The Effect of Aromatherapy with the Essential Oil of Orange on Pain and Vital Signs of Patients with Fractured Limbs Admitted to the Emergency Ward: A Randomized Clinical Trial

Effects of Orange Oil Aromatherapy on Pain and Anxiety During Invasive Interventions in Patients With Hematopoietic Stem Cell Transplants

Invasive interventions, such as peripheral intravenous cannula, port needle placement, and blood collection, are often required for both inpatient and outpatient follow-up patients with hematological malignancies and hematopoietic stem cell transplants. This prospective, randomized controlled experimental study assessed the effect of orange oil inhalation used in aromatherapy on pain and anxiety levels in invasive interventions with hematological malignancies and hematopoietic stem cell transplants. It was conducted prospectively with 80 patients with hematological malignancies who were treated in the adult bone marrow transplant unit and adult hematology service of a private hospital between May 2021 and April 2022. The orange oil inhalation used in aromatherapy was applied to patients in the intervention group. The Visual Analog Scale (VAS) and State-Trait Anxiety Inventory (STAI) were used for data collection. Regarding the personal characteristics of the patients, 42.5% were ≥61 years old, 60% were men, and 85% were married. VAS pain scores of the intervention group were statistically lower than those of the control group (P < .001). However, there was no statistically significant difference in the STAI scores of groups (P >.05). The study results show that orange oil inhalation has been determined to reduce pain during invasive interventions.

Notice of Retraction: The Effect of Aromatherapy with the Essential Oil of Orange on Pain and Vital Signs of Patients with Fractured Limbs Admitted to the Emergency Ward: A Randomized Clinical Trial

[This retracts the article DOI: 10.4103/IJPC.IJPC_37_17.][This retracts the article DOI: 10.15452/CEJNM.2017.08.0024.].

The effect of lemon inhalation aromatherapy on pain, nausea, as well as vomiting and neurovascular assessment in patients for lower extremity fracture surgery: a randomized trial

BACKGROUND

Complementary and integrative medicine may be effective for postoperative outcomes. This study aimed to determine the effect of lemon inhalation aromatherapy on pain, nausea, and vomiting and neurovascular assessment in patients for lower extremity fracture surgery.

METHODS

This is a randomized clinical trial study. Ninety patients who had undergone lower extremity fracture surgery were randomly assigned to the intervention (lemon aromatherapy) and control groups. Lemon aromatherapy was started in the morning of the surgery and extended at two-hour intervals until the end of the surgery, in the recovery room, and 16 h after surgery. Numerical pain and nausea and vomiting scales, the Rhodes Index of Nausea, Vomiting, and Retching, and the WACHS Neurovascular Observation Chart were used to assess the outcomes before and after the intervention (in the recovery room and 4, 8, 12, and 16 h post-surgery). The data were analyzed using the Wilcoxon test, ANCOVA, and Repeated Measure ANCOVA.

RESULTS

A significant difference was observed between the groups in terms of the intensity of pain (P < 0.001) and nausea and vomiting (P = 0.001) during the study period. Moreover, a significant difference was found between groups as to the frequency and severity of nausea, vomiting, and retching. The amount and duration of postoperative vomiting and nausea were significantly lower in the intervention group compared to the control group. In addition, lemon inhalation aromatherapy decreased the frequency of anti-emetic drug administration in the recovery room (P = 0.04) and 16 h post-surgery (P = 0.03).

CONCLUSIONS

This study indicated that aromatherapy reduced pain intensity, postoperative nausea, vomiting, and retching, as well as the incidence of anti-emetic drug administration. Therefore, using lemon inhalation aromatherapy to relieve pain and reduce nausea and vomiting is suggested for lower extremity fracture patients who have undergone surgery.

TRIAL REGISTRATION

This study was registered in the Iranian Registry of Clinical Trail (Number = 57,331, IRCT20130616013690N10, approved 24/07/2021) ( https://www.irct.ir/trial/57331 ).

