Professional Documents
Culture Documents
Clinical Aromatherapy
by Jane Buckle, PhD RN CCAP, Kathy Ryan, RNC-MNN CCAP and Karen B. Chin, RN MS CCAP
Introduction
Published Evidence
Jasmine
Lavender
Rose
A further study Burns, Zobbi, Panzeri, Oskrochi, and
Regalia (2007) carried out in an Italian maternity unit found
significantly more babies born to control participants were
transferred to NICU than in the aromatherapy group: 0 versus
6 (2%, p = 0.017) (Burns et al., 2007). Pain perception
was also reduced in the aromatherapy group for first time
mothers (Burns et al., 2007).
Nausea
Analgesia
Comfort
Infertility
cine cup. Patient are instructed to close their eyes and take a
long slow inhalation through their nose, repeating as needed.
�
Lavender (Lavandula angustifolia) for relaxation and sleep
�
Bergamot (Citrus bergamia) for an uplifting and refreshing
way to reduce stress
�
Ginger (Zingiber officinalis) to relieve nausea
�
Mandarin (Citrus reticulata) for a gentle, calming effect
�
Peppermint (Mentha pipertia) for nausea, headaches,
fatigue and inability to void
�
Tea Tree (Melaleuca alternifolia) to relieve a stuffy nose
and congestion.
Patients are encouraged to use essential oils simultaneously
with the Skylight guided imagery programs available
through the hospital TV system. Lavender, mandarin, and
peppermint are the essential oils most frequently chosen,
and patients report success in relieving discomfort and
decreasing their stress.
�
Clary Sage, Roman Chamomile, and Lavender - While it
has not been observed to be effective to initiate contractions,
the nurses believe this blend may assist to increase
the strength of existing contractions. Contraindications
include a patient with a uterine scar, hyper stimulated
contractions, or in conjunction with Pitocin or any other
medication used to enhance labor. This is one blend that
is discussed with the patient�s physician before use. Documentation
of physician�s approval is placed in nursing
notes for the use of Clary Sage during labor.
�
Lavender and peppermint blended with fractionated
coconut oil and Epsom salts are added to warm water in a
basin for a refreshing foot-bath. Care partners are encouraged
to massage the patient�s feet at the same time.
�
A �Peace� blend containing Bergamot, Lavender and
Mandarin in fractionated coconut oil can be calming, yet
uplifting, during a long labor.
�
For those experiencing grief after a loss or an unexpected
outcome, spritzers containing various combinations of
Frankincense, Jasmine, Lavender, and Rose in a spray
bottle of water are offered. This can be comforting while
the patient is in the hospital, and their own spray is given
to them for use after discharge.
�
Lavender and Roman Chamomile are mixed with a lotion
and given to the Care Partners to use as a comforting
rub during Labor. One patient wrote to thank her nurse
stating: �The delivery made for a long day but the scent
urinating, over forty years ago!
continued on next page
References
Burns, E. E., Blamey, C., Ersser, S. J., Barnetson, L., & Lloyd, A. J. (2000).
An investigation into the use of aromatherapy in intrapartum midwifery
practice. Journal of Alternative and Complementary Medicine, 6(2),141-147.
Burns, E., Zobbi, V., Panzeri, D., Oskrochi, R., & Regalia, A. (2007).
Aromatherapy in childbirth: A pilot randomized controlled trial. BJOG An
International Journal of Obstetrics and Gynaecology, 114, 838-844.
Conrad, P., & Adams, C. (2012). The effects of clinical aromatherapy for
anxiety and depression in the high risk postpartum woman - A pilot study.
Complementary Therapies in Clinical Practice, 18(3), 164-168.
Dhany, A. (2008). Essential oils and massage in intrapartum care. The Practising
Midwife, 11(5), 34-39.
Dhany, A. L., Mitchell, T., & Foy, C. (2012). Aromatherapy and massage
intrapartum service impact on use of analgesia and anesthesia in women
in labor: A retrospective case note analysis. Journal of Alternative and
Complementary Medicine, 18(10), 932-938. http://dx.doi.org/10.1089/
acm.2011.0254
Duarte, M., Ferriera, S., Silva, F., & Dominigues, F. (2012). Synergistic effect
of coriander oil and conventional antibiotics against Acitenobacter baumannii.
Phytomedicine, 19(3), 236-238.
Ensiyeh, J., & Sakineh, M. (2009). Comparing ginger and vitamin B6 for the
treatment of nausea and vomiting in pregnancy: A randomized, controlled
trial. Midwifery, 25(6), 649-653.
Faas, A., Resino, C., & Moya, P. (2011). Neonatal responsiveness to the odor
of amniotic fluid. Archives in Argent Pediatrics, 111(2), 105-109.
Hines, S., Steels, E., Change, A., & Gibbons, K. (2012). Aromatherapy
for treatment of postoperative nausea and vomiting. Cochrane Database
of Systematic Reviews, 2012(4), 1-52. http://dx.doi.org/10.1002/14651858.
CD007598.pub2
Hunt, R., Dienemann, J., Norton, J., & Hartley, W. (2012). Aromatherapy
as treatment for postoperative nausea. A randomized trial. Anesthesia &
Analgesia, 117(3), 597-604.
Imura, M., Misao, H., & Ushijima, H. (2006). The psychological effects of
aromatherapy-massage in healthy postpartum mothers. Journal of Midwifery
& Women�s Health, 51, e21-e25.
Kaviani, M., Azima, S., Alavi, N., & Tabaei, M. H. (2014). The effect of
lavender aromatherapy on pain perception and intrapartum outcome in
primiparous women. British Journal of Midwifery, 22, 125-128.
Pasha, H., Behmanesh, F., Mohsenzadeh, F., Hajahmadi, M., & Moghadamnia,
A. A. (2012). Iranian Red Crescent Medical Journal, 14(11), 744-747.
Schaal, B., Marlier, L., & Soussignan, R. (2000). Human fetuses learn odors
from their pregnant mother�s diet. Chemical Senses, 20(3), 729-737.
Stevens, J., Dahlen, H., Peters, K., & Jackson, D. (2013). Midwives� and
doulas� perspectives of the role of the doula in Australia: A qualitative study.
Midwifery, 27(4), 509-516.
Tillett, J., & Ames, D. (2010). The uses of aromatherapy in women�s health.
Journal of Perinatal and Neonatal Nursing, 24(3), 238-45.
Tisserand, R., & Young, R. (2013). Essential oil safety. New York, NY:
Churchill Livingstone.
Vakilian, K., Atarha, M., Bekhradi. R., & Chaman, R. (2011). Healing advantages
of lavender essential oil during episiotomy recovery: a clinical trial.
Complementary Therapies in Clinical Practice, 17(1), 50-53
Varney, E., & Buckle, J. (2013). Effect of inhaled essential oils on mental
exhaustion and moderate burnout: A small pilot study. Journal of Alternative
and Complementary Medicine, 19(1), 69-71.
Vermetten, E., Schmahl, C., Southwick, S., & Bremner, J. (2007). Positron
tomographic emission study of olfactory induced emotional recall in veterans
with and without combat-related stress disorder. Psychopharmacology
Bulletin, 40(1), 8-30.
Walls, D. (2009). Herbs and natural therapies for pregnancy, birth and
breastfeeding. International Journal of Childbirth Education, 24, 29-37.
Warnke, P., Lott, A., Sherry, E., & Podschun, R. (2013). The ongoing battle
against multi-resistant strains: in vitro inhibition of hospital-acquired MRSA,
VRE, Pseudomonas, ESBL, E coli and Klebsiella species in the presence of
plant derived antiseptic oils. Journal of Cranio-Maxillofacial Surgery, 41(4),
321-326.
2
Akhil
Bharati
Vidyapeeth
Nursing
Childbirth among Primigravidas College,
Sikar,
Rajasthan,
India
. janular@gmail.com
Background: Labour
pain
is
the
most
severe
form
of
pain
that
every
woman
may
experience
during
intranatal
life.
Severe
pain
makes
stress
response
which
may
lead
to
harmful
effects
on
both
mother
and
her
fetus.
This
study
was
carried
out
Tel: +91 7415159891
to
evaluate
the
effect
of
aromatherapy
and
biofeedback
in
promotion
of
labour
outcome
during
childbirth
among
primigravidas.
Methods: This
clinical
trial
was
performed
on
600
nulliparous
women
selected
randomly
who
were
expected
to
have
a
normal
childbirth.
Cases
were
randomly
assigned
to
Aromatherapy
group
(n=200),
biofeedback
group
(n=200)
groups
and
control
group
(n=200).
The
investigator
rated
the
pain
by
using
visual
pain
analog
scale.
Results: Sixty
Nine
percent
(n=137)
of
cases
in
aroma
massage
group
expressed
it
was
helpful,
provided
pain
relief
and
emotional
wellbeing
during
labour.
Our
findings
suggested,
aromatherapy
was
helpful
in
reduction
of
duration
of
labour
(p<0.0001).
Biofeedback
is
also
an
effective
in
reducing
pain
and
duration
of
labour
during
childbirth
compared
with
the
non-experimental
group.
Conclusion: The
results
of
thispresent
study
indicated
thatthe
useofAromatherapy
and
Biofeedback
were
both
effective
methods
of
reducing
pain
perception
and
duration
of
labour
among
women
during
labor.
Keywords: Aromatherapy;
Biofeedback;
Childbirth;
Labour
pain;
Primigravida
anxiety
and
fear
are
factors
contributing
towards
women�s
Introduction
perception
of
pain
and
may
also
affect
their
labour
and
birth
Childbirth
is
considered
a
life-changing
event
for
most
women
experience.
Pain
associated
with
labour
has
been
described
as
who
are
associated
with
great
risks,
and
in
certain
cases
it
may
one
of
the
most
intense
forms
of
pain
that
can
be
experienced
cause
disability
and
even
death
for
the
mother
or
child
[1].
[4].
Many
women
would
like
to
avoid
invasive
methods
of
According
to
the
World
Bank
report
the
maternal
mortality
pain
management
during
labour
and
this
may
contribute
to
ratio
in
India
was
high
as
200
maternal
deaths
per
100000
live
the
development
of
complementary
or
non-pharmacological
births
in
2013
[2].
Maternal
mortality
ratio
(MMR)
is
defined
methods
for
pain
management.
This
study
examined
the
use
of
as
the
death
of
a
woman
while
pregnant
or
within
42
days
of
aromatherapy
and
biofeedback
as
non-pharmacological
methods
termination
of
pregnancy
and
is
received
by
dividing
the
number
for
pain
management
in
labour
[5].
of
maternal
deaths
per
100
000
live
births.Women
with
adequate
In
aromatherapy
therapy,
essential
oils
from
plants
were
psychological
support
and
relaxation
techniques
had
reduced
the
massaged
in
the
skin,
in
a
form
of
bath
or
inhalation
using
a
incidence
of
caesarean
section.
Relaxation
techniques,
mainly
steam
or
burner.
Literature
revealed
that
essential
oils
were
used
breathing
exercises,
had
brought
50%
reduction
in
caesarean
to
heal
various
ailments
by
therapeutically
stimulating
the
nasal/
section
for
psychological
indications
[3].
olfactory
senses
(smell)
via
mental
responses,
circulatory
and
During
labour
conflicting
emotions
are
present;
fear
and
unease
respiratory
functions.
Moreover
it
enhances
physical
and
mental
that
can
be
coupled
with
anticipation
and
gladness.
