Aromatherapy can halve opiate use after surgery: Study
Previous research has shown that anxiety, depression, and disaster (patients believe they will die during surgery) increase postoperative pain and opioid use by up to 50%.
Benefits of aromatherapy for patients after surgery
Aromatherapy, the health-promoting use of essential oils, has been used for thousands of years, and several recent studies have found that lavender and peppermint aromatherapy, especially particular, can reduce anxiety.
However, most of these studies looked at a series of patients who, rather than have a more rigorous randomized, placebo-controlled design, makes it difficult to draw firm conclusions from the results. so difficult.
This study, from Professor Jacques Chelly and colleagues in the Department of Anesthesiology, University of Pittsburgh, Pittsburgh, USA, is one of the first to use a randomized, placebo-controlled design to See if aromatherapy reduces anxiety.
As of January 2020, patients who received primary total hip replacement at UPMC Presbyterian-Shadyside Hospital, Pittsburgh, and who agreed to participate in the study, completed a survey to screen them for evidence of disease. anxiety (PROMIS Emotional distress – Anxiety – Short form 8a).
To date, more than 350 patients have been screened in this way.
Those assessed as having moderate or higher anxiety levels will be enrolled in the ongoing study, which aims to enroll 60 patients.
Participants were randomly assigned to either an active treatment group (aromatherapy) or a placebo group. Those in the intensive care group were given a lavender and mint scented patch, a patch that slowly releases the essential oil when it adheres to hospital clothing, skin, or gowns, for minimal wear. at least one hour before surgery.
The patches are changed every 12 hours and worn for 72 hours after surgery.
Those in the placebo group wore a patch that secreted sweet almond oil, an oil that has not been shown to reduce anxiety.
Levels of anxiety, depression, distress, pain, and opioid consumption were recorded during the study.
Preliminary data on the first 25 participants (mean age 60.6 years, 13 males and 12 females) are presented here. The primary outcome was the effect of aromatherapy on anxiety 48 hours after surgery.
Initial anxiety scores (before surgery) were similar in both groups (23.5 in the aromatherapy group versus 22.9 in the placebo group).
48 hours after surgery, anxiety scores were reduced in both groups, but the reduction was greater in the aromatherapy group (anxiety score was 13.5 in the aromatherapy group versus 16.2 in the aromatherapy group). placebo).
Total opioid use during the first 48 hours after surgery was 50% lower in the aromatherapy group (12 OME) than in the placebo group (24.75 OME). (OME, the oral morphine equivalent, is a measure that allows comparisons between different drugs and methods of administration.)
Data on pain, depression and disaster levels have not yet been analyzed.
The researchers concluded: “Our results suggest that, by managing anxiety, aromatherapy can help manage pain and reduce opioid consumption. This is important, given the role it plays. of opioid use in surgical patients during the general opioid crisis in the United States.”
Opioids have sedative and analgesic effects and are widely prescribed after surgery to control pain. They are also addictive.
Deaths from opioid-related drug use (prescription and over-the-counter, such as heroin) have increased more than sixfold since 1999 in the US, and nearly 600,000 people in the US and Canada have died from overdoses. opioids over the past two decades.
“The pandemic has made the situation worse, with more than 100,000 drug-related deaths reported by 2021,” Professor Chelly said.
It was recently estimated that, without urgent interventions, including public health policy reform and tighter corporate regulations, an additional 1.2 million deaths from opioids in North America by 2029.
Although North America is at the center of the opioid crisis, opioid abuse is a growing public health concern in the UK.
“The evidence supports the concept that routine activities can be a gateway to addiction and long-term opioid use (opioid use disorder) and it is therefore important to consider the technique may reduce postoperative opioid use and thus the development of postoperative opioid use disorder.
“Aromatherapy is a simple and cost-effective technique that can minimize the impact of anxiety on postoperative pain and opioid consumption.
“We hope that providing objective evidence of the benefits of aromatherapy will help address the concerns of those who are skeptical about its value.
“At UPMC Presbyterian-Shadyside Hospital, we routinely administer lavender aromatherapy to patients who report anxiety prior to surgery.”
One possible mechanism of action of aromatherapy is through the limbic system, a brain structure known to regulate pain, emotion, and anxiety. Professor Chelly and colleagues plan to next study the effects of aromatherapy on the brain, using MRI.