A review of citrus plants as functional foods and dietary supplements for human health, with an emphasis on meta-analyses, clinical trials, and their chemical composition

Fruits, flowers, leaves, essential oils, hydrosols, and juices of citrus spp. Are utilized to prepare various forms of food products. Along with their nutritional values, in the health industry, different parts of the plants of the citrus genus have been used as supplements or remedies to prevent or control diseases. This review focused on reported meta-analyses and clinical trials on the health benefits of citrus plants as functional foods. Also, chemical compounds of various citrus species were reviewed. The following information sources were used for data collection: Google Scholar, the Web of Science, Scopus, and PubMed. Various keywords, including "citrus AND chemical compounds," "citrus AND phytochemicals," "citrus species," "citrus AND meta-analysis," "nutritional and therapeutical values of citrus spp.," "clinical trials AND citrus," "clinical trials AND Rutaceae," "health benefits of citrus spp.," "citrus edible or non-edible applications," and scientific names of the citrus plants were utilized to collect data for the review. The scientific name and common name of all twenty-eight citrus species, along with any of the above keywords, were also searched in the mentioned databases. Scientific papers and data sources were sought to review and discuss the citrus plant's nutritional and therapeutic importance. Several meta-analyses and clinical trials have reported beneficial effects of citrus spices on a variety of cancer risks, cardiovascular risk factors, neurologic disorders, urinary tract conditions, and gastrointestinal tract conditions. They have shown anxiolytic, antimicrobial, and pain-alleviating effects. Some of them can be helpful in managing obesity and cardiovascular risk factors.

Polymeric Nanocapsules Containing Fennel Essential Oil: Their Preparation, Physicochemical Characterization, Stability over Time and in Simulated Gastrointestinal Conditions

Plant essential oils, a source of biologically active compounds, represent a promising segment in the pharmaceutical market. However, their volatility, hydrophobicity, poor stability, and low toxicity limit direct use in pharmaceutical-related applications. Nanoencapsulation is a technique that allows overcoming these obstacles by improving bioaccessibility and bioavailability. Nanocapsules (NCs) based on biodegradable and biocompatible poly(ɛ-caprolactone) containing Foeniculum vulgare Mill. essential oil (FEO), known for its biological activities, were successfully prepared by interfacial deposition of the preformed polymer method. The composition of FEO (trans-anethole chemotype) was determined by gas chromatography analyses. The FEO presence inside the NCs was confirmed by nuclear magnetic resonance experiments. The FEO-NCs showed nanometer size (210 nm), low polydispersity index (0.10), negative zeta potential (−15 mV), non-Newtonian rheological behavior, and high efficiency of encapsulation (93%). Moreover, parameters such as FEO-NC particle size, bioactive compound retention, and FEO composition were monitored for 30 days at storage temperatures of 4 and 40 °C, confirming the robustness of the nanosystem. Finally, FEO-NCs were resistant to the simulated gastric digestion and showed an effective bioaccessibility of 29% in simulated intestinal digestion. Based on the results obtained, this FEO-NC nanosystem could find interesting applications in the nutraceutical and pharmaceutical sectors.

Impact of a Dietary Citrus Extract on the Behavior and Production of Lactating Dairy Cows Following Regrouping: A Preliminary Study

Exposure of lab animals, humans, and pigs to olfactory sensory feed additives may reduce response to stress and anxiety. The objective of this preliminary study was to determine if feeding a citrus-based olfactory sensory functional feed extract (derived from Citrus sinensis) reduces the negative impact of regrouping of lactating dairy cows. Thirty-two (parity = 2.0 ± 1.2; mean ± SD), mid-lactation Holstein dairy cows (169.8 ± 16.8 DIM) were enrolled as focal cows in this study and housed individually in a tie-stall facility where they were randomly assigned to 1 of 2 treatment diets: (1) control total mixed ration (TMR) (control; n = 16; primiparous = 7; multiparous = 9), or (2) control TMR with 4 g/d of citrus extract (CE) (Phodé, Terssac, France) (CE; n = 16; primiparous = 7; multiparous = 9). Cows were fed their experimental diets for 7 d in the tie-stall facility (baseline), then moved to 1 of 2 experimental free-stall pens (containing 29 other cows) for a period of 7 d, where they remained on the same treatment diet as before. Compared with their baseline, primiparous control cows had decreased rumination time on d 1 and 2, had decreased lying time on d 1, and tended to have decreased lying time on d 2 and 3 following regrouping. In contrast, primiparous cows fed the CE diet did not experience a change in rumination and lying time. Primiparous CE cows had greater feeding time on d 1 and tended to have greater feeding time on d 2 after regrouping compared to primiparous control cows. Primiparous control cows had greater idle standing time, as compared to the CE cows, across the 7 d after regrouping. Primiparous CE cows initiated less total competitive behavior after regrouping, but were also displaced more frequently from the feed bunk and from the free stalls on d 1 after regrouping, as compared to the primiparous control cows. For multiparous cows, CE supplementation was not consistently associated with any benefits to behavior or production after regrouping, possibly because these cows were more experienced with social stressors. Results indicate that feeding CE to mid-lactation naïve primiparous dairy cows may reduce the initiation of competitive interactions and lessen the reduction in rumination and lying time after regrouping. These results need to be verified in further studies where potential confounding effects (e.g., pen social dynamics, pen location) are minimized.