Tension,
wellbeing
of
patients
[6].
Biofeedback
or
biological
feedback
2This article is available in: www.hsj.gr/archive
ARCHIVOS DE MEDICINA
ISSN 1698-9465
2015
Vol. 9 No. 1:9
Health Science Journal
ISSN 1791-
809Xencompassesatherapeutictechniquewhereanindividualwillbetrainedtoimprovetheirown
healthandwellbeingthroughsignalscomingfromthirownbodies(temperature,heartrate,
musculartension,etc.)
[7].Theunderlyingprincipleisthatchangesinthoughtsandemotionsmayresultinchangesinbod
yfunctioning.Thepresentstudywascarriedouttocomparethereductionofpainanddurationofla
bourbetweenthearomatherapytherapyandbiofeedbacktherapygropduringchildbirthamongprim
igravidas.
Method and Material
ThedatacollectionwasdonefromDec2012toSep2013atselectedhospitalsinCoimbatoreDist,Tam
ilNadu,SouthIndia.
Inclusioncriteriacomprisedonlynulliparouswomen,withasingletonpregnancyofgestationag
e>36weeks,singletonpregnancywithcephalicpresentation,cervicaldilatation=4cmandhavin
gthreeuterinecontractionsin10minutesatleastwithadurationof30seconds.Exclusioncriter
iaincluded,thirdtrimesterbleeding,intrauterinefetalgrowthretardation,multiplepregna
ncy,breechpresentation,beingathletic,addiction(alcoholandcigarettes),usinganalgesic
during3hoursbeforeandduringtheintervention,theuseofsedativedrugs,historyofinfertili
ty,
allergictolavenderoilduringskintest.
Thiswasapost-
testonlyexperimentalgroupdesign.Informationwasgatheredintheformofashortquestionnair
etoelicitmaternalfeedbackaboutreceiving&administeringtheexperiment.Afterexplanation
andobtainingwrittenconsentofwomen,theywererandomlyassignedtothreegroups:
Group 1 Aromatherapy application
Theoilusedforaromatherapywaslavenderoilandwasappliedbymassageduringlabourbytheinves
tigator.Beforethetherapy,
skinallergieswerecheckedbyconductingapatchtestontheskin.Randomlyselectedsubjects(n=
200)receivedaromatherapywhereoilwasappliedoverthebackandabdomenwithaslightmassage.T
hemassagewascontinuedtilltheendoffirststageoflabour.8
ThepainwasassessedinLatentphase,activephaseandtransitionalphase.Routineintrapartumc
arealsogivenforthemotherbythemidwives[9,10].Nofamilymemberswereinvolvedinthisstudy.
Group 2 Biofeedback application
Theinvestigatorpersonallyexplainedthepurposeofthestudywiththerandomlyselectedsubjec
t(n=200).Cardiotokograph,
anelectronicmachinewasusedforbiofeedbackstudy.Inthis,
motheraskedtoexperiencebothfetalheartsoundandvariationinuterinecontractions.Ithelpe
dhertoconsciouslyregulatebothpsychologicalandphysicalprocesses,suchaspain,whichwere
notusuallyunderconsciouscontrol[5].ThepainwasassessedinLatentphase,activephaseandtr
ansitionalphase.Theroutineintrapartumcarealsogivenforthemotherbythemidwives.Nofamil
ymemberswereinvolvedinthisstudy.NeonataloutcomedataincludedAPGARscoresat1and5minute
.
Group 3 Control group (n=200)
Receivedonlyroutineinterventionsaccordingtohospitalpolicies.
Theroutinecarewasgivenbythemidwivesandtheinvestigatorhasrecordedthepainintensitylev
elanddurationoflabouraslikeexperimentalgroup
Ethical Considerations
ThistrialwasapprovedbytheResearchEthicsCommittee(Protocolno:2013/PhDN/KG/006)ofconc
ernedselectedhospitalinCoimbatore,India.Womencompletedinformedwrittenconsentform.Ea
chwomanwasassignedanIDcode,ensuringdatasetanonymity.Womencouldwithdrawfromthestudya
tanypoint.
Limitations of the Study
Thestudywaslimitedtoprimigravidamothersonlywithtwovariableslikepainanddurationoflab
our.Thestudywasconductedinfewteachinghospitalsinthecity.
Results
Theresultsofthepresentstudyarebasedonthefindingsobtainedfromstatisticalanalysisofco
llecteddata.Thewomenunderstudywereprimigravidas.Majorityofmothersunderstudywerehada
gebetween21-25yrs(41%inaromatherapygroup,
48%inBiofeedbackgroupand46%inControlgroup).Mostofthemotherswerethehousewifeinallthr
eegroups50%,53%and53%-
aromatherapygroup,BiofeedbackgroupandControlgrouprespectively.Remainingmothersweret
hecoolie,technicalandprofessionalworkers.
Inthisstudythemeanpainscore(Table1)foraromatherapygroupandbiofeedbackwasreducedwhen
comparedwithcontrolgroup.Similarlythemeanlengthofdurationoflabouralsoreducedinfirst
stageandSecondstageoflabour(Table2).
But�t�testdemonstratedthattherewasasignificantdifferencebetweenaromatherapyandbiofe
edbackgroupinpainscore(Table3)duringlatentphase,activephaseandtransitionalphase.
Whenconsideringthelengthoflabouritwasfoundsignificantdifferencebetweenaromatherapya
ndbiofeedbackgroupinfirststageoflabour(p<0.0001).Butnodifference(Table4)werefoundin
secondandthirdstageoflabour(p=0.0518,p=1.000respectively).Theassociationoffindingsw
ithdemographicandobstetricalscorewasassessedbyusingchi-
squaretest.Itwasreportedthatbodymassindex(.2=35.8),natureofonsetoflabourpain(.2=6.9
),analgesics(.2=43.7),andhistoryofdysmenorrhea(.2=43.7)werehavingassociationwithlab
ourpain(Table5).Butnatureofconception(.2=0.011)andregularantenatalcheckup(.2=3.15)i
snothavingassociationwithlabourpain.
Table 1 MeanandstandarddeviationofpainscoreTime of Assessment
Aromatherapy Group Control group Biofeedback Group
Mean SD Mean SD Mean SD
Latentphase6.20.138.60.57.80.15Activephase7.50.219.00.348.2
0.19Transitionalphase8.30.479.60.219.20.01
This article is available in: www.hsj.gr/archive
ARCHIVOS DE MEDICINA
ISSN 1698-9465
2015
Vol. 9 No. 1:9
Health Science Journal
ISSN 1791-
809Xencompassesatherapeutictechniquewhereanindividualwillbetrainedtoimprovetheirown
healthandwellbeingthroughsignalscomingfromthirownbodies(temperature,heartrate,
musculartension,etc.)
[7].Theunderlyingprincipleisthatchangesinthoughtsandemotionsmayresultinchangesinbod
yfunctioning.Thepresentstudywascarriedouttocomparethereductionofpainanddurationofla
bourbetweenthearomatherapytherapyandbiofeedbacktherapygropduringchildbirthamongprim
igravidas.
Method and Material
ThedatacollectionwasdonefromDec2012toSep2013atselectedhospitalsinCoimbatoreDist,Tam
ilNadu,SouthIndia.
Inclusioncriteriacomprisedonlynulliparouswomen,withasingletonpregnancyofgestationag
e>36weeks,singletonpregnancywithcephalicpresentation,cervicaldilatation=4cmandhavin
gthreeuterinecontractionsin10minutesatleastwithadurationof30seconds.Exclusioncriter
iaincluded,thirdtrimesterbleeding,intrauterinefetalgrowthretardation,multiplepregna
ncy,breechpresentation,beingathletic,addiction(alcoholandcigarettes),usinganalgesic
during3hoursbeforeandduringtheintervention,theuseofsedativedrugs,historyofinfertili
ty,
allergictolavenderoilduringskintest.
Thiswasapost-
testonlyexperimentalgroupdesign.Informationwasgatheredintheformofashortquestionnair
etoelicitmaternalfeedbackaboutreceiving&administeringtheexperiment.Afterexplanation
andobtainingwrittenconsentofwomen,theywererandomlyassignedtothreegroups:
Group 1 Aromatherapy application
Theoilusedforaromatherapywaslavenderoilandwasappliedbymassageduringlabourbytheinves
tigator.Beforethetherapy,
skinallergieswerecheckedbyconductingapatchtestontheskin.Randomlyselectedsubjects(n=
200)receivedaromatherapywhereoilwasappliedoverthebackandabdomenwithaslightmassage.T
hemassagewascontinuedtilltheendoffirststageoflabour.8
ThepainwasassessedinLatentphase,activephaseandtransitionalphase.Routineintrapartumc
arealsogivenforthemotherbythemidwives[9,10].Nofamilymemberswereinvolvedinthisstudy.
Group 2 Biofeedback application
Theinvestigatorpersonallyexplainedthepurposeofthestudywiththerandomlyselectedsubjec
t(n=200).Cardiotokograph,
anelectronicmachinewasusedforbiofeedbackstudy.Inthis,
motheraskedtoexperiencebothfetalheartsoundandvariationinuterinecontractions.Ithelpe
dhertoconsciouslyregulatebothpsychologicalandphysicalprocesses,suchaspain,whichwere
notusuallyunderconsciouscontrol[5].ThepainwasassessedinLatentphase,activephaseandtr
ansitionalphase.Theroutineintrapartumcarealsogivenforthemotherbythemidwives.Nofamil
ymemberswereinvolvedinthisstudy.NeonataloutcomedataincludedAPGARscoresat1and5minute
.
Group 3 Control group (n=200)
Receivedonlyroutineinterventionsaccordingtohospitalpolicies.
Theroutinecarewasgivenbythemidwivesandtheinvestigatorhasrecordedthepainintensitylev
elanddurationoflabouraslikeexperimentalgroup
Ethical Considerations
ThistrialwasapprovedbytheResearchEthicsCommittee(Protocolno:2013/PhDN/KG/006)ofconc
ernedselectedhospitalinCoimbatore,India.Womencompletedinformedwrittenconsentform.Ea
chwomanwasassignedanIDcode,ensuringdatasetanonymity.Womencouldwithdrawfromthestudya
tanypoint.
Limitations of the Study
Thestudywaslimitedtoprimigravidamothersonlywithtwovariableslikepainanddurationoflab
our.Thestudywasconductedinfewteachinghospitalsinthecity.
Results
Theresultsofthepresentstudyarebasedonthefindingsobtainedfromstatisticalanalysisofco
llecteddata.Thewomenunderstudywereprimigravidas.Majorityofmothersunderstudywerehada
gebetween21-25yrs(41%inaromatherapygroup,
48%inBiofeedbackgroupand46%inControlgroup).Mostofthemotherswerethehousewifeinallthr
eegroups50%,53%and53%-
aromatherapygroup,BiofeedbackgroupandControlgrouprespectively.Remainingmothersweret
hecoolie,technicalandprofessionalworkers.
Inthisstudythemeanpainscore(Table1)foraromatherapygroupandbiofeedbackwasreducedwhen
comparedwithcontrolgroup.Similarlythemeanlengthofdurationoflabouralsoreducedinfirst
stageandSecondstageoflabour(Table2).
But�t�testdemonstratedthattherewasasignificantdifferencebetweenaromatherapyandbiofe
edbackgroupinpainscore(Table3)duringlatentphase,activephaseandtransitionalphase.
