA01 i1="01" i2="1"><s0>1076-0512</s0></fA01><fA03 i2="1"><s0>Dermatol. surg.</s0></fA03><fA05><s2>25</s2></fA05><fA06><s2>11</s2></fA06><fA08 i1="01" i2="1" l="ENG"><s1>Skin surgery under local anesthesia leads to stress-induced alterations of psychological, physical, and immune functions</s1></fA08><fA11 i1="01" i2="1"><s1>AUGUSTIN (M.)</s1></fA11><fA11 i1="02" i2="1"><s1>ZSCHOCKE (I.)</s1></fA11><fA11 i1="03" i2="1"><s1>GODAU (N.)</s1></fA11><fA11 i1="04" i2="1"><s1>BUSKE-KIRSCHBAUM (A.)</s1></fA11><fA11 i1="05" i2="1"><s1>PESCHEN (M.)</s1></fA11><fA11 i1="06" i2="1"><s1>SOMMER (B.)</s1></fA11><fA11 i1="07" i2="1"><s1>SATTLER (G.)</s1></fA11><fA14 i1="01"><s1>Department of Dermatology, University Clinics of Freiburg</s1><s2>Freiburg</s2><s3>DEU</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>5 aut.</sZ></fA14><fA14 i1="02"><s1>Department of Psychology, University of Trier</s1><s2>Trier</s2><s3>DEU</s3><sZ>4 aut.</sZ></fA14><fA14 i1="03"><s1>Clinic of Dermatology</s1><s2>Darmstadt</s2><s3>DEU</s3><sZ>6 aut.</sZ><sZ>7 aut.</sZ></fA14><fA14 i1="04"><s1>Rosenparkklinik</s1><s2>Darmstadt</s2><s3>DEU</s3><sZ>6 aut.</sZ><sZ>7 aut.</sZ></fA14><fA20><s1>868-871</s1></fA20><fA21><s1>1999</s1></fA21><fA23 i1="01"><s0>ENG</s0></fA23><fA43 i1="01"><s1>INIST</s1><s2>17417</s2><s5>354000080374500070</s5></fA43><fA44><s0>0000</s0><s1>© 2000 INIST-CNRS. All rights reserved.</s1></fA44><fA45><s0>9 ref.</s0></fA45><fA47 i1="01" i2="1"><s0>00-0032372</s0></fA47><fA60><s1>P</s1></fA60><fA61><s0>A</s0></fA61><fA64 i1="01" i2="1"><s0>Dermatologic surgery</s0></fA64><fA66 i1="01"><s0>USA</s0></fA66><fC01 i1="01" l="ENG"><s0>BACKGROUND. Although excision of nevi under local anesthesia is a frequent and harmless operation, it apparently causes increased stress in many patients. However, thus far no studies have focused on the question of whether there are measurable effects on psychological, physiological, and immunological parameters. OBJECTIVE. To assess the perioperative stress reactions of patients undergoing skin surgery under local anesthesia for nevo-cellular nevi. METHODS. Fifty consecutive patients with pigmented nevi were examined at five points of measurement: 1 week and 30 minutes before the operation, during the operation, 30 minutes and 1 week after the operation. Somatic parameters included blood pressure, pulse, respiratory rate, and the level of pain. Lymphocyte subpopulations, white blood cell count, and cortisol in saliva were determined. Anxiety and general psychological distress were evaluated with validated questionnaires. RESULTS. There was a significant increase in anxiety at the time of surgery. In parallel, the physiological parameters as well as the CD56<sup>+</sup> lymphocytes changed significantly. Preoperation anxiety and intraoperation pain were significantly higher in women (P <.001), but did not depend on age. CONCLUSION. There appears to be an interaction between physiological and emotional components in the operative stress reaction under local anesthesia. In patients with skin cancer, the perioperative stress may lead to transient impairment of immune function.