Evaluating the Aromatherapy Recommendation for Pain in the Holistic Nurses' Pain Relief Tools for Patients and Self-Care

Purpose of Study: The purpose of the study was to evaluate the usefulness of the aromatherapy (AT) recommendation in the American Holistic Nurses Association's (AHNA's) Holistic Nurses' Pain Relief Tools for Patients and Self-Care (Pain Tool). Methodology: An observational survey design was used and a purposeful sample of 55 nurses were invited to a two-part, 15-question survey administered via SurveyMonkey. The demographic data were analyzed with quantitative analysis and the open-ended questions were analyzed via content analysis. Results: A total of 55 registered nurses completed the survey and the mean age of participants was 53 years old. Lavender essential oil (EO) was used by 100% (N = 55) of participants and the inhalation method was favored (93%; n = 51). The AT recommendation was most helpful for educational purposes (29%; n = 16) and to reduce symptoms of pain (21%; n = 8). A majority of participants used the five holistic nursing core values (70%; n = 31) as well as promote more options for pain management (48%; n = 13) to improve outcomes (30%; n = 13). Respondents recommend the addition of more EOs and safety information (23%; n = 8). Finally, five recommendations were made to AHNA. Implication for Practice: Nurses who use AT (guideline) as a safe, cost-effective intervention for pain improve quality outcomes.

The effects of foot massage on hemodialysis patients' sleep quality and restless leg syndrome: a comparison of lavender and sweet orange essential oil topical application

OBJECTIVES

Hemodialysis (HD) patients suffer more sleep problems (poor sleep quality and restless leg syndrome [RLS]). Complementary therapy, especially massage with aromatherapy oil is one of the non-pharmacological treatment options with less adverse effects than routine methods. The purpose of this study was to determine the effects of foot massage with of lavender and orange essential oil on HD patients' sleep quality and RLS.

METHODS

This is a double blind randomized controlled trial on 105 HD patients was conducted at a large educational hospital in Iran, Hamadan province between January and September 2017. Patients divided into three groups with random allocation (35 participants per groups in lavender, orange, and control group). Foot massage during HD with lavender and orange essential oil was administered to the patients three times a week for three weeks, and every massage lasted half an hour. The control group received routine care. Before the intervention, the end of the first, second, and third weeks Pittsburgh Sleep Quality Index (PSQI) and RLS questionnaire were completed for all three groups. Data were statistically analyzed with Independent Samples t-test, chi-square test and repeated-measures analysis of variance (ANOVA) by SPSS version 16.

RESULTS

The mean score of sleep quality and RLS in the intervention groups were significantly different compare with the control group in all three time of data collecting (p<0 001).

CONCLUSIONS

Aromatherapy prepared with lavender oil and sweet orange may be recommended to increase sleep quality and RLS level of the HD patients.

The Effects of Inhalation Aromatherapy on Postoperative Abdominal Pain: A Three-Arm Randomized Controlled Clinical Trial

PURPOSE

This study compares the effects of inhalation aromatherapy using essential oils of sweet orange and damask rose on postoperative abdominal pain.

DESIGN

A randomized three-arm controlled trial.

METHODS

In this randomized double-blinded, and parallel-group controlled trial, a total of 120 patients who underwent open abdominal surgeries were enrolled using a sequential sampling method. Participants were then randomly assigned to three groups of sweet orange, damask rose, and placebo (distilled water) using the permuted block randomization. When the patients regained full consciousness, a clean gauze impregnated with four drops of either distilled water or essential oils of sweet orange or damask rose were attached to the collar of the patients, and they were asked to inhale the aroma through normal breathing for 30 minutes. Abdominal pain severity was recorded using the visual analog scale at four time points including before the intervention (baseline) and 4, 8, and 12 hours after the intervention.

