Assessment of psychological tension after premedication by measurement of salivary chromogranin A.

Study Objective: Although some sedatives or analgesics are commonly used for premedication to reduce psychological tension before surgery or anesthesia, it remains unclear which drug is more suitable. Because salivary chromogranin A is a reliable index for estimating psychological tension, this variable was measured during the perioperative period after premedication.

Design: Prospective, randomized control study.

Setting: Operating room at a general hospital.

Patients: Thirty adult female patients undergoing abdominal total hysterectomy were randomly assigned to 3 groups of 10 patients each.

Interventions: On the day before surgery, saliva was collected, and 0.1 mg/kg of midazolam (midazolam group) or 0.02 mg/kg of butorphanol (butorphanol group) was injected intramuscularly 30 minutes before entering the operating rooms. For the control group, no premedication was performed. Saliva was collected as the patient entered the operating room and then the patient received an epidural catheter insertion followed 5 minutes later by collection of the saliva.

Measurements And Main Results: Salivary chromogranin A was assayed using a radioimmunoassay, and revised values calculated from the protein concentration of the saliva were regarded as data. Revised salivary chromogranin A levels increased in the control and butorphanol groups at the time of entrance to the operating room and after epidural treatment compared with the value of the day before surgery, whereas it did not change statistically in the midazolam group.

Conclusions: From the standpoint of reducing psychological tension before surgery or anesthesia, midazolam as a sedative may be more suitable for premedication.