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Prospective Pilot Investigation: Presurgical Depressive Symptom Severity and Anesthesia Response in Women Undergoing Surgery for Gynecologic Mass Removal

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Abstract

Background

Anesthesia depth has been associated with mortality. The association between anesthesia depth and presurgery physical and health status, however, is currently debated. Depression is one comorbid condition that warrants investigation given its association to reduced frontal lobe activity and high prevalence in known surgery samples (e.g., gynecologic mass removal).

Purpose

This pilot study examined the hypothesis that severity of acute depressive symptoms would associate with greater sensitivity to anesthesia as measured by a frontal lobe electroencephalogram (EEG)-based monitor during the anesthesia induction phase among women undergoing gynecologic mass removal.

Method

This was a prospective and surgery anesthesia-controlled pilot investigation with 31 women undergoing surgery for removal of pelvic/gynecologic masses. Participants completed the Millon Behavioral Medicine Diagnostic (MBMD) inventory to assess depressive-related symptomatology. A Bispectral Index Score (BIS™) monitor (Aspect Medical Systems Inc., MA) was placed on the left frontal region to measure change in response from a set pre-anesthesia baseline point throughout the induction phase (6.5 min of the anesthetic). BIS™ change was calculated using a modified “area under the curve with respect to ground” formula.

Results

Greater sensitivity to anesthesia during induction was significantly associated with higher MBMD future pessimism scores and marginally associated with higher MBMD depression scores. Depressive personality, anxiety severity, tumor type, age, medication use, and comorbidity scores were not found to be predictors of BIS score change.

Conclusion

These pilot findings suggest that preoperative psychological health and anesthesia response are not independent. Acute presurgery depression and anesthesia response warrant closer empirical examination.

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Acknowledgments

This project is dedicated to J. S. Gravenstein, M.D., Professor, Department of Anesthesiology, for his insightful comments and support toward this project. This work was completed in partial fulfillment of Ms. Andre’s Master of Science degree in the Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA. This work was supported in part by the NIH/NCATS Clinical and Translational Science Award to the University of Florida UL1 TR000064, the I. Heermann Anesthesia Foundation (MH, CP), NINDS K23NS060660 (CP), and R01-NR014181 (CP).

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Authors and Affiliations

  1. Department of Clinical and Health Psychology, University of Florida, P.O. Box 100165, Gainesville, FL, 32610-0165, USA

    Catherine C. Price, Deidre B. Pereira, Rachel Andre & Peter Nguyen

  2. Department of Anesthesiology, University of Florida, Gainesville, FL, USA

    Catherine C. Price, Mary Herman & Christoph Seubert

  3. College of Nursing, University of Florida, Gainesville, FL, USA

    Cynthia Wilson Garvan

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  1. Catherine C. Price
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Correspondence to Catherine C. Price.

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Price, C.C., Pereira, D.B., Andre, R. et al. Prospective Pilot Investigation: Presurgical Depressive Symptom Severity and Anesthesia Response in Women Undergoing Surgery for Gynecologic Mass Removal. Int.J. Behav. Med. 22, 521–529 (2015). https://doi.org/10.1007/s12529-014-9451-1

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