The Effectiveness of Aromatherapy in the Management of Pain, Nausea-Vomiting, Abdominal Tension and Anxiety after Caesarean: Systematic Review and Meta-analysis

Öz

Objective: The aim of this study is to examine the effectiveness of aromatherapy application in the management of pain, nausea-vomiting, abdominal tension and anxiety after caesarean section.
Methods: This is systematic review and meta-analysis, and searches were performed between March and April 2021. The data were synthesized by meta-analysis.
Results: Fifteen studies included in the study, 14 of which were randomized placebo-controlled experimental and one quasi-experimental and published in 2011-2021. The total sample size of the studies was 1430 (aromatherapy: 762 and placebo: 668). The combined results of eight studies showed that the pain intensity in the aromatherapy group was statistically significantly lower than in the control group (MD: -1.61, Z= 5.15, p< 0.0001). The combined results of the three studies shown that the mean anxiety score of the aromatherapy group has been to be less than the control group (MD: -9.68, Z= 3.52, p= 0.0004), and four studies reported that the probability of nausea and vomiting was less than the control group (OR: 0.29, Z= 3.17, p= 0.002). Again, the results of the two studies showed that while the aromatherapy group was similar to the control group in terms of the possibility of moderate and severe abdominal tension (OR: 0.39, Z=1.04, p=0.30), tension-related pain was less common in the aromatherapy group (OR: 0.16, Z=. 3.18, p= 0.001).
Conclusion: This study showed that aromatherapies with some herbs are effective in reducing postoperative pain, anxiety, nausea-vomiting and pain due to abdominal tension after caesarean section.

Anahtar Kelimeler

• Aromatherapy
• Caesarean Section
• Postoperative Period
• Pain
• Anxiety
• Nausea-Vomiting
• Abdominal Tension

Sezaryen Sonrası Ağrı, Bulantı-Kusma, Abdominal Şişkinlik ve Anksiyetenin Yönetiminde Aromaterapinin Etkinliği: Sistematik Derleme ve Meta-Analiz

Öz

Amaç: Bu çalışmanın amacı sezaryen sonrası gelişen ağrı, bulantı-kusma, abdominal şişkinlik ve anksiyetenin yönetiminde aromaterapi uygulamasının etkinliğini incelemektir.
Yöntem: Bu sistematik derleme ve meta-analiz için taramalar Mart-Nisan 2021 tarihleri arasında “aromaterapi (aromatheraphy) AND sezaryen (cesarean section)” anahtar kelimeleri ile PubMed, EBSCO, Embase, Web of Science, PsycINFO, Cochrane, Türkiye Klinikleri, TR Dizin ve Ulusal Tez Merkezi veri tabanlarında yapılmıştır. Araştırmaların metodolojik kalitesi Joanna Briggs Institute tarafından geliştirilen deneysel ve yarı deneysel çalışmalar için Kritik Değerlendirme Kontrol Listeleri ile değerlendirilmiştir. Veriler meta-analiz yapılarak sentez edilmiştir.
Bulgular: Çalışmaya 2011–2021 yıllarında yayımlanan 14’i randomize plesebo kontrollü deneysel ve biri yarı deneysel olmak üzere toplam 15 araştırma dâhil edilmiştir. Araştırmaların toplam örneklem hacmi 1430’dur (aromaterapi: 762 ve plasebo: 668). Sekiz çalışmanın birleştirilmiş sonuçları aromaterapi grubunda ağrı yoğunluğunun kontrol grubuna göre istatistiksel olarak anlamlı bir şekilde daha düşük olduğunu göstermiştir (MD: -1.61, Z= 5.15, p< 0.0001). Üç araştırmanın birleştirilmiş sonuçlarına göre aromaterapi grubunun anksiyete puan ortalamasının (MD: -9.68, Z= 3.52, p= 0.0004) ve dört araştırmada da bulantı-kusma görülme olasılığının (OR: 0.29, Z= 3.17, p= 0.002) kontrol grubuna göre daha az olduğunu gösterilmiştir. Yine iki araştırmanın sonuçları da aromaterapi grubunun orta ve şiddetli düzeylerde abdominal şişkinlik görülme olasılığı bakımından kontrol grubuna benzer iken (OR: 0.39, Z= 1.04, p= 0.30), şişkinliğe bağlı ağrının aromaterapi grubunda daha az olduğu (OR: 0.16, Z= 3.18, p= 0.001) saptanmıştır.
Sonuç: Bu çalışma bazı bitkiler ile yapılan aromaterapilerin sezaryen sonrası gelişen postoperatif ağrı, anksiyete, bulantı-kusma ve abdominal şişkinliğe bağlı ağrıyı azaltmada etkili olduğunu göstermiştir.