FINDINGS

Pain reduction after sweet orange inhalation was significantly greater than placebo (at 8 and 12 hours after the intervention) and damask rose (at 12 hours after the intervention). The differences in the mean score of pain severity between all before-and-after observations were statistically significant in the three groups, except in the placebo group between the baseline score of pain severity and the pain severity score at 4 hours after the intervention.

CONCLUSIONS

Inhalation aromatherapy using sweet orange seems to be more effective than the damask rose in reducing pain severity after open abdominal surgeries.

Can lavender oil inhalation help to overcome dental anxiety and pain in children? A randomized clinical trial

Aromatherapy with essential oils can be used to relieve children. The aim of this study was to evaluate the correlations between psychological and physiologic findings after lavender oil inhalation among children assigned to undergo tooth extraction. A total of 126 children aged between 6 and 12 years were enrolled in the study. The groups were randomly divided into control and lavender groups. The lavender group inhaled 100% lavender oil for 3 min before the interventions, the control group received no prior application. Psychological assessments were made using face image scale (FIS), Face, Legs, Activity, Cry, Consolability (FLACC) and Wong-Baker pain rating scale (WBS). Physiologic changes were assessed using vital signs evaluations. All parameters were noted prior to applications, after inhalation, anesthesia injection, and tooth extraction. The lavender group showed significant lower anxiety and pain scores after tooth extraction (p < 0.05). Significantly lower levels of blood pressures and a significant pulse rate drop were found after inhalation in the lavender group. A statistically significant increase in heart rate was observed after anesthesia injection and tooth extraction in the control group (p < 0.05).Conclusion: Lavender oil can be preferred as a treatment of choice in routine pediatric dentistry.Trial registration number: NCT04115891 (Lavender Oil Inhalation Help to Overcome Dental Anxiety Among Children)What is Known:• Dental anxiety is the most common factor that causes children to have difficulty with the dentist and their parents during treatment.• Aromatherapy with essential oils can be used to relieve children.What is New:• Aromatherapy with lavender oil relieves the child by reducing the level of anxiety and facilitates dental treatment.• During surgical procedures such as local anesthesia and tooth extraction, lavender oil inhalation decreases pain levels of children.

Comparison the effects of inhalation and massage aromatherapy with lavender and sweet orange on fatigue in hemodialysis patients: a randomized clinical trial

OBJECTIVES

Fatigue, regardless of the causes, could leave a negative impact on individual performance. The aim of this study was to compare the effects of inhalation and massage aromatherapy with lavender and sweet orange on fatigue among hemodialysis patients.

METHODS

This study was a randomized controlled trial. The patients (96 patients) were allocated to three groups (control, an inhalation aromatherapy, and an aromatherapy massage group). A demographic questionnaire as well as the rhoten fatigue scale (RFS) was used to collect the data. The data were analyzed by descriptive and analytical statistics using SPSS version 18.

RESULTS

Before the intervention, there was no significant difference among the groups regarding fatigue level (p=0.54). However, eight and 16 weeks after the study, the levels of fatigue in both experimental groups were significantly lower than the control group (p < 0.05).

CONCLUSIONS

Interventions with essential oils are effective in reducing fatigue in hemodialysis patients, although the effects of aromatherapy massage on fatigue are stronger than the effects of inhalation aromatherapy.

Striking essential oil: tapping into a largely unexplored source for drug discovery

Essential oils (EOs) have been used therapeutically for centuries. In recent decades, randomized controlled (clinical) trials have supported efficacy in specific therapeutic indications for a few of them. Some EOs, their components or derivatives thereof have been approved as drugs. Nevertheless, they are still considered products that are mainly used in complementary and alternative medicine. EO components occupy a special niche in chemical space, that offers unique opportunities based on their unusual physicochemical properties, because they are typically volatile and hydrophobic. Here we evaluate selected physicochemical parameters, used in conventional drug discovery, of EO components present in a range of commercially available EOs. We show that, contrary to generally held belief, most EO components meet current-day requirements of medicinal chemistry for good drug candidates. Moreover, they also offer attractive opportunities for lead optimization or even fragment-based drug discovery. Because their therapeutic potential is still under-scrutinized, we propose that this be explored more vigorously with present-day methods.

Use of Essential Oils by Health Care Professionals for Health Maintenance

This study explores essential oils' use by health care professionals for health maintenance. A qualitative, descriptive design was employed, and a convenience sample of 10 participants was interviewed. Four themes were identified: an essential oils' community, essential oils' use, essential oils' acceptance, and essential oils' benefits and harms.