In most cases surgical interventions in the maxillofacial area are accompanied by the appearance of stress reactions. GABA–ergic and opioidergic systems play a key role in the development of psycho–emotional stress, in the mechanisms of pain control. However, changes in these blood biochemical parameters in surgical stress in dental patients, depending on their individual and typological features, remain to be unexplored at present. The purpose of the study was to research the expression of neurohumoral markers of antistress protection (gamma–aminobutyric acid, β–endorphins, leu–enkephalins) in the blood of dental patients with different individual and typological features before surgery. Material and methods. Clinical observations and laboratory studies were performed before surgery in 98 surgical dental patients of young and middle age. We identified the types of temperament and the level of neuroticism in these patients according to the method of G. Eysenck. We also determined psycho–emotional state using the hospital scale of anxiety and depression (HADS). Pain sensitivity in patients was studied by electrostimulation of the mental nerve. GABA levels, concentrations of β–endorphins and leu–enkephalins were studied in the blood. The study results were statistically processed. Results and discussion. A certain pattern and a correlation between the dynamics of blood content of biochemical markers of antistress protection in patients with psycho–emotional stress, their indicators of neuroticism and types of pain perception were revealed. In particular, low levels of neuroticism were found in individuals with high thresholds of pain sensitivity and pain tolerance. Phlegmatic patients had statistically significant increase in blood of GABA (р < 0,05) and leu–enkephalins (р < 0,01) before surgery, and in sanguine patients statistically significant increase in blood of β–endorphins (р < 0,05) and leu–enkephalins (р < 0,05). Patients who had low thresholds for pain sensitivity (type 1 pain perception) were emotionally labile with high levels of neuroticism and reactive anxiety. In the conditions of surgical stress development, they revealed unsatisfactory dynamics of all investigated markers of antistressor protection in blood (р > 0,05). Conclusion. The severity of clinical manifestations of psycho–emotional stress (reactive anxiety, depressive disorders) in dental patients before surgery depends on the levels of neuroticism. Under conditions of psycho–emotional stress, the dynamics of the content of neurohumoral markers of antistress protection (gamma–aminobutyric acid, β–endorphins, leu–enkephalins) in the blood differs in patients with different individual and typological features and closely correlates with their types of pain perception.

Keywords: gamma–aminobutyric acid, β–endorphins, leu–enkephalins, pain sensitivity, temperament, neuroticism

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