Whenconsideringthelengthoflabouritwasfoundsignificantdifferencebetweenaromatherapya
ndbiofeedbackgroupinfirststageoflabour(p<0.0001).Butnodifference(Table4)werefoundin
secondandthirdstageoflabour(p=0.0518,p=1.000respectively).Theassociationoffindingsw
ithdemographicandobstetricalscorewasassessedbyusingchi-
squaretest.Itwasreportedthatbodymassindex(.2=35.8),natureofonsetoflabourpain(.2=6.9
),analgesics(.2=43.7),andhistoryofdysmenorrhea(.2=43.7)werehavingassociationwithlab
ourpain(Table5).Butnatureofconception(.2=0.011)andregularantenatalcheckup(.2=3.15)i
snothavingassociationwithlabourpain.
Table 1 MeanandstandarddeviationofpainscoreTime of Assessment
Aromatherapy Group Control group Biofeedback Group
Mean SD Mean SD Mean SD
Latentphase6.20.138.60.57.80.15Activephase7.50.219.00.348.2
0.19Transitionalphase8.30.479.60.219.20.01
Table 2 Mean
and
standard
deviation
of
Duration
of
labour
Table 3 Comparison
of
Pain
score
between
aromatherapy
and
biofeedback
group
Table 4 Comparison
of
Duration
of
labour
between
aromatherapy
and
biofeedback
group
Table 5 Association
of
Pain
score
with
selected
obstetrical
variable
Individual
reviews
showed
that
there
is
no
significant
difference
between
aromatherapy
group
and
Biofeedback
Group.
Although
morewomeninaromatherapygroupweresatisfiedwithpainrelief
(p=0.6443)
and
caesarean
section
(p=0.0304)
was
reduced
(Table
6).
No
women
in
either
group
had
a
postpartum
haemorrhage
(p=1.000).
The
findings
of
the
study
were
concluded
that
aroma
therapy
and
biofeedback
were
found
effective
when
compared
with
control
group.
S.
No.
Selected
obstetrical
variables
Pain
score
Value
of
.2
P
value
At
5%
Level
of
significance
Result
Below
Median
Above
Median
1.
Quetelet�s
Body
mass
index
a) <
24
b) =
24
132
183
189
96
35.8401
0.
S
2.
Nature
of
onset
of
labour
pain
a) Spontaneous
b) Induced
181
134
133
152
6.9879
0.008206
S
3.
Nature
of
conception
a) Assisted
b) Natural
05
285
05
305
0.0113
0.915298
NS
4.
Analgesics
given
a) Yes
b) No
225
75
30
270
259.335.
0.
S
5
History
of
Dysmenorrhea
a) Yes
b) No
53
142
175
130
43.7265
0
S
6
Regular
antenatal
check
up
a)Yes
b)No
138
152
170
140
3.1547
0.07571
NS
Discussion
This
study
has
evaluated
the
effectiveness
of
aromatherapy
and
biofeedback
in
reduction
of
pain
and
duration
of
labour
during
childbirth.
Overall
there
was
a
slight
difference
between
aroma
therapy
and
biofeedback
therapy.
But
when
compared
with
aroma
therapy
there
was
a
limited
pain
reduction
in
biofeedback
therapy.
However
biofeedback
therapy
also
found
effective
when
compared
with
control
group.
Duchene,
1998
reported
that
4This article is available in: www.hsj.gr/archive
ARCHIVOS DE MEDICINA
ISSN 1698-9465
2015
Vol. 9 No. 1:9
Health Science Journal
ISSN 1791-
809Xwomenwhopracticedbiofeedback,hadsignificantreductioninlaborpainaccordingtotheMc
GillPainQuestionnairescaleandalsoreductionindurationoflabour[10].
Aromatherapyisacosteffectivenonpharmacologicalpainreliefmethod.Thepresentstudyshowe
dthat,aromatherapywaseffectiveinreductionofpainanddurationoflabour.Nomaternalandneo
nataladverseeffectswereassociatedwitharomatherapy.
Themajorityofwomenreportedsatisfactionabouttheirlabourexperience.Toconfirmthis,Chan
getal.,
[11]demonstratedastudyinwhicharomatherapymassagewaseffectiveonpainreductionandallev
iationoffearduringlabor.Ourfindingalsoshowedthatmeanpainintensityinfirststageoflabo
rwasreducedwhencomparingwithnon-
experimentalgroup.ItwasalsosupportedbyanotherstudyconductedbyBurnsetal.,[12]
where,theyconcludedthataromatherapywasusefultorelievepainandalsostrengthentheuterin
econtractionsduringlabor.
TherecentstudybyAbbaspoor,
[13]alsoconfirmedthat,lavenderoilmassagewasacosteffectiveinterventionduringchildbir
thtodecreasepainanddurationoflabourduringthefirstandsecondstageoflbour.SimilarlyJen
nings[14]reportedthatlavenderoilpromotesrelaxation,anditmaygivesootheeffecttotheski
nandstimulatethenerveendingswhenapplyinglikeamassage.
Lavendermassageusedinaromatherapycanreducethepainduringfirststageoflaboranditcanred
uceawiderangeofworstlabouroutcomes.Aromatherapyisanalternativetreatmentduringlabour
inreductionofpain,insteadofusingpharmacologicalmethodsofpainrelievers[15].However,t
hefinalresultofourstudyalsoshowedthataromatherapywasmoreusefulthanbiofeedbacktherap
yanditwascomparedwithcontrolgroup.Aresearchstudyreportedthatlinaloolwhichispresenti
nlavenderoilishavingsedativeandlocalanestheticeffect.Thisconstituentmayreducetheper
ceptionoflabourpain.Italsoincreasethesecretionofepinephrinewhichmayresponsibleforth
ereductionofpainperceptionbythemother[16].
Biofeedbackisalsoavaluabletoolinreductionoflabourpainwhichfacilitatespsychologicali
nterventionsthataiddevelopinggreaterskillsfocopingandimprovedfunctioningonmeasureso
fpainintensity,adaptivebeliefsaboutpainandthelevelofdepression[17].Duringbiofeedbac
ktherapy,electrodeswereattachedtothepatient'sskin,whichsendsdatatoascrutinizingcart
on.Thebiofeedbacktherapistreadsthedimensionsandthroughtrialanderrorsignalsoutmental
undertakingsthathelpstonormalizethepatient'swhoebodyprocesses[18].
Giardinoetal.,
[19]statedthat,biofeedbackistomakeapersonwhoisinananxiousstatetobecomeawareofthephy
siologicalchangesandsledsmanipulatetobeinarelaxedstate.Sutartoetal.,
[20]examinedtheeffectofresonantbreathingbiofeedbackteachingfordecreasingstressamong
constructingoperators.
Outcomesdemonstratedthatdespondency,anxiety,andstresssignificantlydeclinedafterthet
raininginexperimentalgroup.Moreoverwhenusedasanadjuncttoothertherapeuticinterventio
nsitshownasaneffectivetreatmentforreducingoreliminatingsymptomsofseverapain-
relatedconditions,
includinglowbackpain[21].Asanon-
pharmacologicalnursingintervention,biofeedbacktherapyiseasytoadminister,costeffecti
ve,harmless,doesnotrequiremuchtraining,anditisappealingtothemother[22].Thepresentst
udyresultsshowedthatbiofeedbacktherapyalsoagoodandeffectivenonpharmacologicalmethod
forreductionofpainanddurationoflborwhencomparedwithcontrolgroupwhereas,whencompared
witharomatherapy,ithaslesssignificanteffectsonthe both variables.
Conclusion
Theresultsofthispresentstudysuggesttheuseofaromatherapyandbiofeedbackasaneffectivem
ethodofreducingpainperceptionanddurationoflaouramongwomenduringlabor.
Asanon-
pharmacologicalnursingintervention,theseareeasytoadminister,costeffective,harmless,
donotrequiremoretraining,
andappealingtothemother.Thisinterventionmaybeusedbyhealthcarepractitioners(midwives
,medicalandnursingstaff,
studentnurses)aspartoftheirroutinewhenprovidingcarewithwomenduringthelaborprocess.
Acknowledgements
Wesincerelythankallwomenwhogaveconsentandparticipatedinthisstudy.
Declarations
Funding: NofundingsourcesCompeting interests:
Therearenocompetingintereststodeclare.
Ethical approval: ThestudywasapprovedbytheInstitutionalethicscommittee.
Table 6 Resultsbyindividualreview-AromatherapytherapyversusBiofeedbackgroupOutcome
No of women in Aromatherapy
Group (n=200)
No of women in Biofeedback
Group (n=200))
RR95%CI p value
Positive
outcome
Negative
outcome
Positive
outcome
Negative
outcome
Painintensity15248148521.02700.9171to1.15010.6443Satisfactionwithpainrelief14852150
500.97370.8695to1.09040.6443Satisfactionwithhildbirthexperience13763135651.01480.88
71to1.16090.8303Assistedvaginalbirth12575130700.96150.8294to1.11480.6032Caesareanse
ction7822
180201.09091.0083to1.18030.0304Adverseeffectforwomen(PPH)20000200001.0000.9903to1.0
0981.000Postnataldepression1901018911
1.04420.9873to1.10430.1300Adverseeffectofinfants17822
180201.00530.9600to1.05280.8226APGARScore<7atfirst5minute17921 17228
1.04070.9671to1.11990.2865
This article is available in: www.hsj.gr/archive
ARCHIVOS DE MEDICINA
ISSN 1698-9465
2015
Vol. 9 No. 1:9
Health Science Journal
ISSN 1791-
809Xwomenwhopracticedbiofeedback,hadsignificantreductioninlaborpainaccordingtotheMc
GillPainQuestionnairescaleandalsoreductionindurationoflabour[10].
Aromatherapyisacosteffectivenonpharmacologicalpainreliefmethod.Thepresentstudyshowe
dthat,aromatherapywaseffectiveinreductionofpainanddurationoflabour.Nomaternalandneo
nataladverseeffectswereassociatedwitharomatherapy.
Themajorityofwomenreportedsatisfactionabouttheirlabourexperience.Toconfirmthis,Chan
getal.,
[11]demonstratedastudyinwhicharomatherapymassagewaseffectiveonpainreductionandallev
iationoffearduringlabor.Ourfindingalsoshowedthatmeanpainintensityinfirststageoflabo
rwasreducedwhencomparingwithnon-
experimentalgroup.ItwasalsosupportedbyanotherstudyconductedbyBurnsetal.,[12]
where,theyconcludedthataromatherapywasusefultorelievepainandalsostrengthentheuterin
econtractionsduringlabor.
TherecentstudybyAbbaspoor,
[13]alsoconfirmedthat,lavenderoilmassagewasacosteffectiveinterventionduringchildbir
thtodecreasepainanddurationoflabourduringthefirstandsecondstageoflbour.SimilarlyJen
nings[14]reportedthatlavenderoilpromotesrelaxation,anditmaygivesootheeffecttotheski
nandstimulatethenerveendingswhenapplyinglikeamassage.
Lavendermassageusedinaromatherapycanreducethepainduringfirststageoflaboranditcanred
uceawiderangeofworstlabouroutcomes.Aromatherapyisanalternativetreatmentduringlabour
inreductionofpain,insteadofusingpharmacologicalmethodsofpainrelievers[15].However,t
hefinalresultofourstudyalsoshowedthataromatherapywasmoreusefulthanbiofeedbacktherap
yanditwascomparedwithcontrolgroup.Aresearchstudyreportedthatlinaloolwhichispresenti
nlavenderoilishavingsedativeandlocalanestheticeffect.Thisconstituentmayreducetheper
ceptionoflabourpain.Italsoincreasethesecretionofepinephrinewhichmayresponsibleforth
ereductionofpainperceptionbythemother[16].