Anahtar Kelimeler

• Aromaterapi
• sezaryen
• postoperatif period
• ağrı
• aksiyete
• bulantı-kusma
• abdominal şişkinlik

Kaynakça

1. 1. World Health Organization [Internet]. WHO Statement on Caesarean Section Rates. (2021). [cited by 18.05.2021] Available from: https://apps.who.int/iris/bitstream/handle/10665/161442/WHO_RHR_15.02_eng.pdf.
2. 2. Ergin A, Mallı P. Doğumda kullanılan aromaterapiler: Sistematik derleme. KOU Sag Bil Derg 2019;5(2):72-80.
3. 3. World Health Organization [Internet]. Caesarean section rates continue to rise, amid growing inequalities in Access. (2021). [cited by 18.05.2021] Available from: https://www.who.int/news/item/16-06-2021-caesarean-section-rates-continue-to-rise-amid-growing-inequalities-in-access.
4. 4. Corso E, et al. Enhanced recovery after elective caesarean: A rapid review of clinical protocols, and an umbrella review of systematic reviews. BMC Pregnancy Childbirth 2017;17(1):1-10.
5. 5. Türkiye İstatistik Kurumu [TÜİK] [Internet]. Doğum İstatistikleri. (2020). [cited by 18.03.2021] Available from: https://data.tuik.gov.tr/Search/Search?text=do%C4%9Fum&dil=1.
6. 6. Sağlık Bakanlığı [Internet]. Sağlık göstergeleri. (2019). [cited by 15.04.2021] https://sbsgm.saglik.gov.tr/Eklenti/39024/0/haber-bulteni-2019pdf.pdf.
7. 7. Şenoğlu A, Öztürk M, Karaçam Z. Cesarean section rates and ındications in Turkey: A systematic review and meta-analysis. AJRNH 2021;4(4):31-57.
8. 8. Bilgiç Ş. Hemşirelikte holistik bir uygulama; aromaterapi. NKMJ 2017;5(3):134-141.

