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Pseudocholinesterase activity increases and heart rate variability decreases with preoperative anxiety

Published online by Cambridge University Press:  29 April 2005

T. Ledowski
Affiliation:
University Hospital Schleswig-Holstein, Department of Anaesthesiology and Intensive Care Medicine, Campus Kiel, Kiel, Germany
B. Bein
Affiliation:
University Hospital Schleswig-Holstein, Department of Anaesthesiology and Intensive Care Medicine, Campus Kiel, Kiel, Germany
R. Hanss
Affiliation:
University Hospital Schleswig-Holstein, Department of Anaesthesiology and Intensive Care Medicine, Campus Kiel, Kiel, Germany
P. H. Tonner
Affiliation:
University Hospital Schleswig-Holstein, Department of Anaesthesiology and Intensive Care Medicine, Campus Kiel, Kiel, Germany
N. Roller
Affiliation:
University Hospital Schleswig-Holstein, Department of Anaesthesiology and Intensive Care Medicine, Campus Kiel, Kiel, Germany
J. Scholz
Affiliation:
University Hospital Schleswig-Holstein, Department of Anaesthesiology and Intensive Care Medicine, Campus Kiel, Kiel, Germany
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Abstract

Summary

Background and objective: The objective of this study was to determine the influence of preoperative anxiety on the activity of plasma cholinesterase and heart rate (HR) variability.

Methods: A total of 50 subjects were studied, 25 male patients one day preoperatively and 25 male volunteers without surgical intervention as a control group. Blood samples were taken to determine plasma cholinesterase activity. HR variability was recorded for a period of 256 beat-to-beat intervals and analysed by frequency domain analysis into very low frequency (VLF: 0.02–0.04 Hz), low frequency (LF: 0.04–0.15 Hz) and high frequency (HF: 0.15–0.4 Hz). LF/HF ratio and total power over the 0.02–0.4 Hz range were calculated. Anxiety levels were assessed using the hospital anxiety and depression scale, the self-rating anxiety scale and a visual analogue scale.

Results: The patient group had significantly higher anxiety scores. Plasma cholinesterase activity was significantly higher in patients vs. controls (6646 vs. 5324 units L−1). Total power, LF and HF were significantly lower in the patients (1489 vs. 2581 ms2; 656 vs. 1186 ms2; 491 vs. 964 ms2, respectively).

Conclusions: Preoperative anxiety increases plasma cholinesterase activity and decreases HR variability.

Type
Original Article
Copyright
2005 European Society of Anaesthesiology

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References

Maranets I, Kain ZN. Preoperative anxiety and intraoperative anesthetic requirements. Anesth Analg 1999; 89: 13461351.Google Scholar
Scheinin M, Scheinin H, Ekblad U, Kanto J. Biological correlates of mental stress related to anticipated caesarean section. Acta Anaesthesiol Scand 1990; 34: 640644.Google Scholar
Modai I, Mendelsohn E, Schwartz B. Serum cholinesterase in state anxiety. J Clin Psychiatry 1987; 48: 204206.Google Scholar
Mathew RJ, Hsu LL, Semchuk KM, Claghorn JL. Acetylcholinesterase and pseudocholinesterase activities in anxiety. Am J Psychiatry 1980; 137: 11181120.Google Scholar
Markakis DA, Hart PS, Lau M, Brown R, Fisher DM. Does age or pseudocholinesterase activity predict mivacurium infusion rate in children? Anesth Analg 1996; 82: 3943.Google Scholar
Bevan JC, Reimer EJ, Smith MF, et al. Decreased mivacurium requirements and delayed neuromuscular recovery during sevoflurane anesthesia in children and adults. Anesth Analg 1998; 87: 772778.Google Scholar
Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand 1983; 67: 361370.Google Scholar
Schulz-Stubner S, de Bruin J, Neuser J, Rossaint R. Validation of an observer-based rating set compared to a standardized written psychological test for the diagnosis of depression and anxiety in a university preadmission test center. Anaesthesiol Intensivmed Notfallmed Schmerzther 2001; 36: 331335.Google Scholar
Papanikolaou MN, Voulgari A, Lykouras L, Arvanitis J, Christodoulou GN, Danou-Roussaki A. Psychological factors influencing the surgical patients consent to regional anaesthesia. Acta Anaesthesiol Scand 1994; 38: 607611.Google Scholar
Millar K, Jelicic M, Bonke B, Asbury AJ. Assessment of preoperative anxiety: comparison of measures in patients awaiting surgery for breast cancer. Br J Anaesth 1995; 74: 180183.Google Scholar
Taittonen M, Kirvela O, Aantaa R, Kanto J. Cardiovascular and metabolic responses to clonidine and midazolam premedication. Eur J Anaesthesiol 1997; 14: 190196.Google Scholar
Sleigh JW, Henderson JD. Heart rate variability and preoperative anxiety. Acta Anaesthesiol Scand 1995; 39: 10591061.Google Scholar
Watkins LL, Grossmann P, Krishnan R, Blumenthal JA. Anxiety reduces baroreflex cardiac control in older adults with major depression. Psychosom Med 1999; 61: 334340.Google Scholar
Cameron BM, Allen RC, Merril C. A prospective study of serum pseudocholinesterase in patients with chronic spinal pain: a preliminary study. Spine 2000; 25: 19171924.Google Scholar
Umetani K, Singer DH, McCraty R, Atkinson M. Twenty-four hour time domain heart rate variability and heart rate relations to age and gender over nine decades. J Am Coll Cardiol 1998; 31: 593601.Google Scholar
Watkins LL, Grossmann P, Krishnan R, Sherwood A. Anxiety and vagal control of heart rate. Psychosom Med 1998; 60: 498502.Google Scholar
Paris A, Tonner PH, Bein B, v. Knobelsdorff G, Scholz J. Heart rate variability in anesthesia. Anaesthesiol Reanim 2001; 26: 6069.Google Scholar