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| Date: 04-15-2016 | HC# 091554-542 |
Marofi M, Sirousfard M, Moeini M, Ghanadi A. Evaluation of the effect of aromatherapy with Rosa damascenaMill. on postoperative pain intensity in hospitalized children in selected hospitals affiliated to Isfahan University of Medical Sciences in 2013: A randomized clinical trial. Iran J Nurs Midwifery Res. 2015;20(2):247-254.
Treating postoperative pain in children is a challenge, particularly since narcotics have many adverse effects. Aromatherapy with Damask rose (Rosa damascena, Rosaceae) flower essential oil is reported to reduce pain and anxiety and is considered safe for children. In addition, it is an accepted therapy in Iranian culture which is readily available and affordable. For those reasons, the authors chose to conduct a double-blind, placebo-controlled, clinical trial to evaluate the effect of aromatherapy with Damask rose on children's postsurgical pain.
Children (n = 64; aged 3-6 years) hospitalized in the pediatric surgery ward of Imam Hossein and Al-Zahra hospitals in Isfahan, Iran, participated in this study. Included patients had single incisions; were not being transferred to the intensive care unit after surgery; had a caretaker; had no history of respiratory diseases; did not have a rennet allergy; did not use narcotics, tranquilizers, or benzodiazepines 1 week prior to surgery; had no respiratory allergy to essences, perfumes, or aromas in the patient or mother; had no history of dermatologic allergy or dermatitis in the patient or mother; and had no chronic pain. Excluded patients had an infection at the incision site, had a dermatologic or respiratory allergy during the study, or stopped treatment during the study.
The Toddler Preschooler Postoperative Pain Scale (TPPPS) questionnaire was administered upon arrival in the recovery room postoperatively. The questionnaire has items for verbal expression of pain, facial expressions of pain, and body expression of pain. The aromatherapy was then initiated; 1-2 drops of either Damask rose extract or the placebo, sweet almond (Prunus dulcis, Rosaceae) oil, were placed on an eye pad and laid 30 cm from the child's head. The brand and manufacturer of the treatments were not provided. Another dose of oil was placed on the pads 3, 6, 9, and 12 hours after surgery. Thirty minutes after each aromatherapy dosing, TPPPS was administered to evaluate pain intensity. Both groups had routine postoperative care including sedation, antipyretics, and antibiotics. Baseline characteristics were similar between groups. Immediately after surgery, the pain intensity was similar between groups, also indicating that the groups were homogeneous.
Both treatment groups had a significant decrease in pain intensity over time (P < 0.001). However, the Damask rose group had a significantly greater decrease in pain intensity compared with placebo after treatment at all time points (P < 0.05).
The authors acknowledge that the decrease in pain scores over time is probably due to the medications administered post-surgery. However, the Damask rose group had a significantly greater decline in pain. Sweet almond oil aromatherapy was chosen because it has no respiratory effects and is often used as a placebo. A strength of this study was that the control group was treated with a pleasant odor, thereby reducing the possibility that the benefit was solely due to a pleasant smell countering the scent of the hospital. A limitation of the study is that the authors did not measure whether aromatherapy treatment decreased the intake of postoperative medications. Another limitation is the relatively short duration of the postoperative aromatherapy. Also, the effectiveness of the blinding may be questioned since presumably the people administering the pain questionnaire could smell the odor. These encouraging preliminary results warrant larger and more robust studies to confirm the findings.
—Heather S. Oliff, PhD
