1987 Volume 33 Issue 11 Pages 2103-2121
The effect of oral surgical stress upon the body was psychophsiologically investigated using changes in blood sugar levels as a parameter, because both the endocrine and autonomic nervous systems are involved in the blood sugar control mechanism.
Subjects were selected among patients who were scheduled for extraction of an impacted cranter in the lower jaw at our outpatient clinic and had no family or past history of diabetes nor subjective symptoms of this disease. Since our preliminary experiment revealed that blood sugar variation of ± 10% was regarded to be within the range of measurement errors, the selected patients were divided into 3 groups based on the presence (increase or decrease) or absence of differences in blood sugar levels of more than 10% before and after operation. Citanest® was used for infiltration local anesthesia in this study, because it contains no epinephrine which affects the blood sugar control mechanism.
Although there were no significant intergroup differences in sex, age, physique, obesity, meal, menstrual state, surgical site, amount of local anesthetic, operation duration, autonomic nervous function, personality or motional trend related to dental treatment, the patients showed various blood sugar changing patterns when they were put under surgical stress. As a result, we further determined inner environmental factors in detail and found different emotional patterns between groups with increased and decreased blood sugar levels. The group with increased blood sugar levels had anxiety about dental treatment at a significantly higher level. Since the autonomic nervous system and emotion have a close relationship and cooperate to control blood sugar levels, we then measured blood pressure and pulse rate, which are well-known physical parameters for the autonomic nervous system, during operation. As a result, changes in blood sugar levels before and after operation were related to the dynamics of these parameters, suggesting that emotional changes related to dental treatment praticipated in changes in autonomic nervous reactions and blood sugar levels while surgical stress was being applied to the body.
In conclusion, the use of changes in blood sugar levels as a parameter has great significance in the objective evaluation of patients' emotion under surgical stress.