Respuesta al estrés prequirúrgico en la cirugía sin ingreso: efectos sobre las poblaciones linfocitarias de un procedimiento de psicoprofilaxis quirúrgica / Response to presurgical stress in outpatient surgery: effects on lymphocyte populations of psychological treatment to prevent surgical anxiety

RESUMEN

OBJETIVO: Estudio prospectivo randomizado para averiguar el efecto de un programa de psicoprofilaxis quirúrgica sobre las poblaciones linfocitarias en sujetos que van a ser tratados con cirugía sin ingreso. MATERIAL Y MÉTODOS: Se estudiaron 74 pacientes que iban a ser tratados en la Unidad de Cirugía Mayor Ambulatoria del Hospital Universitario de Albacete. Los pacientes se asignaron de forma aleatoria a un grupo control (n=37) o a un grupo experimental (n= 37). Se consideraron dos momentos: basal (consulta preoperatoria) y antequirófano (antes de comenzar la cirugia). En el grupo experimental se realizó un procedimiento de psicoprofilaxis que consistía en una entrevista, un video y un boletín de información peroperatoria y entrenamiento en habilidades para controlar la ansiedad. Se midieron con pruebas psicométricas los niveles de ansiedad de estado (STAI) y salud general (Goldberg), así como las poblaciones linfocitarias (linfocitos totales, CD 3, CD 4, CD 4RA, CD 4RO, CD 8, CD 56, CD 19 y CD 57). Los valores observados se expresaron como media aritmética y su desviación estándar. RESULTADOS: En el grupo con psicoprofilaxis quirúrgica los niveles de CD 19 (linfocitos B) disminuyeron significativamente menos respecto al control en el antequirófano. No se encontraron diferencias en las demás variables estudiadas entre ambos grupos. CONCLUSIONES: La psicoprofilaxis en pacientes de cirugía ambulatoria previene la disminución de las células B antes de la cirugía

ABSTRACT

OBJECTIVE: To determine the effect of a psychological stress control intervention on lymphocyte populations in patients preparing for outpatient surgery. PATIENTS AND METHODS: A prospective randomized controlled trial enrolling 74 patients scheduled for major outpatient surgery at the Hospital Universitario de Albacete in Spain. The patients were randomized to a control (n=37) or experimental group (n=37). Measurements were recorded at baseline (preoperative visit) and before entering the operating room (just before surgery). The experimental group received treatment in a psychological stress control program consisting of an interview, watching a video, provision of informative literature about the operation and techniques for controlling anxiety. Anxiety was measured with the State-Trait Anxiety Inventory. The General Health Questionnaire (Goldberg) was applied, and lymphocyte populations were assessed (total white cell count; CD3, CD4, CD4RA, CD4RO, CD8, CD56, CD19, and CD56 lymphocyte counts). Values were expressed as means (SD). RESULTS: The group that received psychological stress prevention therapy had significantly lower CD19 (B lymphocyte) cell counts than did the control group just before surgery. No differences were found between the groups for any other variables. CONCLUSIONS: Psychological stress control therapy prevents a decrease in B cell populations before outpatient surgeryOBJECTIVE: To determine the effect of a psychological stress control intervention on lymphocyte populations in patients preparing for outpatient surgery. PATIENTS AND METHODS: A prospective randomized controlled trial enrolling 74 patients scheduled for major outpatient surgery at the Hospital Universitario de Albacete in Spain. The patients were randomized to a control (n=37) or experimental group (n=37). Measurements were recorded at baseline (preoperative visit) and before entering the operating room (just before surgery). The experimental group received treatment in a psychological stress control program consisting of an interview, watching a video, provision of informative literature about the operation and techniques for controlling anxiety. Anxiety was measured with the State-Trait Anxiety Inventory. The General Health Questionnaire (Goldberg) was applied, and lymphocyte populations were assessed (total white cell count; CD3, CD4, CD4RA, CD4RO, CD8, CD56, CD19, and CD56 lymphocyte counts). Values were expressed as means (SD). RESULTS: The group that received psychological stress prevention therapy had significantly lower CD19 (B lymphocyte) cell counts than did the control group just before surgery. No differences were found between the groups for any other variables. CONCLUSIONS: Psychological stress control therapy prevents a decrease in B cell populations before outpatient surgery