</s0></fC01><fC02 i1="01" i2="X"><s0>002B25A</s0></fC02><fC03 i1="01" i2="X" l="FRE"><s0>Peau</s0><s5>01</s5></fC03><fC03 i1="01" i2="X" l="ENG"><s0>Skin</s0><s5>01</s5></fC03><fC03 i1="01" i2="X" l="SPA"><s0>Piel</s0><s5>01</s5></fC03><fC03 i1="02" i2="X" l="FRE"><s0>Chirurgie</s0><s5>02</s5></fC03><fC03 i1="02" i2="X" l="ENG"><s0>Surgery</s0><s5>02</s5></fC03><fC03 i1="02" i2="X" l="SPA"><s0>Cirugía</s0><s5>02</s5></fC03><fC03 i1="03" i2="X" l="FRE"><s0>Anesthésie locale</s0><s5>03</s5></fC03><fC03 i1="03" i2="X" l="ENG"><s0>Local anesthesia</s0><s5>03</s5></fC03><fC03 i1="03" i2="X" l="SPA"><s0>Anestesia local</s0><s5>03</s5></fC03><fC03 i1="04" i2="X" l="FRE"><s0>Stress</s0><s5>04</s5></fC03><fC03 i1="04" i2="X" l="ENG"><s0>Stress</s0><s5>04</s5></fC03><fC03 i1="04" i2="X" l="SPA"><s0>Stress</s0><s5>04</s5></fC03><fC03 i1="05" i2="X" l="FRE"><s0>Immunité</s0><s5>05</s5></fC03><fC03 i1="05" i2="X" l="ENG"><s0>Immunity</s0><s5>05</s5></fC03><fC03 i1="05" i2="X" l="SPA"><s0>Inmunidad</s0><s5>05</s5></fC03><fC03 i1="06" i2="X" l="FRE"><s0>Angoisse anxiété</s0><s5>06</s5></fC03><fC03 i1="06" i2="X" l="ENG"><s0>Anxiety</s0><s5>06</s5></fC03><fC03 i1="06" i2="X" l="SPA"><s0>Angustia ansiedad</s0><s5>06</s5></fC03><fC03 i1="07" i2="X" l="FRE"><s0>Trouble émotion</s0><s5>07</s5></fC03><fC03 i1="07" i2="X" l="ENG"><s0>Emotional disorder</s0><s5>07</s5></fC03><fC03 i1="07" i2="X" l="SPA"><s0>Trastorno emocíon</s0><s5>07</s5></fC03><fC03 i1="08" i2="X" l="FRE"><s0>Psychosomatique</s0><s5>08</s5></fC03><fC03 i1="08" i2="X" l="ENG"><s0>Psychosomatics</s0><s5>08</s5></fC03><fC03 i1="08" i2="X" l="SPA"><s0>Psicosomática</s0><s5>08</s5></fC03><fC03 i1="09" i2="X" l="FRE"><s0>Homme</s0><s5>09</s5></fC03><fC03 i1="09" i2="X" l="ENG"><s0>Human</s0><s5>09</s5></fC03><fC03 i1="09" i2="X" l="SPA"><s0>Hombre</s0><s5>09</s5></fC03><fC03 i1="10" i2="X" l="FRE"><s0>Etude statistique</s0><s5>20</s5></fC03><fC03 i1="10" i2="X" l="ENG"><s0>Statistical study</s0><s5>20</s5></fC03><fC03 i1="10" i2="X" l="SPA"><s0>Estudio estadístico</s0><s5>20</s5></fC03><fC07 i1="01" i2="X" l="FRE"><s0>Peau pathologie</s0><s5>37</s5></fC07><fC07 i1="01" i2="X" l="ENG"><s0>Skin disease</s0><s5>37</s5></fC07><fC07 i1="01" i2="X" l="SPA"><s0>Piel patología</s0><s5>37</s5></fC07><fN21><s1>024</s1></fN21></pA></standard></inist><affiliations><list><country><li>Allemagne</li></country><region><li>Bade-Wurtemberg</li><li>District de Darmstadt</li><li>District de Fribourg-en-Brisgau</li><li>Hesse (Land)</li><li>Rhénanie-Palatinat</li></region><settlement><li>Darmstadt</li><li>Fribourg-en-Brisgau</li><li>Trèves (Allemagne)</li></settlement><orgName><li>Université de Trèves</li></orgName></list><tree><country name="Allemagne"><region name="Bade-Wurtemberg"><name sortKey="Augustin, M" sort="Augustin, M" uniqKey="Augustin M" first="M." last="Augustin">M. Augustin</name></region><name sortKey="Buske Kirschbaum, A" sort="Buske Kirschbaum, A" uniqKey="Buske Kirschbaum A" first="A." last="Buske-Kirschbaum">A. Buske-Kirschbaum</name><name sortKey="Godau, N" sort="Godau, N" uniqKey="Godau N" first="N." last="Godau">N. Godau</name><name sortKey="Peschen, M" sort="Peschen, M" uniqKey="Peschen M" first="M." last="Peschen">M. Peschen</name><name sortKey="Sattler, G" sort="Sattler, G" uniqKey="Sattler G" first="G." last="Sattler">G. Sattler</name><name sortKey="Sattler, G" sort="Sattler, G" uniqKey="Sattler G" first="G." last="Sattler">G. Sattler</name><name sortKey="Sommer, B" sort="Sommer, B" uniqKey="Sommer B" first="B." last="Sommer">B. Sommer</name><name sortKey="Sommer, B" sort="Sommer, B" uniqKey="Sommer B" first="B." last="Sommer">B. Sommer</name><name sortKey="Zschocke, I" sort="Zschocke, I" uniqKey="Zschocke I" first="I." last="Zschocke">I. 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