Holistic Aromatherapy Applications in Postoperative Pain Management by Nurses: A Narrative Review
Abstract
Background: Postoperative pain remains a significant clinical challenge, with conventional pharmacological management often leading to adverse effects like sedation, respiratory depression, and potential for dependency. This has accelerated the search for complementary and integrative therapies. Aromatherapy, the controlled use of essential oils for therapeutic purposes, is increasingly employed by nurses as a non-pharmacological intervention to manage acute pain, leveraging the nursing profession's holistic model of care. Aim: This narrative review aims to synthesize and critically evaluate the current evidence on the application of holistic aromatherapy by nurses for postoperative pain management. Methods: A comprehensive literature search was conducted using PubMed, CINAHL, Scopus, and PsycINFO for articles published between 2013 and 2024. Keywords included "aromatherapy," "essential oils," "postoperative pain," "nursing," "non-pharmacological intervention," and "integrative medicine." Results: The findings indicate that aromatherapy, particularly using oils like lavender, bergamot, and peppermint, shows promise in reducing self-reported pain intensity and anxiety, and in decreasing the requirement for rescue analgesics. The primary proposed mechanisms involve the olfactory system's connection to the limbic system and the modulation of pain pathways. However, the evidence is limited by methodological heterogeneity, small sample sizes, and challenges in blinding. Nursing assessments for patient suitability and adherence to safety protocols are identified as critical for successful implementation. Conclusion: Aromatherapy represents a valuable, low-risk adjunct to conventional postoperative pain management within the nursing scope of practice. To solidify its place in evidence-based practice, future research must prioritize rigorous, large-scale randomized controlled trials with standardized interventions and objective outcome measures.
Full text article
References
American Holistic Nurses' Association. (2001). Position on the role of nurses in the practice of complementary and alternative therapies. Beginnings (American Holistic Nurses' Association), 21(2), 1-2.
Benyamin, R., Trescot, A. M., Datta, S., Buenaventura, R. M., Adlaka, R., Sehgal, N., ... & Vallejo, R. (2008). Opioid complications and side effects. Pain physician, 11(2S), S105.
Boesl, R., & Saarinen, H. (2016). Essential oil education for health care providers. Integrative Medicine: A Clinician's Journal, 15(6), 38.
Buckle, J. (2014). Essential oils in practice. Clinical Aromatherapy-E-Book; Churchill Livingstone: Edinburgh, UK.
Chen, S. J., Chen, C. H., & Chang, H. Y. (2021). Effects of inhaling essential oil on headache-related quality of life among nurses working in emergency and critical care units. Hu Li Za Zhi, 68(5), 51-64. DOI:10.6224/JN.202110_68(5).08
Czarnecki, M. L., Michlig, J. R., Norton, A. M., Stelter, A. J., & Hainsworth, K. R. (2022). Use of aromatherapy for pediatric surgical patients. Pain Management Nursing, 23(6), 703-710. https://doi.org/10.1016/j.pmn.2022.08.003
Gan, T. J. (2017). Poorly controlled postoperative pain: prevalence, consequences, and prevention. Journal of pain research, 2287-2298. https://doi.org/10.2147/JPR.S144066
Gong, M., Dong, H., Tang, Y., Huang, W., & Lu, F. (2020). Effects of aromatherapy on anxiety: A meta-analysis of randomized controlled trials. Journal of affective disorders, 274, 1028-1040. https://doi.org/10.1016/j.jad.2020.05.118
Graham, V., Flemming, K., & Booth, J. (2022). The physiological effects of menthol on thermoreception and pain perception: A systematic review. Journal of Advanced Nursing, 78(5), 1245-1258.