Biofeedbackisalsoavaluabletoolinreductionoflabourpainwhichfacilitatespsychologicali
nterventionsthataiddevelopinggreaterskillsfocopingandimprovedfunctioningonmeasureso
fpainintensity,adaptivebeliefsaboutpainandthelevelofdepression[17].Duringbiofeedbac
ktherapy,electrodeswereattachedtothepatient'sskin,whichsendsdatatoascrutinizingcart
on.Thebiofeedbacktherapistreadsthedimensionsandthroughtrialanderrorsignalsoutmental
undertakingsthathelpstonormalizethepatient'swhoebodyprocesses[18].
Giardinoetal.,
[19]statedthat,biofeedbackistomakeapersonwhoisinananxiousstatetobecomeawareofthephy
siologicalchangesandsledsmanipulatetobeinarelaxedstate.Sutartoetal.,
[20]examinedtheeffectofresonantbreathingbiofeedbackteachingfordecreasingstressamong
constructingoperators.
Outcomesdemonstratedthatdespondency,anxiety,andstresssignificantlydeclinedafterthet
raininginexperimentalgroup.Moreoverwhenusedasanadjuncttoothertherapeuticinterventio
nsitshownasaneffectivetreatmentforreducingoreliminatingsymptomsofseverapain-
relatedconditions,
includinglowbackpain[21].Asanon-
pharmacologicalnursingintervention,biofeedbacktherapyiseasytoadminister,costeffecti
ve,harmless,doesnotrequiremuchtraining,anditisappealingtothemother[22].Thepresentst
udyresultsshowedthatbiofeedbacktherapyalsoagoodandeffectivenonpharmacologicalmethod
forreductionofpainanddurationoflborwhencomparedwithcontrolgroupwhereas,whencompared
witharomatherapy,ithaslesssignificanteffectsonthe both variables.
Conclusion
Theresultsofthispresentstudysuggesttheuseofaromatherapyandbiofeedbackasaneffectivem
ethodofreducingpainperceptionanddurationoflaouramongwomenduringlabor.
Asanon-
pharmacologicalnursingintervention,theseareeasytoadminister,costeffective,harmless,
donotrequiremoretraining,
andappealingtothemother.Thisinterventionmaybeusedbyhealthcarepractitioners(midwives
,medicalandnursingstaff,
studentnurses)aspartoftheirroutinewhenprovidingcarewithwomenduringthelaborprocess.
Acknowledgements
Wesincerelythankallwomenwhogaveconsentandparticipatedinthisstudy.
Declarations
Funding: NofundingsourcesCompeting interests:
Therearenocompetingintereststodeclare.
Ethical approval: ThestudywasapprovedbytheInstitutionalethicscommittee.
Table 6 Resultsbyindividualreview-AromatherapytherapyversusBiofeedbackgroupOutcome
No of women in Aromatherapy
Group (n=200)
No of women in Biofeedback
Group (n=200))
RR95%CI p value
Positive
outcome
Negative
outcome
Positive
outcome
Negative
outcome
Painintensity15248148521.02700.9171to1.15010.6443Satisfactionwithpainrelief14852150
500.97370.8695to1.09040.6443Satisfactionwithhildbirthexperience13763135651.01480.88
71to1.16090.8303Assistedvaginalbirth12575130700.96150.8294to1.11480.6032Caesareanse
ction7822
180201.09091.0083to1.18030.0304Adverseeffectforwomen(PPH)20000200001.0000.9903to1.0
0981.000Postnataldepression1901018911
1.04420.9873to1.10430.1300Adverseeffectofinfants17822
180201.00530.9600to1.05280.8226APGARScore<7atfirst5minute17921 17228
1.04070.9671to1.11990.2865
References
1
Sharron
SH
(2006)
The
Life-Changing
Significance
of
Normal
Birth.
J
Perinat
Educ
15:
1�3.
2
The
World
Bank
(2014)
Maternal
mortality
ratio
(modeled
estimate,
per
100,000
live
births).
WHO,
Geneva.
3
Chalmers
B,
Porter
R
(2001)
Assessing
effective
care
in
normal
labor:
the
Bologna
score.
Birth
28:
79-83.
4
Manizheh
P,
Leila
P
(2009)
Perceived
environmental
stressors
and
pain
perception
during
labor
among
primiparous
and
multiparous
women.
J
Reprod
Infertil
10:
217-223.
5
Brown
ST,
Douglas
C,
Flood
LP
(2001)
Women's
Evaluation
of
Intrapartum
Nonpharmacological
Pain
Relief
Methods
Used
during
Labor.
J
Perinat
Educ
10:
1-8.
6
Smith
AC,
Carmel
TC,
Caroline
AC
(2011)
Aromatherapy
for
pain
management
in
labour.
Cochrane
Database
Syst
Rev
6:
CD009215.
7
Barrag�n
Loayza
IM,
Sol�
I,
Juand�
Prats
C
(2011)
Biofeedback
for
pain
management
during
labour.
Cochrane
Database
Syst
Rev
:
CD006168.
8
Morgan
BM,
Bulpitt
CJ,
Clifton
P,
Lewis
PJ
(1982)
Analgesia
and
satisfaction
in
childbirth
(the
Queen
Charlotte's
1000
Mother
Survey).
Lancet
2:
808-810.
9
Janula.R,
Esther
John
(2013)
Effectiveness
of
Expectant
Father�s
Presence
During
first
stage
of
Labour.
Int
J
Nurs
Educ
5:
77-81.
10
Duchene
P
(1989)
Effects
of
biofeedback
on
childbirth
pain.
J
Pain
Symptom
Manage
4:
117-123.
11
Chang
MY,
Wang
SY,
Chen
CH
(2002)
Effects
of
massage
on
pain
and
anxiety
during
labour:
a
randomized
controlled
trial
in
Taiwan.
J
Adv
Nurs
38:
68-73.
12
Burns
EE,
Blamey
C,
Ersser
SJ,
Barnetson
L,
Lloyd
AJ
(2000)
An
investigation
into
the
use
of
aromatherapy
in
intrapartum
midwifery
practice.
J
Altern
Complement
Med
6:
141-147.
13
Abbaspoor
Z
(2012)
Lavender
aroma
massage
in
reducing
labour
pain
and
duration
of
labour:
A
randomized
controlled
trial.
Afr
J
Pharm
Pharmacol
7:
426-430.
14
Maddocks-Jennings
W,
Wilkinson
JM
(2004)
Aromatherapy
practice
in
nursing:
literature
review.
J
Adv
Nurs
48:
93-103.
15
Pollard
KR
(2008)
Introducing
aromatherapy
as
a
form
of
pain
management
into
a
delivery
suite.
J
Assoc
Chartered
Physiother
in
Women�s
Health
Autumn
103:
12-16.
16
Linck
VM,
da
Silva
AL,
Figueir�
M,
Piato
AL,
Herrmann
AP,
et
al.
(2009)
Inhaled
linalool-induced
sedation
in
mice.
Phytomedicine
16:
303-307.
17
Newton-John
TR,
Spence
SH,
Schotte
D
(1995)
Cognitive-behavioural
therapy
versus
EMG
biofeedback
in
the
treatment
of
chronic
low
back
pain.
Behav
Res
Ther
33:
691-697.
18
Joseph
N
(2013)
What
is
Biofeedback
Therapy?.
Medical
News
Today
2:
1-3.
19
Giardino
ND,
Chan
L,
Borson
S
(2004)
Combined
heart
rate
variability
and
pulse
oximetry
biofeedback
for
chronic
obstructive
pulmonary
disease:
Preliminary
findings.
Appl
Psychophysiol
Biofeedback
29:
121-133.
20
Sutarto
AP,
Wahab
MN,
Zin
NM
(2012)
Resonant
breathing
biofeedback
training
for
stress
reduction
among
manufacturing
operators.
Int
J
Occup
Saf
Ergon
18:
549-561.
21
Nielson
WR,
Weir
R
(2001)
Biopsychosocial
approaches
to
the
treatment
of
chronic
pain.
Clin
J
Pain
17:
S114-127.
22
Raju
J,
Singh
M
(2013)
Effectiveness
of
Biofeedback
as
a
Tool
to
Reduce
the
Perception
of
Labour
Pain
among
Primigravidas:
Pilot
Study.
TJFMPC
7:
87-90.
Reproduced with permission of the copyright owner. Further reproduction prohibited
without
permission.
Original Article Original Article
Effect of Lavender Oil Aroma in the Early Hours of Postpartum Period on
Maternal Pains, Fatigue, and Mood: A Randomized Clinical Trial
Abstract
Background: Busy care providers focus on the serious complications of postpartum
period. This
issue causes the seemingly trivial complications, such as mother�s pains, fatigue,
and psychological
status, to be less taken into account. The study aimed to determine the effect of
lavender oil aroma in
the early hours of postpartum period on maternal pains, fatigue, and mood in
primiparous mothers.
Methods: This randomized clinical trial was conducted on 56 participants; 29 in
intervention group
and 27 in control group. The intervention group received lavender oil in three
doses during the
first 24 h after delivery. Sesame oil was used in the control group. Intensity of
pain, fatigue, and
distress level was measured by visual analog scale before and after the
interventions. Besides, mood
status was assessed through the positive and negative affect schedule. Results: The
mean age of
all the participants was 23.88 � 3.88 years. After the first intervention and also
in the tomorrow
morning assessment, significant differences were found between the two groups
regarding perineal
pain (P = 0.004, P < 0.001), physical pain (P < 0.001), fatigue (P = 0.02, P <
0.001), and distress
scores (P < 0.001). In addition, significant differences were found concerning the
mean scores of
positive (P < 0.001) and negative (P = 0.007, P < 0.001) moods between the two
groups after the
interventions. Repeated measures analyses showed that the two groups were
significantly different
over time in all the evaluated variables. Conclusions: Lavender oil aromatherapy
starting in the first
hours of postpartum period resulted in better physical and mood status compared to
nonaromatic
group.
Keywords: Fatigue, lavender oil aromatherapy, mood, perineal pain, postpartum
Introduction
Department of Midwifery,
School of Nursing and
Midwifery, Shiraz University of
Medical Sciences, Shiraz, Iran,
1Student Research Committee,
School of Nursing and
Midwifery, Shiraz University of
Medical Sciences, Shiraz, Iran,
2Department of Obstetrics and
Gynecology, Infertility Research
Center, Shiraz University of
Medical Sciences, Shiraz, Iran,
3Department of Biostatistics,
Medical School, Shiraz
University of Medical Sciences,
Shiraz, Iran, 4Research Center
for Traditional Medicine and
History of Medicine, Shiraz
University of Medical Sciences,
Shiraz, Iran
Farideh Vaziri,
Department of Midwifery,
School of Nursing and
Midwifery, Shiraz University of
Medical Sciences, Zand Street,
Shiraz, Iran.
E-mail: vazirif@sums.ac.ir
postpartum.
