Kim Jung T, Ren Christine J, Fielding George A, Pitti Abhishek, Kasumi Takeo, Wajda Michael, Lebovits Allen, Bekker Alex
Department of Anesthesiology, New York University Medical Center, New York, NY 10016, USA.
Obes Surg. 2007 Jul;17(7):920-5. doi: 10.1007/s11695-007-9170-7.
Parenteral administration of opioids and NSAIDs has been the mainstay for postoperative pain control in patients undergoing laparoscopic adjustable gastric banding (LAGB). Both classes of drugs, however, are associated with serious adverse effects. An addition of complimentary analgesic techniques may decrease requirement for traditional analgesics, thus reducing the incidence of side-effects. We designed the study to evaluate the effectiveness of Lavender aromatherapy in reducing opioid requirements after LAGB.
A prospective randomized placebo controlled study was carried out on 54 patients undergoing LAGB. Upon arrival to the post-anesthesia care unit (PACU), patients in the study group were treated with lavender oil, which was applied to the oxygen face mask; the control group patients received nonscented baby oil. Postoperative pain was treated with morphine. Numerical rating scores (0-10) were used to measure the level of pain at 5, 30, and 60 min. Sedation was evaluated using the Observer Assessment of Alertness/Sedation scale (0-5). Data analyzed included the amount of opioids, NRS, OAA/S, PACU discharge time, as well as the incidence of side-effects.
The two groups were comparable with regard to patient characteristics, intraoperative drug use, and surgical time. Significantly more patients in the Placebo group (PL) required analgesics for postoperative pain (22/27, 82%) than patients in the Lavender group (LAV) (12/26, 46%) (P = .007). Moreover, the LAV patients required significantly less morphine postoperatively than PL patients: 2.38 mg vs 4.26 mg, respectively (P = .04). There were no differences in the requirements for post-operative antiemetics, antihypertensives, or PACU discharge time.
Our results suggest that lavender aromatherapy can be used to reduce the demand for opioids in the immediate postoperative period. Further studies are required to assess the effect of this therapy on clinically meaningful outcomes, such as the incidence of respiratory complications, delayed gastric emptying, length of hospital stay, or whether this therapy is applicable to other operations.
对于接受腹腔镜可调节胃束带术（LAGB）的患者，胃肠外给予阿片类药物和非甾体抗炎药一直是术后疼痛控制的主要手段。然而，这两类药物都伴有严重的不良反应。增加辅助镇痛技术可能会减少对传统镇痛药的需求，从而降低副作用的发生率。我们设计了这项研究，以评估薰衣草芳香疗法在减少LAGB术后阿片类药物需求方面的有效性。
对54例接受LAGB的患者进行了一项前瞻性随机安慰剂对照研究。到达麻醉后护理单元（PACU）后，研究组患者使用薰衣草油治疗，将其涂抹在氧气面罩上；对照组患者使用无香味的婴儿油。术后疼痛采用吗啡治疗。采用数字评分量表（0 - 10分）测量5分钟、30分钟和60分钟时的疼痛程度。使用观察者警觉/镇静评估量表（0 - 5分）评估镇静情况。分析的数据包括阿片类药物用量、数字评分量表、警觉/镇静评估量表、PACU出院时间以及副作用的发生率。
两组在患者特征、术中用药和手术时间方面具有可比性。安慰剂组（PL）中需要术后镇痛的患者（22/27，82%）明显多于薰衣草组（LAV）（12/26，46%）（P = 0.007）。此外，LAV组患者术后所需吗啡量明显少于PL组患者：分别为2.38毫克和4.26毫克（P = 0.04）。术后止吐药、降压药的需求或PACU出院时间没有差异。
我们的结果表明，薰衣草芳香疗法可用于减少术后即刻对阿片类药物的需求。需要进一步研究来评估这种疗法对临床有意义结局的影响，如呼吸并发症的发生率、胃排空延迟、住院时间，或者这种疗法是否适用于其他手术。
