Montgomery, G.H., Bovbjerg, D.H., Schnur, J.B., David, D., Goldfarb, A., Weltz, C.R., Schechter, C., Graff-Zivin, J., Tatrow, K., Price, D.D. and Silverstein, J.H. (2007) A randomized clinical trial of a brief hypnosis intervention to control side effects in breast surgery patients. Journal of the National Cancer Institute, 99, 1304-1312. doi:10.1093/jnci/djm106

has been cited by the following article:

• TITLE: Salivary alpha-amylase activity—An indicator of relaxation response in perioperative patients

  AUTHORS: Chika Minowa, Kikuyo Koitabashi

  KEYWORDS: Anxiety; Pain; Salivary α-Amylase Activity; Autonomic Nervous System; Surgical Stress

  JOURNAL NAME: Open Journal of Nursing, Vol.2 No.3, September 28, 2012

  ABSTRACT: The psychological stress of most perioperative patients has been reduced by many interventions. In order to evaluate the effects of these interventions, biomarkers are being considered as objective assessment tools in addition to the subjective assessment tools. It has been thought that salivary α-amylase (sAA) activity is associated with sympathetic nervous system activity, which reflects psychological stress. We examined the relationship between sAA, self-reported data, and autonomic nervous system activity to assess the reliability of sAA as a marker for relaxing response in surgery-related stress. The sAA, the State anxiety, Visual Analogue Scale (VAS) of pain, and heart rate variability were used to assess prior to and after the relaxation on the day before surgery, and on postoperative days (POD) 1, 2, 3, and 7. A total of 75 patients participated and 301 relaxing response readings were obtained. We found that the sAA significantly decreased depending upon the pain and anxiety by relaxation, but they were unrelated to sympathetic nervous system activity. There was weak correlation between the change in sAA, and anxiety and VAS pain. Thus, sAA appears to be an easy-to-use, non-invasive and good marker for relaxing response within a short period in surgery-related stress patients.