Methods
Participants and setting
Interventions
Results
Mean�SD* P
Perineal pain
Lavender 70.03�19.12 60.93�23.51 46.37�20.67 <0.001 0.001 <0.001
Control 71.11�16.88 77.00�16.00 74.48�15.01
P** 0.825 0.004 <0.001
Physical pain
Lavender 62.64�20.12 34.51�36.23 18.75�20.51 <0.001 <0.001 <0.001
Control 69.54�23.29 70.54�24.39 59.36�31.82
P*** 0.240 <0.001 <0.001
Fatigue
Lavender 41�16.25 30.95�15.86 21.68�14.30 <0.001 0.02 <0.001
Control 39.33�15.11 40.33�14.46 38.22�15.14
P** 0.69 0.02 <0.001
Distress perception
Lavender 26.20�18.65 17.13�17.28 8.55�11.53 0.04 0.009 <0.001
Control 24.74�15.88 25.40�17.42 32.85�19.66
P** 0.85 0.05 <0.001
Discussion
the 1st day postpartum and gives us an idea about the need
for appropriate actions. A link between the maternal mood
scores in the early days of postpartum and the mood scores
at 4, 6, 8, and 12 weeks after birth has been reported.[29-31]
Conclusions
Acknowledgments
Conflicts of interest
References
1.
Cunningham FG, Levono KJ, Bloom SL, Hauth JC, Rouse DJ,
Spoong CY. Williams obstetrics. 23th ed., Ch. 17, Sec. 4.
New York: The McGraw-Hill Companies; 2010.
2.
Walsh D. A review of evidence around postnatal care and
breastfeeding. Obstet Gynaecol Reprod Med 2011;21:346-50.
3.
East CE, Sherburn M, Nagle C, Said J, Forster D. Perineal pain
following childbirth: Prevalence, effects on postnatal recovery
and analgesia usage. Midwifery 2012;28:93-7.
4.
Yelland J, McLachlan H, Forster D, Rayner J, Lumley J. How is
maternal psychosocial health assessed and promoted in the early
postnatal period? Findings from a review of hospital postnatal
5.
Amorim Francisco A, Junqueira Vasconcellos de Oliveira SM,
Barbosa da Silva FM, Bick D, Gonzalez Riesco ML.
Women�s experiences of perineal pain during the immediate
6.
Way S. A qualitative study exploring women�s personal
experiences of their perineum after childbirth: Expectations,
reality and returning to normality. Midwifery 2012;28:e712-9.
7.
R�is�nen S, Vehvil�inen-Julkunen K, Heinonen S. Need for and
consequences of episiotomy in vaginal birth: A critical approach.
Midwifery 2010;26:348-56.
8.
Taylor J, Johnson M. How women manage fatigue after
childbirth. Midwifery 2010;26:367-75.
9.
Troy NW, Dalgas-Pelish P. The effectiveness of a self-care
intervention for the management of postpartum fatigue. Appl
Nurs Res 2003;16:38-45.
10.
Lee MS, Choi J, Posadzki P, Ernst E. Aromatherapy for
health care: An overview of systematic reviews. Maturitas
2012;71:257-60.
11.
Abuhamdah S, Chazot PL. Lemon balm and lavender herbal
essential oils: Old and new ways to treat emotional disorders?
Curr Anaesth Crit Care 2008;19:221-6.
12.
Pollard K. Introducing aromatherapy as a form of pain
management into a delivery suite. J Assoc Chart Physiotherapists
Womens Health 2008;103:12-6.
13.
Brand E, Kothari C, Stark MA. Factors related to breastfeeding
discontinuation between hospital discharge and 2 weeks
14.
Atlantis E, Chow CM, Kirby A, Singh MF. An effective
exercise-based intervention for improving mental health and
15.
Connell J, Brazier J, O�Cathain A, Lloyd-Jones M, Paisley S.
Quality of life of people with mental health problems: A synthesis
of qualitative research. Health Qual Life Outcomes 2012;10:138.
16.
Bijur PE, Silver W, Gallagher EJ. Reliability of the visual
analog scale for measurement of acute pain. Acad Emerg Med
2001;8:1153-7.
17.
Wolfe F. Fatigue assessments in rheumatoid arthritis: Comparative
performance of visual analog scales and longer fatigue
18.
Crawford JR, Henry JD. The positive and negative affect
schedule (PANAS): Construct validity, measurement properties
and normative data in a large non-clinical sample. Br J Clin
Psychol 2004;43:245-65.
19.
Tillett J, Ames D. The uses of aromatherapy in women�s health.
J Perinat Neonatal Nurs 2010;24:238-45.
20.
Razaghi N, Sadat Hoseini AS, Aemmi SZ, Mohebbi T,
Boskabadi H. The effects of lavender scent on pain of blood
21.
�etinkaya B, Basbakkal Z. The effectiveness of aromatherapy
massage using lavender oil as a treatment for infantile colic. Int J
22.
Sheikhan F, Jahdi F, Khoei EM, Shamsalizadeh N, Sheikhan M,
Haghani H. Episiotomy pain relief: Use of lavender oil essence
in primiparous Iranian women. Complement Ther Clin Pract
2012;18:66-70.
23.
Olapour A, Behaeen K, Akhondzadeh R, Soltani F,
Al Sadat Razavi F, Bekhradi R. The effect of inhalation of
aromatherapy blend containing lavender essential oil on cesarean
postoperative pain. Anesth Pain Med 2013;3:203-7.
24.
Hadi N, Hanid AA. Lavender essence for post-cesarean pain.
Pak J Biol Sci 2011;14:664-7.
25.
Sobhani A, Sharmi H. Effect of lavender oil on pain relief after
cesarean section. J Gilan Med Univ 2002;16:80-6.
26.
Vakilian K, Atarha M, Bekhradi R, Chaman R. Healing
advantages of lavender essential oil during episiotomy recovery:
A clinical trial. Complement Ther Clin Pract 2011;17:50-3.
27.
Taylor J, Johnson M. The role of anxiety and other factors in
predicting postnatal fatigue: From birth to 6 months. Midwifery
2013;29:526-34.
28.
Lee SH. Effects of aroma inhalation on fatigue and sleep
quality of postpartum mothers. Korean J Women Health Nurs
2004;10:235-43.
29.
Yamashita H, Yoshida K, Nakano H, Tashiro N. Postnatal
depression in Japanese women. Detecting the early onset of
postnatal depression by closely monitoring the postpartum mood.
J Affect Disord 2000;58:145-54.
30.
Hannah P, Adams D, Lee A, Glover V, Sandler M. Links
between early post-partum mood and post-natal depression. Br J
Psychiatry 1992;160:777-80.
31.
Adewuya AO. Early postpartum mood as a risk factor for
postnatal depression in Nigerian women. Am J Psychiatry
2006;163:1435-7.
32.
Imura M, Misao H, Ushijima H. The psychological effects
of
aromatherapy-massage in healthy postpartum mothers.
34.
Lehrner J, Marwinski G, Lehr S, Johren P, Deecke L. Ambient
odors of orange and lavender reduce anxiety and improve mood
35.
Wu JJ, Cui Y, Yang YS, Kang MS, Jung SC, Park HK, et al.
Modulatory effects of aromatherapy massage intervention on
36.
Cho MY, Min ES, Hur MH, Lee MS. Effects of aromatherapy
on the anxiety, vital signs, and sleep quality of percutaneous
Caution
Pregnancy
Debra Rose
Wilson
Childbirth Class
Postpartum
Brooke Kelly
Infant Care
References
Beckmann, R., Ling, F., Barzansky, B., Herbert, W., Laube, D., Smith, R.
(2010). Obstetrics and Gynecology, 6th edition, Lippincott, Williams &
Wilkins: St. Louis.
Toda, M., & Morimoto, K. (2011). Evaluation of effects of lavender and peppermint
aromatherapy using sensitive salivary endocrinological stress markers.
Stress & Health: Journal of the International Society for the Investigation of
Stress, 27(5), 430-435. doi:10.1002/smi.1402
Tohidpour, A., Sattari, M. Omidbaigi, R. et al. (2010). Antibacterial effects
of essential oils from two medicinal plants against Methicillin-resistant
Staphylococcus aureus (MRSA). Phytomedicine, 17, 142-145.
http://icea.org/content/icea-approved-workshops
Email address:
Mohamed Abdel-Hamed Metawie, Hadayat AbdEl-Raof Amasha, Ragaa Ali Abdraboo, Sally
Ebrahim Ali. Effectiveness of Aromatherapy
with Lavender Oil in Relieving Post Caesarean Incision Pain. Journal of Surgery.
Special Issue: Postoperative Pain Syndrome.
Vol. 3, No. 2-1, 2015, pp. 8-13. doi: 10.11648/j.js.s.2015030201.12
1. Introduction
Caesarean section (CS) is the most common operation all
over the world, the rate of this operation reaches near 50% of
all types of deliveries (1). Pain is a major problem in surgery,
including post cesarean section pain and pain relief and
patient satisfaction are still inadequate in many cases (2) . Pain
can make the recovery difficult and delays mothers to get in
touch with the newborns, besides being an obstacle to a good
breastfeeding position, self-care, newborn care, and to do
daily activities (3). Therefore, relieving post caesarean pain is
an issue that cannot be ignored. Non-pharmacological
methods increased the individual control feeling, decreased
the feeling of weakness, improved the activity level and
(9) (10,11)
essence and massage with lavender oil .
2. Methods
2.1. Design
A quasi-experimental design was used in the current study.
This study was conducted at Postpartum Unit affiliated to
Suez-Canal University Hospital, Egypt. The hospital
introduces teaching facilities and provides maternal and child
services around the clock, free charge.
2.2. Subjects
A sample of convenience of 100 mothers post CS, were
selected and assigned into two groups: group I was the study
group consisted of 50 mothers; and group II was the control
group consisted of 50 mothers. Both study and control groups
were selected according to the following inclusion criteria:
age from 21 � 35 years old, full term, after six hours of
operation, spinal anesthesia and not suffering from medical
and/or gynecological health problems.
3. Results
The mean age of the study group was 27.22 � 4.4, years
and that of the control group was 26.2 � 3.8 years. Figure 2
illustrates that 32.0% of the study group and 30% of the
control group were illiterate. Meanwhile, only 6.0 of the
study group and few percent (2.0%) of the control group
graduated from university.
10 Mohamed Abdel-Hamed Metawie et al.: Effectiveness of Aromatherapy with Lavender
Oil in Relieving Post Caesarean Incision Pain
Fig. (1). Distribution of the study and control groups according to their age
(n=100).
Fig. (2). Distribution of the study and control groups according to their
educational level (n=100).
Table 1. Distribution of the study and control groups according to their incision
pain level as recorded by the Visual Analogue Scale (VAS) & Modified Version
of Johansson Pain-O-Meter MJPOM (n=100).