9. 9. Hines S, et al. Aromatherapy for treatment of postoperative nausea and vomiting. Cochrane Database Syst Rev 2018;10(3):CD007598.
10. 10. Lakhan SE, Sheafer H, Tepper D. The effectiveness of aromatherapy in reducing pain: A systematic review and meta-analysis. Pain Res Treat 2016;2016:8158693.
11. 11. United States Food and Drug Administration [Internet]. Aromatherapy. (2020). [cited by 18.04.2021] Available from: https://www.fda.gov/cosmetics/cosmeticproducts/aromatherapy#essentialoil.
12. 12. Abdelhakim AM, et al. The effect of inhalation aromatherapy in patients undergoing cardiac surgery: A systematic review and meta-analysis of randomized controlled trials. Complement Ther Med 2020;48:102256.
13. 13. Amirhosseini M, et al. Effectiveness of aromatherapy for relief of pain, nausea, and vomiting after percutaneous nephrolithotomy: A randomized controlled trial. Complement Med Res 2020;27(6):440-448.
14. 14. Di Vito M, et al. Is aromatherapy effective in obstetrics? A systematic review and meta‐analysis. Phytother Res 2020;1-10.
15. 15. Maghami M, et al. The effect of aromatherapy with peppermint essential oil on nausea and vomiting after cardiac surgery: A randomized clinical trial. Complement Ther Clin Pract 2020;40:101199.
16. 16. Mahboubi M. Mentha spicata L. essential oil, phytochemistry and its effectiveness in flatulence. J Tradit Complement Med 2021;11(2):75-81.
17. 17. Seyyed-Rasooli A, et al. Comparing the effects of aromatherapy massage and inhalation aromatherapy on anxiety and pain in burn patients: A single-blind randomized clinical trial. Burns 2016;42(8):1774-1780.
18. 18. Niazi A, et al. Effect of complementary medicine on pain relief and wound healing after cesarean section: A systematic review. JoP 2021;24(2):41-53.
19. 19. Zimpel SA, et al. Complementary and alternative therapies for post-caesarean pain. Cochrane Database Syst Rev 2020; 1;9:CD011216.
20. 20. Moher D, et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Int J Surg 2010;8(5):336-341.
21. 21. Tufanaru C, et al. Explanation for the critical appraisal tool for RCTs with individual participants in parallel groups. In: Aromataris E, Munn Z, editors. JBI Manual for Evidence Synthesis. JBI, (2020). [cited by 15.07.2021] Available from: https://synthesismanual.jbi.global
22. 22. Tufanaru C, et al. Explanation for the critical appraisal tool for Quasi-Experimental Studies (experimental studies without random allocation). In: Aromataris E, Munn Z, editors. JBI Manual for Evidence Synthesis. JBI, (2020). [cited by 15.07.2021] Available from: https://synthesismanual.jbi.global
23. 23. Abbasijahromi A, et al. Compare the effect of aromatherapy using lavender and damask rose essential oils on the level of anxiety and severity of pain following C-section: A double-blinded randomized clinical trial. J Complement Integr Med 2020;17(3). doi: 10.1515/jcim-2019-0141.
24. 24. Abdraboo RA, Amasha HAR, Ali SE. Effectiveness of inhalation of lavender oil in relievıng post-cesarean section pain. MJN 2020;12(1):113-122.
25. 25. Fazel N, et al. The Anethum graveolens L’s (Dill) essential oil affects the intensity of abdominal flatulence after cesarean section: A randomized, double-blind placebo-controlled trial. J Herb Med 2017;8(12):8-13.
26. 26. Gharabaghi PM, et al. Evaluation of the effect of preemptive administration of Rosa damascena extract on post-operative pain in elective cesarean sections. Afr J Pharm Pharmacol 2011;5(16):1950-1955.
27. 27. Hadi N, Hanid A. Lavender essence for post cesarean pain. PJBS 2011;14(11):664-667.
28. 28. 28. Khadem E, et al. Effect of topical chamomile oil on postoperative bowel activity after cesarean section: A randomized controlled trial. J Res Pharm Pract 2018;7(3):128-135.
29. 29. Mirhosseini S, et al. Effect of aromatherapy massage with orange essential oil on postoperative pain after cesarean section: A randomized controlled trial. J Complement Integr Med 2021;18(3):579-583.
30. 30. Najafi B, et al. The effect of chamomile flower essence on pain severity after elective caesarean section under spinal anaesthesia: A randomized clinical trial. J Clin Diagnostic Res 2017;11(11):UC01-UC04.
31. 31. Olapour A, et al. The effect of inhalation of aromatherapy blend containing lavender essential oil on cesarean postoperative pain. Anesth Pain 2013;3(1):203-207.
32. 32. Pakseresht S, et al. Effect of lavender aromatherapy on the pain level after cesarean section. Herb Med J 2020;5(1):11-20.
33. 33. Shahinfar J, et al. The effect of mint extract on the incidence and severity of nausea and vomiting after cesarean section under spinal anesthesia: A randomized clinical trial. Patient Saf Qual Improve J 2017;5(1):482-487.
34. 34. Sharifipour F, Sohailbaigi S, Dastmozd L. Comparison of the citrus arantium and salvia officinalis aroma impacts on post cesarean anxiety. Acta Medica Mediterr 2016;32:977-981.
35. 35. Sharifipour F, Baigi SS, Mirmohammadali M. The aromatic effect of Citrus arantium on pain and vital signs after cesarean section. IJBPAS 2015;4(7):5063-5072.
36. 36. Zeraati H, et al. The effect of ginger extract on the incidence and severity of nausea and vomiting after cesarean section under spinal anesthesia. Anesth Pain Med 2016;6(5):e38943.
37. 37. Lane B, et al. Examination of the effectiveness of peppermint aromatherapy on nausea in women post C-section. J Holist Nurs 2012;30(2):90-104.
38. 38. Cho MY, et al. Effects of aromatherapy on the anxiety, vital signs, and sleep quality of percutaneous coronary intervention patients in intensive care units. Evid Based Complement Alternat Med 2013;2013:381381.
39. 39. Hodge NS, McCarthy MS, Pierce RMA. Prospective randomized study of the effectiveness of aromatherapy for relief of postoperative nausea and vomiting. J Perianesth Nurs 2014;29(1):5-11.