Wang Jian-Ying, Huang Hsueh-Yang, Chu Wan-O, Peng Tzu-Rong, Lee Ming-Chia, Chen Shih-Ming, Lee Jen-Ai
Department of Pharmacy, New Taipei City Hospital, New Taipei, Taiwan.
Department of Pharmacy, Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan.
Tzu Chi Med J. 2024 May 24;36(3):330-339. doi: 10.4103/tcmj.tcmj_240_23. eCollection 2024 Jul-Sep.
Postoperative nausea and vomiting (PONV) are common complications following surgical procedures. While drug-based treatments are standard, there is increasing interest in nonpharmacological alternatives, such as aromatherapy, due to potential benefits and minimal side effects. This study aimed to assess the effectiveness of aromatherapy in preventing PONV.
A comprehensive systematic review and meta-analysis were conducted using PubMed, Cochrane Library, EMBASE, and CINAHL databases for studies published up to May 2023. The included studies were randomized controlled trials (RCTs) and nonrandomized studies of interventions that examined the impact of aromatherapy on PONV. The risk of bias was assessed, and the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach was employed to evaluate the certainty of the evidence.
Eleven studies were selected for review, with eight RCTs included in the meta-analysis. Aromatherapy effectively reduced postoperative nausea severity (standardized mean difference [SMD]: -0.93, 95% confidence interval [CI]: -1.64 to -0.22; = 0.010), but the reduction in vomiting episodes was not statistically significant (SMD: -0.81, 95% CI: -1.98-0.37; = 0.180). Subgroup analysis indicated that ginger essence, lavender, and peppermint oils were particularly effective in managing postoperative nausea. However, due to significant statistical heterogeneity and potential biases in the studies, the results should be interpreted with caution. The certainty of the evidence, as evaluated by the GRADE approach, was low.
Preliminary evidence supports the potential benefit of aromatherapy in reducing the severity of postoperative nausea. However, given the low certainty of current evidence, more rigorous and standardized research is needed. The safety, affordability, and potential benefits to patient comfort make aromatherapy a promising area for further research in postoperative care.
术后恶心呕吐（PONV）是外科手术后常见的并发症。虽然基于药物的治疗是标准方法，但由于潜在益处和最小的副作用，人们对非药物替代方法（如芳香疗法）的兴趣日益增加。本研究旨在评估芳香疗法预防PONV的有效性。
使用PubMed、Cochrane图书馆、EMBASE和CINAHL数据库对截至2023年5月发表的研究进行全面的系统评价和荟萃分析。纳入的研究为随机对照试验（RCT）和非随机干预研究，这些研究考察了芳香疗法对PONV的影响。评估了偏倚风险，并采用推荐分级、评估、制定和评价（GRADE）方法来评估证据的确定性。
选择了11项研究进行综述，其中8项RCT纳入荟萃分析。芳香疗法有效降低了术后恶心的严重程度（标准化均值差[SMD]：-0.93，95%置信区间[CI]：-1.64至-0.22；P = 0.010），但呕吐发作次数的减少无统计学意义（SMD：-0.81，95% CI：-1.98至0.37；P = 0.180）。亚组分析表明，姜精油、薰衣草和薄荷油在处理术后恶心方面特别有效。然而，由于研究中存在显著的统计异质性和潜在偏倚，结果应谨慎解释。通过GRADE方法评估，证据的确定性较低。
初步证据支持芳香疗法在降低术后恶心严重程度方面的潜在益处。然而，鉴于当前证据的确定性较低，需要更严格和标准化的研究。芳香疗法的安全性、可承受性以及对患者舒适度的潜在益处使其成为术后护理中一个有前景的进一步研究领域。