Items
.
cccc2
2222 P value
No (%) No (%)
8 (16.0)
35 (70.0)
6 (12.0)
0 (0.0)
1 (2.0)
0 (0.0)
18 (36.0)
17 (34.0)
11 (22.0)
4 (08.0)
0 (0.0)
9 (18.0)
11 (22.0) 52.10 <0.001**
16 (32.0)
14 (28.0)
0 (0.0)
1(2.0)
0 (0.0) 50.97 <0.001**
29 (58.0)
20 (40.0)
** Significant at p-value<0.001
Table 2. Distribution of the study and control groups according to their incision
pain intensity as recorded by the Modified Version of Johansson Pain-O-Meter
(MJPOM) (n=100)
Items
Study group (n=50) Control group (n=50) .
cccc
2
2222
P-value
No % No %
Sensory Pain
Cutting 4 8.0 12 24.0
Tearing 0 0.0 0 0.0
Sharp 0 0.0 3 6.0
Burning 1 2.0 3 6.0
Cramping 0 0.0 1 2.0
Pressing 0 0.0 11 22.0 35.80 <0.001**
Aching 2 4.0 1 2.0
Gnawing 30 60.0 19 38.0
Pinching 2 4.0 0 0.0
Stinging 11 22.0 0 0.0
Sore 0 0.0 0 0.0
Affective Pain
Torturing 4 8.0 12 24.0
Killing 0 0.0 0 0.0
Suffocating 0 0.0 3 6.0
Terrifying 1 2.0 3 6.0
Dreadful 0 0.0 1 2.0
35.80 <0.001**
Fearful 0 0.0 11 22.0
Troublesome 2 4.0 1 2.0
Tiring 30 60.0 19 38.0
Irritating 2 4.0 0 0.0
Nagging 11 22.0 0 0.0
** Significant at p -value<0.001
2 Mohamed Abdel-Hamed Metawie et al.: Effectiveness of Aromatherapy with Lavender
Oil in Relieving Post Caesarean Incision Pain
The same table indicates that the word "tiring" was the
most frequently used as an affective pain descriptor between
the two groups (study, 60.0% & control, 38.0%). However,
the word "killing" was not used as an affective pain
descriptor between the two groups. A highly statistically
significant difference also was found between both groups in
relation to pain intensity recorded (p<0.001).
Table 3 shows that there was a statistically significant
relation between the effect of lavender oil and educational
level (p < 0.05). Lavender oil was more effective between
educated mothers rather than non-educated ones. The same
table shows relation between pain intensity according to the
visual analogue scale and parity. A highly statistically
significant difference was found between the effect of
lavender oil and parity (p <0.001), lavender oil was more
effective with multiparous than primiparous. However, there
was no statistically significant relation between the others
selected variables (antenatal care & wanted pregnancy) and
lavender oil inhalation post CS (p= >0.05 & 0.05
respectively).
Table 3. Relation between pain intensity according to the visual analogue scale and
selected variables to the study group (n=50).
p-value .
.
Pain Level
Selected Variables Mild Moderate Severe Very Severe Worst
N (%) N (%) N (%) N (%) N (%)
Education
16.29. <0.05*
Non-educated (n=16) 1(6.3) 12(75.0) 3(18.8) 0(0.0) 1(6.3)
Educated (n=34) 7(20.6) 23(67.6) 3(8.8) 0(0.0) 0(0.0)
Parity
38.34 <0.001**
Para1(n=8) 0(0.0) 2.0(25.0) 5(62.3) 0(0.0) 1(12.5)
Para 2 (n=11) 0(0.0) 10(90.0) 1(9.1) 0(0.0) 0(0.0)
Para 3 or more (n=31) 8(25.8) 23(74.8) 0(0.0) 0(0.0) 0(0.0)
Antenatal care
1.70 >0.05
Yes (n=42) 5(11.9) 32(76.2) 4(9.5) 0(0.0) 1(2.4)
No (n=8) 3(37.5) 3(37.5) 2(25.0) 0(0.0) 0(0.0)
Wanted pregnancy
5.67 >0.05
Yes (n=34) 5(14.7) 26(76.5) 2(5.9) 0(0.0) 1(2.9)
No (n=16) 3(18.8) 9(56.3) 4(25.0) 0(0.0) 0(0.0)
* Significance at <0.05
Table 4. Correlation between Visual Analogue Scale score and Modified version of
Johansson Pain-O-Meter (MJPOM)
Variables
Modified version of Johansson Pain-O-Meter (JPOM)
r p- value
Visual Analogue Scale .522(**) .000
** Correlation is significant at the 0.01 level (2-tailed).
Table 4 shows that there was a positive correlation
between Visual Analogue Scale and Modified version of
Johansson Pain-O-Meter (r= .522 at p= .000).
4. Discussion
The pain control after cesarean delivery is a great
challenge for the health care provider because the spread use
of drugs can cause side effects such as; nausea, vomiting and
excessive sedation; and it can cause a delay in getting out of
bed and discharge from the hospital. In addition, the drugs
excrete in breast milk and can cause sedation in baby as well
(14). Pollard (2008) (15), observed that the use of aromatherapy
reduced the need for more invasive forms of pain
management and has a positive effect on client satisfaction.
Side effects of the oils were documented in only two cases
(1%); these side effects were skin irritation and headache. No
adverse reactions were documented with regard to babies
born in the birthing pool.
The result of current study goes in line with other studies
stated that there was a significant reduction in pain level of
postoperative cesarean section after inhaling lavender essence
(16,17) ,on episiotomy pain using lavender oil bath at
four hours and five days after delivery (18,19) .
The current study was in accordance with other studies
reporting analgesic effect of lavender oil and decreased the
number of required analgesics following tonsillectomy in
pediatric patients (20) and found that aromatherapy with
lavender oil a good alternative to reduce normal labour pain
and is more effective than breathing techniques (21). Our data
was also consistent with others of same interest who reported
that aromatherapy with inhalation lavender essential oil is
effective on anxiety and pain in IUD insertion(22) and in
reducing pain following needle insertion into a fistula in
hemodialysis patients (9).
5. Conclusion
In the light of the findings of the current study, it can be
concluded that, lavender oil was an effective method in
postoperative pain control with comparison to placebo
treatment. Lavender oil inhalation appears to be an effective
non-invasive and non-pharmacological intervention for postoperative
pain management. The efficiency of intervention is
2 Mohamed Abdel-Hamed Metawie et al.: Effectiveness of Aromatherapy with Lavender
Oil in Relieving Post Caesarean Incision Pain
Recommendations
�
Hospital managers are encouraged to include
aromatherapy techniques in the training program for
maternity nurses and recommended to be included in
the hospital protocol for management of post-cesarean
incision pain.
�
Lavender oil inhalation for relieving post cesarean pain
may be added in maternal nursing curricula of nursing
schools.
References
[1]
Ganji, F., Yusefi, H., & Baradaran, A. Effect of a participatory
intervention to reduce the number of unnecessary cesarean
sections performed in Shahrekord of Iran. J. Medical Sci;
2006; 6, 690-692.
[2]
Stourac P, Kucharov� E, Krikava I, Mal� R, Kosinov� M,
Harazim H, Sm�kalov� O, B�rt�kov� I, Stoudek R, Janku P,
Huser M, W�gnerov� K, Haklov� O, Hakl L, Schwarz D,
Zelinkov� H, Littnerov� S, Jarkovsk� J, G�l R, Sevc�k P.
Establishment and evaluation of a post caesarean acute pain
service in a perinatological center:retrospective observational
study. Ceska Gynekol. 2014 Fall;79(5):363-370
[3]
Granot, M., Lowenstein, L., Yarnitsky, D., Tamir, A., &
Zimmer, E.Z. Post cesarean section pain prediction by
preoperative experimental pain assessment. Anesthesiol; 2004;
98(6), 1422-6.
[4]
Yildirim, G., & Sahin, N.H. The effect of breathing and skin
stimulation on labour pain perception of Turkish women. Pain
Research & Management; 2004; 9(4), 183-7.
[5]
Smith, C.A., Collins, C.T., Cyna, A.M., & Crowther, C.A.
Complementary and alternative therapies for pain
management in Labour. Cochrane Database of Systematic
Reviews; 2006;18(4), CD003521.
[6]
Marzouk T, Barakat R, Ragab A, Badria F, Badawy A.
Lavender-thymol as a new topical aromatherapy preparation
for episiotomy: A randomised clinical trial. J Obstet Gynaecol.
2014 ; 10:1-4.
[7]
Kim, J.T., Wajda, M., Cuff, G., Serota, D., Schlame, M.,
Axelrod, D.M., Guth, A.A., & Bekker, A.Y. (2006).
Evaluation of aromatherapy in treating postoperative pain:
Pilot study. World Institute of Pain Practice; 2006; 6 (4), 273277.
[8]
Hadi, N., & Hanid, A.A. Lavender essence for post cesarean
pain. Pakistan J Biolo Sci; 2011; 14(11), 664.667.
[9]
Nesami, M.B., Espahbodi, F., Nikkhah, A., Shorofi, S.A., &
Charati, J.Y. The effects of lavender aromatherapy on pain
following needle insertion into a fistula in hemodialysis
patients. Complement Ther Clin Pract. 2014 ;20(1):1-4
[10]
Zahra, A., & Leila, M.S. Lavender aromatherapy massages in
reducing labor pain and duration of labor: A randomized
controlled trial. African Journal of Pharmacy and
Pharmacology; 2013; 7(8), 426-430.
[11]
Henry, A., & Nand, S., Intrapartum pain management at the
Royal Hospital for Women: Australia and New Zealand
Journal of Obstetrics and Gynecology, 2004; 44(4):307-317.
[12]
Melzack R, Katz J. Measurement of pain. Surg Clin North Am
1999; 79:231-252.
[13]
Gaston-Johansson F. Measurement of pain: the psychometric
properties of the Pain-O-meter, a simple inexpensive pain
assessment tool that could change health care practices. J Pain
and Symptom Management 1996; 12 (3), 172�181.
[14]
Fr�guls B1, Joya X, Garc�a-Algar O, Pall�s CR, Vall O,
Pichini S. A comprehensive review of assay methods to
determine drugs in breast milk and the safety of breastfeeding
when taking drugs. Anal Bioanal Chem. 2010
Jun;397(3):1157-79
[15]
Pollard, K.R. Introducing aromatherapy as a form of pain
management into a delivery suite. Journal of the Association
of Chartered Physiotherapists in Women�s Health; 2008; 103,
12�16.
[16]
Sobhani, A., Sharemi, H., Orangpur, R., Shokuhi, F., & Oudi,
M. Effect of lavender oil in cesarian pain relief. J Gilan Univ
Med Sci; 2007; 16(62), 80-86.
[17]
Olapour, A., Behaeen, K., Akhondzadeh, R., Soltani, F.,
Razavi, S.F., & Bekhradi, R. The effect of inhalation of
aromatherapy blend containing Lavender essential oil on
cesarean postoperative pain. Anesthesiol Pain Med; 2013; 3(1),
203-7.
[18]
Sheikhan, F., Jahdi, F., Khoei, E.M., Shamsalizadeh, N.,
Sheikhan, M., & Haghani, H. Episiotomy pain relief: Use of
Lavender oil essence in primiparous Iranian women.
Complement Ther Clin Pract. 2012 Feb;18(1):66-70
[19]
Masoumi, Z., Keramat, A., & Hajiaghaee, R. Systemic review
on effect of herbal medicine on pain after perineal episiotomy
and cesarean cutting. J Med Plants;2011; 4(40), 1-6.
[20]
Soltani, R., Soheilipour, S., Hajhashemi, V., Asghari, G.,
Bagheri, M., & Molavi, M. Evaluation of the effect of
aromatherapy with lavender essential oil on post-
tonsillectomy pain in pediatric patients: A Randomized
Controlled Trial; Int J Pediatr Otorhinolaryngol. 2013
Sep;77(9):1579-81
[21]
Seraji, A., & Vakilian, K. The comparison between the
effects of aromatherapy with lavender and breathing
techniques on the reduction of labor pain. Complement Med;
2011; 1(1), 31-39
[22]
Shahnazi M, Nikjoo R, Yavarikia P, Mohammad-Alizadeh-
Charandabi S. Inhaled lavender effect on anxiety and pain
caused from intrauterine device insertion. J Caring Sci. 2012
Nov 28;1(4):255-61.