Guo, P., Li, P., Zhang, X., Liu, N., Wang, J., Yang, S., ... & Zhang, W. (2020). The effectiveness of aromatherapy on preoperative anxiety in adults: A systematic review and meta-analysis of randomized controlled trials. International Journal of Nursing Studies, 111, 103747. https://doi.org/10.1016/j.ijnurstu.2020.103747
Hashemzadeh, K., & Dehdilani, M. (2022). The effect of aromatherapy on anxiety in patients before coronary artery bypass graft surgery. International Journal of New Chemistry, 9(4). Doi: 10.22034/ijnc.2022.4.13
Haskins, S. C., Bronshteyn, Y., Perlas, A., El-Boghdadly, K., Zimmerman, J., Silva, M., ... & Narouze, S. (2021). American Society of Regional Anesthesia and Pain Medicine expert panel recommendations on point-of-care ultrasound education and training for regional anesthesiologists and pain physicians—part I: clinical indications. Regional Anesthesia & Pain Medicine, 46(12), 1031-1047. https://doi.org/10.1136/rapm-2021-102560
Hawkins, J., Hires, C. Y., Dunne, E. W., & Keenan, L. A. (2020). Aromatherapy reduces fatigue among women with hypothyroidism: A randomized placebo-controlled clinical trial. Journal of Complementary and Integrative Medicine, 17(1). https://doi.org/10.1515/jcim-2018-0229
Herz, R. S. (2016). The role of odor-evoked memory in psychological and physiological health. Brain sciences, 6(3), 22. https://doi.org/10.3390/brainsci6030022
Huang, H., Wang, Q., Guan, X., Zhang, X., Kang, J., Zhang, Y., ... & Li, X. (2021). Effect of aromatherapy on preoperative anxiety in adult patients: A meta-analysis of randomized controlled trials. Complementary therapies in clinical practice, 42, 101302. https://doi.org/10.1016/j.ctcp.2021.101302
Jo Kreitzer, M., Koithan, M., Sullivan, S. D., Nunez, M., & Voss, M. (2022). Integrative nursing and the ANA scope and standards of practice: expanding the reach of nursing for families and society. Creative Nursing, 28(4), 228-233. https://doi.org/10.1891/CN-2022-0041
Kaptchuk, T. J. (2018). Open-label placebo: reflections on a research agenda. Perspectives in biology and medicine, 61(3), 311-334. https://doi.org/10.1353/pbm.2018.0045
Kaptchuk, T. J., Hemond, C. C., & Miller, F. G. (2020). Placebos in chronic pain: evidence, theory, ethics, and use in clinical practice. bmj, 370. https://doi.org/10.1136/bmj.m1668
Lakhan, S. E., Sheafer, H., & Tepper, D. (2016). The effectiveness of aromatherapy in reducing pain: A systematic review and meta‐analysis. Pain research and treatment, 2016(1), 8158693. https://doi.org/10.1155/2016/8158693
Laufenberg-Feldmann, R., Kappis, B., Cámara, R. J., & Ferner, M. (2018). Anxiety and its predictive value for pain and regular analgesic intake after lumbar disc surgery-a prospective observational longitudinal study. BMC psychiatry, 18(1), 82. https://doi.org/10.1186/s12888-018-1652-8
Lindquist, R., Tracy, M. F., & Snyder, M. (Eds.). (2018). Complementary and alternative therapies in nursing. Springer Publishing Company.
Mirhosseini, S., Abbasi, A., Norouzi, N., Mobaraki, F., Basirinezhad, M. H., & Mohammadpourhodki, R. (2021). Effect of aromatherapy massage by orange essential oil on post-cesarean anxiety: a randomized clinical trial. Journal of Complementary and Integrative Medicine, 18(3), 579-583. https://doi.org/10.1515/jcim-2020-0138
Moayedi, M., & Davis, K. D. (2013). Theories of pain: from specificity to gate control. Journal of neurophysiology, 109(1), 5-12. https://doi.org/10.1152/jn.00457.2012
Mohammadi-Dashtaki, R., Heidari-Soureshjani, S., & Sherwin, C. M. (2023). The Effect of Inhalation Aromatherapy on Patients with Cardiovascular Disease Seeking Pain Relief: A Systematic Review and Meta-analysis. Current Drug Therapy, 18(3), 262-270. https://doi.org/10.2174/1574885518666230217141950
Munday, J., Higgins, N., Mathew, S., Dalgleish, L., Batterbury, A. S., Burgess, L., ... & Coyer, F. (2020). Nurse-led randomized controlled trials in the perioperative setting: A scoping review. Journal of Multidisciplinary Healthcare, 647-660. https://doi.org/10.2147/JMDH.S255785
Reis, D., & Jones, T. (2017). Aromatherapy: using essential oils as a supportive therapy. Clinical journal of oncology nursing, 21(1), 16-20.
Saritaş, S., Kavak, F., & Savaş, B. (2018). The effect of lavender oil on anxiety levels of patients before laparoscopic cholecystectomy. Complementary Therapies in Clinical Practice, 32, 51-54. https://doi.org/10.1016/j.ctcp.2018.05.003
Tadesse, M., Ahmed, S., Regassa, T., Girma, T., Hailu, S., Mohammed, A., & Mohammed, S. (2022). Effect of preoperative anxiety on postoperative pain on patients undergoing elective surgery: Prospective cohort study. Annals of medicine and surgery, 73, 103190. https://doi.org/10.1016/j.amsu.2021.103190
Weaver, C., Yackzan, S., Herron, R., Nettro, A., & Davies, C. (2021). Essential oil use with breast imaging a pilot study. Journal of Holistic Nursing, 39(2), 108-115. https://doi.org/10.1177/0898010120939719
Zhang, P., Liao, X., Yuan, Q., Lyu, F., & Xie, S. (2023). Effect of aromatherapy on postoperative pain relief: A systematic review and meta-analysis of randomized controlled trials. European Journal of Integrative Medicine, 62, 102289. https://doi.org/10.1016/j.eujim.2023.102289
Authors
Copyright (c) 2024 Sultan Dughaylib Almutairi, Marwan Saad Altokhais, Saud Nasser Alotaibi, Abdullah Rashed Al-Humyani, Abdulhamid Ali Hassan Alfaify, Gadeer Mesfer Alqahtani, Danah Abduaziz Bin Kasmoul

This work is licensed under a Creative Commons Attribution 4.0 International License.
