Anxiety and endocrine changes in surgical patients

There is a need for research to identify the relationship between psychological and endocrine responses to surgical operations, and to discover whether these responses differ with variations in practice between different settings. This preliminary study investigated 17 patients undergoing middle ear operations in two hospitals. Measurements included state anxiety, Recovery Inventory, cortisol excretion and noradrenaline excretion. All were made pre-operatively and on three post-operative days. Recovery Inventory correlated (between subjects) with state anxiety, but this relationship was confined to the post-operative days. No correlation between a psychological measure and an endocrine one reached significance. There was a non-significant tendency for pre-operative anxiety to be lower in one ward than another; cortisol levels were significantly higher in the same ward overall. These results do not support a view that anxiety is related to processes mediating physical recovery. Explanations for the difference in cortisol levels are considered. It is suggested that the influence of pre-operative psychological preparation on endocrine responses deserves systematic investigation.