The Effect of Inhalation of Aromatherapy Blend containing Lavender Essential
Oil on Cesarean Postoperative Pain
ABSTRACT
Background: Pain is a major problem in patients after cesarean and medication such
as aromatherapy which is a complementary therapy, in which the essences of the
plants oils are used to reduce such undesirable conditions.Objectives: In this
study, the effect of aromatherapy using Lavender (Lavandula) essential oil on
cesarean postoperative pain was assessed. Materials and Methods: In a triple blind,
randomized placebo-controlled trial study, 60 pregnant women who were admitted to a
general hospital for cesarean section, were divided randomly into two groups. After
cesarean, the Lavender group inhaled about 3 drops of 10% Lavender oil essence and
the placebo group inhaled 3 drops of placebo after the start of postoperative pain,
four, eight and 12 hours later, for 5 minutes from the 10 cm distance. Patient's
pain was measured by the VAS (Visual Analog Scale) score before and after each
intervention, and vital sign, complications and level of satisfaction of every
patient were recorded before and after aromatherapy.Results: There was no
statistically significant difference between groups in age, height, weight, and
time to the first analgesicrequirement. Patients in the Lavender group had less
postoperative pain in four (P = 0.008), eight (P = 0.024) and 12 (P = 0.011) hours
after first medication than the placebo group. The decreased heart rate and
patients' level of satisfaction with analgesia were significantly higher in the
Lavender group (P = 0.001). In the placebo group, the use of diclofenac
suppositories for complete analgesia was also significantly higher than the
Lavender group (P = 0.008).Conclusions: The inhaled Lavender essence may be used as
a part of the multidisciplinary treatment of pain after cesarean section, but it is
not recommended as the sole pain management.
.Article type: Research Article; Received: 22 Dec 2012, Revised: 16 Jan 2013,
Accepted: 26 Jan 2013; Epub: 01 Jul 2013; DOI: 10.5812/
aapm.9570
.Implication for health policy/practice/research/medical education:
The addition of inhalation aromatherapy using lavender essence oil to the pain
control protocol, which includes NSAIDs and opioids,
may decrease the side effects of such drugs and also may decrease treatment costs
of cesarean postoperative pain for patients
and decision makers and experts in the health sector.
.Please cite this paper as:
Olapour A, Behaeen K, Akhondzadeh R, Soltani F, al Sadat Razavi F, Bekhradi R. The
Effect of Inhalation of Aromatherapy Blend containing
Lavender Essential Oil on Cesarean Postoperative Pain. Anesth Pain. 2013;3(1):203-
7. DOI: 10.5812/aapm.9570
.Copyright � 2013, Iranian Society of Regional Anesthesia and Pain Medicine
(ISRAPM); Published by Kowsar Corp.
This is an Open Access article distributed under the terms of the Creative Commons
Attribution License (http://creativecommons.org/licenses/by/3.0), which permits
unrestricted use, distribution, and reproduction in any medium, provided the
original work is properly cited.
1. Background
Pain is amongst the most common problems after surgery
(1). Pain is an unpleasant sensory and emotional experience,
which is associated with the real or probablydamage of tissue. Unrelieved
postoperative pain in addition
to creating fears in the surgical patients, it makesadverse psychological impact on
them (2, 3). The uncontrolled
postoperative pain will make a lot of acute and chronic effects, including systemic
mediators, hypercoagulability,
postoperative immunosuppression, and delayed
wound healing (4). So, one of the main aims of anesthesia
is to reduce postoperative pain. However, many drugs that are used for this
purpose, especially opioidsand NSAIDs (None Steroidal Anti Inflammatory Drugs),
have side effects such as respiratory distress, nausea, itching, and
gastrointestinal bleeding (5). Recent studieshave indicated interest in using
complementary therapies
such as heat and cold therapy, hypnotism, music therapy and aromatherapy.
Aromatherapy is used for the relief of pain, anxiety, depression, insomnia and
fatigue, using the existing oils in different parts of the plant such as Lavandula
angustifolia (6-11). Lavandula is a flowering plant from the Lamiaceae family,
native to the western Mediterranean region. The lipophilic monoterpenes atthe plant
are reacted to the cell membranes, and cause changes in the activity of ion
channels, carriers and nervous
receptors. Such property can explain the soothingand anti-bacterial effects of
Lavender oil (12).
2. Objectives
Cesarean surgery is common, especially in our country, and the patient's
postoperative pain is a serious problem. Furthermore, the extent of conventional
method for the pain relief is a prescription of opioids and NSAIDs, which are also
associated with certain complications, and needsadditional methods of the pain
control, consequently, we decided to assess the effect of the inhalation
aromatherapy
using Lavender oil essence on postoperative pain.
was documented based on the Visual Analog Scale (VAS).The VAS is a standard tool
like a 10 cm ruler including 10 numbers begin from 0 (no pain) and end to 10 (most
severe
pain). Different states of a human face in response to pain severity have been
plotted on the other side of ruler. The patients were asked to choose one of them
according
to their pain severity. The number shown on the back of the ruler was considered as
pain score. The Lavenders
(Lavandula angustifolia) are a genus of several species of flowering plants in the
mint family, Lamiaceae.
In this study, Lavender essence 10% was provided by the Barij Essence
Pharmaceudical Company (Kashan,Iran). Placebo was a base of aromatherapy blend
without Lavender essence which was provided by the Barij Essence
Pharmaceudical Company too. In the beginning, possible side effects of drugs used
in the study, were explained
to the patients, and after obtaining informedconsent, patients were entered into
the operating room. Patients were performed monitoring by ECG
(Electrocardiography),
monitoring for heart rate recording, NIBP(None Invasive Blood Pressure) and
Pulseoximetry. After embedding the peripheral intravenous cannula, 500 cc of
Ringer's crystalloid fluid was infused for patients. Afterwards,
regional block with spinal anesthesia was performed
with 60 mg of Lidocaine 5%, and then the patients underwent cesarean section.
Opioid or benzodiazepine was not used after cesarean section in operating room
assedation. Pain score were measured using the VAS score for all patients. After
the onset of postoperative pain (if VAS > 3), four, eight and 12 hours after that,
the inhalation aromatherapy was performed using Lavender essence. In one group,
three drops of aromatherapy blend containing
Lavender essence 10% (provided by The Barij Essence Pharmaceutical Compnay) were
poured on cotton incast containers, and the patient was asked to inhale itfor 5
minutes from a distance of 10 cm; and pain score was measured using the VAS again,
and if the VAS was greater than three, analgesic was given in accordance with the
hospital routine protocol (the first time, intramuscular injection of Diclofenac
sodume 75 mg and next times, Diclofenac suppositories 100 mg). Using the
sameprocedure, aromatherapy was performed in the othergroup by three drops of
placebo (a base of aromatherapy blend without Lavender essence) where its smell and
appearance
were similar to the Lavender oil essence. Heart rate, blood pressure, nausea,
vomiting, dizziness, andpatient's satisfaction were recorded before and after the
aromatherapy based on the questionnaire. During theresearch, the project executive
and the patients were notaware of the type of drug and placebo, and after the study
and data analysis, the Lavender and the placebo were disclosed
by the Barij Essence Pharmaceudical Company. All data were analyzed using the SPSS
for Windows (version19.0). Independent T-test was used compare the meanpain in two
groups; the Paired t- test was used to comparethe pain before and after
intervention. The significance
level was set to P = 0.05.
4. Results
In this study, all patients were ASA class I. At the time of the onset of the pain
after cesarean section, aromatherapy
with Lavender essence was performed. Average age, height, weight in the two groups
showed no significantdifference, and times of need to the first analgesic from
cesarean section were similar in the two groups (Table
1). After using the drug comparing it with before, therewas more decrease in the
VAS score in the Lavender group than the placebo group, these values were
significant in four, eight and 12 hours after the first intervention (Table
2). In the Lavender group, the level of satisfaction from the drug was 90 %, while
in the placebo group, a 50% satisfaction
was reported (P = 0.001) (Figure 1). In the Lavender group, using Diclofenac
suppository for completing analgesia
was 43.3%, and in the placebo group was 76.7% (P =0.008) (Figure 2).
After using the drug comparing it with before, heart rateshowed a greater reduction
in the Lavender group compared
with the placebo group, which has been shown in the table (Table 3). However, no
difference was observed in terms of the blood pressure between the two groups. In
terms of the complication incidence, only one patient in the placebo group had
nausea, and none of the patients in both groups had vomiting and dizziness.
Time of first request of analgesia after Spinal anesthesia 98.83 � 9.16 98.33 �
9.67 0.72
Table 2. Comparison of the VAS in Two Groups
Lavender group, Mean � SD Placebo group, Mean � SD P value Pain reduction after
medication for the first time 0.23 � 0.43 0.27 � 0.64 0.353
Pain reduction 4 hours after medication for the first time 1.37 � 0.89 0.5 � 0.57
0.008
Pain reduction 8 hours after medication for the first time 1.63 � 0.89 0.4 � 0.49
0.024
Pain reduction 12 hours after medication for the first time 1.40 � 0.62 0.2 � 0.48
0.011
Table 3. Comparison of Heart Rate in Two Groups
Lavender group, Mean � SD Placebo group, Mean � SD P value Pain reduction after
medication for the first time 4.83 � 5.96 0.63 � 2.45 < 0.001
Pain reduction 4 hours after medication for the first time 3.30 � 4.60 0.77 � 4.24
0.439
Pain reduction 8 hours after medication for the first time 4.30 � 5.62 0 � 3.16
0.016
Pain reduction 12 hours after medication for the first time 2.2 � 2.82 0.57 � 2.23
0.798
5. Discussion
This study investigated the effect of inhaled Lavender essence on the pain relief
after cesarean. The results showed that pain after surgery in four, eight and 12
hours after the onset of symptoms following inhalation of Lavender
essence have had a significant decrease compared with the placebo group. The pain
control after cesarean delivery is a great challenge for the anesthesiologists and
gynecologists, because the spread use of drugs can cause side effects such as
nausea, vomiting and excessivesedation; and it can cause a delay in getting out of
bed and discharge from the hospital. In addition, the drugsexcrete in breast milk
and can cause sedation in baby as
well (13). The use of non-opioid analgesics and alternative treatment alone has
failed to establish an effective and satisfactory analgesia for patients. It seems
necessary to use multiple methods of analgesia (multi-modal) for the pain relief
after Cesarean section and to have more research in this area (4). The effects of
various forms of Lavender essence on postoperative pain control have been
investigated in the previous studies. In a study performed
by Sobhani and Colleagues in 2004 in Rasht cityon pain relief after cesarean
section, in each three stages
of the intervention (in which its first stage was performed
six hours after the onset of the pain) there was a significant reduction in pain
after inhaling Lavender essence.
