Introduction. Surgical interventions are accompanied by acute stress reactions, which are staged and cause functional changes, primarily in the nervous, cardiovascular, endocrine systems. The study of biochemical stress markers in blood provides valuable information about the state of patient’s state under conditions of surgical aggression. Aim: To investigate the biochemical manifestations of stress reactions in blood of dental patients with different
individual psychological characteristics during planned surgical treatments in the maxillofacial department. Materials and methods. The level of neuroticism was determined in 64 patients at the Department of Maxillofacial Surgery of Lviv Regional Clinical Hospital, by testing according to the well-known Eysenck method. The level of reactive anxiety and depressive manifestations in patients was determined using the Hospital Anxiety and Depression Scale (HADS). Before the surgery (before premedication) and fve hours after its completion, the content of cortisol, prolactin and interleukin-1β was examined in the peripheral venous blood of the patients. Results and discussion. Before premedication, the highest levels of cortisol and prolactin in the peripheral venous blood of patients with high neuroticism and anxiety, which could not be eliminated by antistress therapy in the stage of preoperative preparation, were found. In the pre-surgery period, all patients, regardless of their level of neuroticism, had a low level of interleukin 1-β in blood - 8.5 ± 3.6 pg/ml (p = 0.2547). Despite the satisfactory anaesthetic support of the surgical interventions, all patients had increased cortisol in blood, due to the development of an acute inflammatory reaction induced by surgical trauma. In the postsurgical period, there was also a statistically signifcant increase of interleukin 1-β in the blood in all patients - up to 19.7 ± 4.6 pg/ml. There is a close relationship (χ2 = 17.89, p < 0.01) between the anxious state of the patients and the increase in the concentration of prolactin in their blood. Conclusions. Under conditions of surgical stress in dental patients before analgesia, similar changes occur at biochemical level - the blood cortisol and prolactin levels increase, the intensity of this process being more pronounced in emotionally labile patients (with a high level of  neuroticism). There is a close relationship between the psycho-emotional state of patients (their level of anxiety)
and the dynamics of prolactin concentration in blood, while the concentration of cortisol in blood is affected by phlogogenic factors caused by surgical trauma. 

 Introduction. The main purpose of this research was to study the effectiveness of local fbrinolytic therapy in the rehabilitation of patients with traumatic injuries of the zygomatic-orbital complex. Materials and methods. Patients in the control group (15 persons) received in the postoperative period standard antibiotic therapy, and analgesic, antiinflammatory and anti-edematous therapy. Patients in the main group (17) received into the parabulbar tissues an additional injection of „Hemase” 5000 ME once a day, for 4-5 days. The effectiveness of the treatment was compared by determining the state of microcirculation, sensory sensitivity and level of enolase in the venous blood. Results and discussion. The general conjunctival index in the control group was 18.9 ± 1.2 points on the 7th day and 16.1 ± 1.8 points on the 14th day, and 15.7 ± 1.0 (p <0.05) and 11.7 ± 1.1 points (p <0.05), respectively, in the experimental one. The threshold of electrical excitability of the infraorbital nerve in patients of the control group on the 7th day was 68.4 ± 5.2 μA, while in the main one - 48.1 ± 5.3 μA (p <0,05). On day 14, the difference in the excitability threshold was even more pronounced: in the control - 52.9 ± 4.8 μA, in the main group- 33.2 ± 3.4 μA (p <0.05), with the index on the healthy side at 27.1 ± 1.9 μA. It was also found out that, in the control group, the level of enolase on both the 7th and 14th day exceeded the values obtained during the examination of patients in the main group: 24.5 ± 1.5 ng/ml to 19 , 4 ± 1.3 ng/ ml and 15.6 ± 1.4 ng/ml to 15.1 ± 1.5 ng/ml. Conclusions. The obtained data allowed stating that application of the proposed course of postoperative rehabilitation helps restore the conduction of nerve trunks, has an anti-edematous effect on the soft tissues of the infraorbital area and improves the hemodynamics of the suborbital artery and vein. 

 The aim: Scientifc work aims at determining the frequency and nature of disorders in psycho-emotional and autonomic systems in patients with combined trauma of the middle face. Materials and methods: Examination included 112 patients with combined trauma of the middle face.Their psycho-emotional state was assessed using the Impact of Event Scale (IES) and the Hospital Anxiety and Depression Scale (HADS). All patients were tested using questionnaires developed by Wayne A.M.. The Kerdo index was used to assess autonomic tone, while autonomic reactivity was determined using a Czermak-Gering carotid sinus test. Biochemical markers of stress - adrenocorticotropic hormone (ACTH), cortisol and anti-stress system - β-endorphins,and Garkavi L.Kh. adaptation index. Results: Patients with severe traumatic brain injury - 26.78%, and severe fractures of the facial bones - 48.21%. The consequence of traumatic events is the appearance of post-traumatic stress disorders in their mental function. Post-traumatic stress is also manifested at the hematological level in the characteristic stress reactions: the growth in the blood of stress markers - ACTH and cortisol and anti-stress factors, including β-endorphins
Conclusions: Middle facial injuries cause disorders of the psycho-emotional sphere, which are manifested in anxiety and depressive disorders. The post-traumatic period is accompanied by stress disorders, which are confrmed by hematological studies with a signifcant increase in stress markers (ACTH and cortisol) and an insignifcant increase in anti-stress factors in the blood. Insufcient stress-limiting function of the hypothalamic-pituitary system slows down the healing process and requires appropriate correction.