Objectives. The psychophysiological model of adjustment to surgery predicts associations between (1) heightened pre-operative state-anxiety and intra-operative neuroendocrine responses, (2) neuroendocrine responses and complications; and (3) heightened pre-operative state-anxiety and post-operative recovery. The present study examined these associations. Methods. Participants were 39 patients (mean age 71.9 ± 6.1 years) undergoing elective carotid endarterectomy surgery under local anaesthesia. In the week prior to surgery, patients completed baseline measures of physical and mental functioning using the MOS 36-item Short-Form Health Survey (SF-36). In addition to this, they undertook a 24-hour urine save to measure cortisol and catecholamines. Measures of state-anxiety were completed on the evening prior to surgery. A second 24-hour urine save was started at the time of anaesthetic induction. Follow-up measures of physical and mental functioning were completed 1 month following surgery. All complications were recorded during hospitalization. Results. There was a significant negative association between pre-operative state-anxiety and intra-operative cortisol (r =-.52, p ≤ .001). Using hierarchical regression analysis, pre-operative state-anxiety accounted for 10% of the variance in intra-operative cortisol responses after controlling for medical and demographic factors. There were no significant associations between neuroendocrine responses and complications. Pre-operative state-anxiety was a significant determinant of poorer mental functioning following surgery, explaining 10% of the variance in scores after adjusting for baseline mental functioning. Conclusions. Results from this study show increasing pre-operative anxiety to be associated with lower intra-operative cortisol responses and poorer mental functioning 1 month following surgery. © 2005 The British Psychological Society.

Item Type:	Refereed Article
Research Division:	Psychology and Cognitive Sciences
Research Group:	Psychology
Research Field:	Biological Psychology (Neuropsychology, Psychopharmacology, Physiological Psychology)
Objective Division:	Health
Objective Group:	Clinical Health (Organs, Diseases and Abnormal Conditions)
Objective Field:	Nervous System and Disorders
Author:	Pearson, S (Dr Sue Pearson)
ID Code:	48885
Year Published:	2005
Web of Science® Times Cited:	16
Deposited By:	Menzies Institute for Medical Research
Deposited On:	2007-08-01
Last Modified:	2012-03-05
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