Effects on postoperative salivary cortisol of relaxation/music and patient teaching about pain management.

TitleEffects on postoperative salivary cortisol of relaxation/music and patient teaching about pain management.
Publication TypeJournal Article
Year of Publication2013
AuthorsGood M, Albert JM, Arafah B, Anderson GCranston, Wotman S, Cong X, Lane D, Ahn S
JournalBiol Res Nurs
Volume15
Issue3
Pagination318-29
Date Published2013 Jul
ISSN1552-4175
KeywordsHumans, Hydrocortisone, Pain Management, Patient Education as Topic, Postoperative Period, Relaxation Therapy, Saliva
Abstract

The physiological and psychological stress of surgery and postoperative pain can leave patients more susceptible to infection and complications. The present study was designed to determine whether two interventions, patient teaching (PT) for pain management and relaxation/music (RM), reduced cortisol levels, an indicator of stress, following abdominal surgery. Patients (18-75 years) were randomly assigned to receive PT, RM, a combination of the two, or usual care; the 205 patients with both pre- and posttest cortisol values were analyzed. A 2 × 2 factorial design was used to compare groups for PT effects and RM effects. Stress was measured by salivary cortisol before and after 20-min tests of the interventions in the morning and afternoon of postoperative Day 2. Saliva was stimulated with lemon juice and analyzed with high-sensitivity salivary cortisol enzyme immunoassay. Comparisons using analysis of covariance (ANCOVA), controlling for baseline levels, showed no PT effect or RM effect on cortisol in the morning or afternoon. Post hoc ANCOVA showed no significant effects when intervention groups were compared to the control group. Although in previous studies, RM reduced pain and music reduced cortisol on Day 1, in the present study the cortisol response to surgery was not attenuated by PT or RM on Day 2. The RM intervention can be used for pain but needs to be further tested for effects on plasma cortisol in abdominal surgery patients on their first postoperative day.

DOI10.1177/1099800411431301
Alternate JournalBiol Res Nurs
PubMed ID22472905
Grant ListR01 NR3933 / NR / NINR NIH HHS / United States