Effects of Mental and Physical Stress on Emotional Sweating, and Variabilities of Heart Rate and Blood Pressure during Noxious Stimulation in Oral Cavity

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  • HIRATSUKA Masao
    Department of Dentistry for Geriatric and Handicapped, Fukuoka Dental College

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  • 口腔内侵害刺激時の精神的・肉体的ストレスが精神性発汗ならびに心拍・血圧変動に及ぼす影響

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Abstract

To elucidate the stress reactions for anxiety and pain of the patient during dental treatment, the effect of mental and physical stress on emotional sweating, heart rate and blood pressure caused by painful stimulation in the oral cavity were compared with those caused by its mimic stimulation. The stimulation used were injection of local anesthesia (LA) to the buccal mucosa and application of electric current (EC) to the incisor. Degree of anxiety and pain for the stimulation were evaluated with a visual analogue scale. The subjects in this study were eighteen healthy adult volunteers aged 20 to 29. The emotional sweating were measured by a sweating ratemeter. The blood pressure was continuously measured using a noninvasive monitoring system, and the R-R intervals of ECG were recorded on memory recorder. Discrete data of the R-R interval and systolic blood pressure, every 180 sec, were analyzed by MemCalc system with use of the maximum entoropy method. The power spectra were quantified by the area in two components, that is, a low frequency component from 0.04 to 0.15 Hz (LF, LFsys) and a high frequency component from 0.15 to 0.4 Hz (HF). Results were as follows ; 1. Effects of stimulation with LA and EC. Whether the painful stimulation of LA and EC was real or mimic, emotional sweating was significantly increased during and 1 min after the stimulation. On the spectrum analysis, changes in heart rate variability, HF of R-R interval caused by the mimic stimulation of LA showed significantly higher than that of baseline in the period of 3min after the end of stimulation. A low frequency component of systolic blood pressure (LFsys) caused by the mimic stimulation of LA and EC was significantly lower than that of baseline in the period between 3min before and 3min after the stimulation. There were no significant difference in emotional sweating, and variabilities of heart rate and systolic blood pressure between the real and mimic stimulations of LA and EC. 2. Analysis according to anxious degree The emotional sweating during the mimic stimulation of LA and EC showed significantly higher in the high anxiety group than in low anxiety group. HF was significantly smaller in the high anxiety group than in the low anxiety group in the period of 3 to 6min after the end of mimic stimulation with EC. 3. Analysis according to painful degree The changes in emotional sweating, and variabilities of heart rate and systolic blood pressure caused by stimulation of both LA and EC had no relation to the stimulus intensity. The present results showed that the mimic stimulation in the oral cavity with LA and EC increased emotional sweating as well as the real stimulation. This suggests that the anxiety of dental treatment influences on the patient more than pain, as far as the intensities of stimuli used by the author. Furthermore, spectrum analysis of heart rate variability suggests that fluctuations of HF after stimulation are affected by the degree of anxiety.

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