These results are similar to our study except that:
1) in the mentioned study, intervention was not immediately
performed after the onset of the pain and 2) we used Lavender essence 10% (14).
conducted by Ailsa also using Lavender oil bath for 10 days after vaginal delivery,
the slight reduction of pain, though significant, was seen in the Lavender group
compared to the control group (15). Furthermore, in Khadivzadeh's study in which
Lavender cream has been used to relieve episiotomy pain, the pain on days three,
five and 10 afterbirth was significantly reduced compared to the controlgroup, but
this difference was not significant in the first 24 hours of the delivery (16). We
found that Diclofenac suppository dosage as a supplemental analgesic drug in the
Lavender group was significantly lower than the placebo group. These findings are
similar to a study by Jung TK on patients who underwent laparoscopic gastricbanding
surgery. But in our study the Lavender essence 10% was used. In that study, despite
the decrease of pain, the score was not significantly different in the two groups,
but morphine consumption was decreased significantlyin the Lavender group (17). In
the present study, patient's satisfaction with supplemental analgesia techniqueswas
considered, and it showed that satisfaction withtreatment in the Lavender group was
significantly higher than the placebo group. This satisfaction has also been
reported in two previous studies, which wereconducted on obese patients undergoing
laparoscopic adjustable gastric banding and patients undergoingbreast biopsy
surgery with the difference that we used Lavender essence 10% (17, 18). Also, in a
study conducted by Mohammadkhani on postpartum perineal pain,patients receiving
Lavender were more satisfied than controls (19). Due to the lack of reported side
effects such as nausea, vomiting and dizziness in the group treatedwith Lavandula
in our study and other studies on this drug, it can be concluded that this drug
doesnot have serious and common side effects of the opioid analgesics and NSAIDs,
and further studies could be used as part ofa multimodal analgesic treatment of
postoperative pain. Based on findings of our study, it can be concluded that the
inhaled Lavender essence may be used as a part of the multimodal analgesic
treatment after cesarean section,but it is not recommended using the sole analgesic
treatment.
Acknowledgements
Authors� Contribution
Study concept and design: Olapour, Behaeen and Raza
vi. Analysis and interpretation of data: Olapour, Behaeen and Bekhradi. Drafting of
the manuscript: Akhondzadeh,
Soltani and Razavi. Collection and possession of raw data: Razavi. Critical
revision: Behaeen, Akhondzadeh and Razavi.
Financial Disclosure
Funding/Support
Ahvaz Jundishapur University of Medical Sciences, Vice Chancellor for Research and
Technology. Trial Registration:
www.irct.ir Identifier: IRCT201204249552N1.
References
1.
McQuay H, Derry S, Wiffen P, Moore A, Eccleston C. Postoperative
pain management: Number-needed-to-treat approachversus procedure-specific pain
management approach. Pain. 2012;154(1):180
2.
Ochroch EA, Gottschalk A. Impact of acute pain and its management
for thoracic surgical patients. Thorac Surg Clin.2005;15(1):105-21
3.
Pritchard MJ. Managing anxiety in the elective surgical patient.Br J Nurs.
2009;18(7):416-9
4.
Hurley RW, Wu ChLChap. Acute Postoperative Pain. In: Miller RD, Eriksson LI,
Fleisher LA, Wiener-Kronish JP, Young WL, editors.Miller�s Anesthesia. 7 ed. USA:
Churchill Livingstone; 2010. p. 27572781
5.
Gupta A, Kaur K, Sharma S, Goyal S, Arora S, Murthy RS. Clinical aspects of acute
post-operative pain management & its assessment.
J Adv Pharm Technol Res. 2010;1(2):97-108
6.
Hadi N, Hanid AA. Lavender essence for post-cesarean pain. Pak J
Biol Sci. 2011;14(11):664-7
7.
Kim S, Kim HJ, Yeo JS, Hong SJ, Lee JM, Jeon Y. The effect of lavender
oil on stress, bispectral index values, and needle insertion pain in volunteers. J
Altern Complement Med. 2011;17(9):823-6
8.
Podichetty VK, Varley ES. Re: Oleske D M, Lavender S A, Andersson G B, et al. Are
back supports plus education more effective than
education alone in promoting recovery from low back pain? Results from a randomized
clinical trial. Spine 2007;32:2050-7. Spine (Phila Pa 1976). 2008;33(3):349-50
9.
Sheikhan F, Jahdi F, Khoei EM, Shamsalizadeh N, Sheikhan M, Haghani H. Episiotomy
pain relief: Use of Lavender oil essence in primiparous Iranian women. Complement
Ther Clin Pract.2012;18(1):66-70
10.
Yip YB, Tse SH. The effectiveness of relaxation acupoint stimulation
and acupressure with aromatic lavender essential oil for non-specific low back pain
in Hong Kong: a randomised controlled
trial. Complement Ther Med. 2004;12(1):28-37
11.
Yip YB, Tse SH. An experimental study on the effectiveness of acupressure with
aromatic lavender essential oil for sub-acute, non-specific neck pain in Hong Kong.
Complement Ther Clin Pract.2006;12(1):18-26
12.
van Wyk BE. A broad review of commercially important southern African medicinal
plants. J Ethnopharmacol. 2008;119(3):342-55
13.
Fukuda K. Opioids. In: Miller RDEL, Fleisher LA, Wiener-KronishJP, Young WL,
editors.Miller�s Anesthesia. USA: Churchill Living-stone; 2010. p. 769-824
14.
Sobhani A, Sharemi H, Orang pur R, Shokuhi F, Oudi M. Effect of Lavender Oil in
cesarian pain relief. J Gilan Univ Med Sci. 2007;16(62):80-86
15.
Masoumi Z, Keramat A, Hajiaghaee R. Systemic review on effect of Herbal Medicine on
pain after perineal episiotomy and cesearean
cutting. J Med Plants. 2011;4(40):1-6
16.
Khadivzadeh T, Molkizadeh M, Rakhshandeh M. Evaluation of lavander cream effect on
episiotomy pain and wound healing in primiparous women. Int J Gynecol Obstetrics.
2009;107(Supplement
2):S498-S499
17.
Kim JT, Ren CJ, Fielding GA, Pitti A, Kasumi T, Wajda M, et al. Treatment
with lavender aromatherapy in the post-anesthesia care unit reduces opioid
requirements of morbidly obese patients undergoing laparoscopic adjustable gastric
banding. Obes Surg.2007;17(7):920-5
18.
Kim JT, Wajda M, Cuff G, Serota D, Schlame M, Axelrod DM, et al. Evaluation of
aromatherapy in treating postoperative pain: pilot study. Pain Pract.
2006;6(4):273-7
19.
Mohammadkhani S. The effect of massage aromatherapywith Lavender
oil on active phase pain intensity and satisfaction of labornullipara women.
Iranian J Reproduct Med. 2009;7(Suppl 1):10-20
Iran Red Crescent Med J. 2015 April; 17(4): e25880. DOI:
10.5812/ircmj.17(4)2015.25880
Published online 2015 April 25. Research Article
12,*2
Mental Health Research Group, Health Metrics Research Center, Iranian Institute for
Health Sciences Research, ACECR, Tehran, IR Iran
Received: December 10, 2014; Revised: December 28, 2014; Accepted: January 11, 2015
Background: Labor and delivery is a stressful stage for mothers. During these
periods, sleep-related disorders have been reported. The
problems of inadequate sleep include decrease in concentration, judgment,
difficulty in performing daily activities, and an increase in
irritability. Even the effects of moderate sleep loss on life and health quality
can be similar to sleep deprivation. some research aggravated
by aromatherapy on sleep quality in different periods of life so might be useful
for the improve of sleep quality in postpartum women.Objectives: This study aimed
to determine the effect of aromatherapy on the quality of sleep in postpartum
women. The sample was
recruited from medical health centers of Zanjan University of Medical
Sciences.Patients and Methods: This study was a randomized clinical trial with the
control group. A total of 158 mothers in postpartum period
(with certain inclusion criteria) were enrolled in the study and assigned randomly
to two groups of control and intervention. Lavender
fragrance (made by Barij Essence Pharmaceutical Co.) was used by participants in
the intervention group nightly before sleeping.
The fragrance was dropped on cotton balls, which were placed on a cylindrical
container at mothers� disposal. Keeping the container
at a projected distance of 20 cm, the participants inhaled 10 deep breaths and then
the container was placed beside their pillow until
morning. This procedure was done 4 times a week for 8 weeks. For the control group,
the same intervention was done with the placebo. The
instrument for collecting data was Pittsburgh sleep quality index, which was
completed at the baseline, fourth, and eighth weeks after the
intervention. Data were analyzed using independent t test and repeated measures
analysis of variance calculated by SPSS16.Results: Before the intervention, there
were no significant differences between mothers in two groups (P > 0.05). After 8
weeks follow up, a
significant improvement appeared in mothers� sleep quality in the intervention
group. Aromatherapy increased sleep quality mean score
(�SD) from 8.2911 (� 2.1192) to 6.7975 (� 2.3663) (P < 0.05), but in the control
group sleep quality mean score (�SD) changes from 8.4557 (�
2.3027) to 7.5696 (� 1.1464) (P > 0.05). Comparing sleep quality between control
and intervention groups after 8 weeks from the beginning
of the intervention indicated that aromatherapy was effective in the improvement of
mothers� sleep quality (P < 0.05).Conclusions: Considering the effects of
aromatherapy on the improvement of mother�s sleep quality during postpartum period,
1. Background
Labor and delivery is a stressful stage for mothers. This
stage entails a change in their life style (1). Pregnancy
and postpartum are two important stages for women
and their families (2). During these periods, sleep-related
disorders have been reported (3). Sleep is an important
process in human life. The problems of inadequate
sleep include decrease in concentration, judgment, difficulty
in performing daily activities, and an increase
in irritability (4). Research shows that inadequate sleep
affects hemostatic and nerve functions, as well as mood.
Even the effects of moderate sleep loss on life and health
quality can be similar to sleep deprivation. Many medical
practitioners and patients are faced with such prob
creates a lot of problems not only for them but also for
their families (9). One of the most important side effects
of inadequate quality of sleep is the incident and severity
of postpartum depression (3, 10). Another adverse
side effect of impaired sleep patterns is the cessation of
breastfeeding and decreased mother-infant attachment
(11). Sleep deprivation can even decrease the growth of
infant (12), and reduce mothers� immune functioning,
metabolism, mood, and performance (13).
2. Objectives
This study aimed to determine the effect of aromatherapy
on the quality of sleep in postpartum women.
The sample was recruited from medical health centers
of Zanjan University of Medical Sciences. This study was
carried out with the hypothesis that the mean score of
quality of sleep would be better in postpartum women
in aromatherapy group compared to control group.
In this study, the tools that have been used by the researcher
for demographic data collection comprised a
questionnaire survey of environmental confounding
factors affecting sleep, Pittsburgh sleep quality index,
and the Edinburgh Postnatal Depression Scale as well
as aromatherapy and registration forms that were completed
by mothers. Pittsburgh sleep quality index is an
international standardized tool that has been validated
in numerous studies (15, 20). Test-retest reliability and
content validity of its Iranian version have been reviewed
and approved in two studies done by Hossein Abadi et al.
4. Results
Demographic characteristics of study subjects and
their husbands are shown in Table 1. Mothers in both
groups were similar in all demographic characteristics (P
> 0.05). In terms of individual-environmental confounding
factors affecting sleep disorders such as lighting a
bedroom, existence of noise, consuming tea and coffee,
consuming caffeinated soft drinks, herbal remedies,
complaining of pain, general sleep conditions of infants,
and assistance in infants care in two groups showed no
significant differences (P > 0.05). Table 2 shows the mean
and standard deviation of sleep quality index at the beginning
of the study, at the end of the four weeks, and
eight weeks after intervention in two groups. As a result,
the mean score of sleep quality at baseline in aromatherapy
was (8.28 � 2.11) and in placebo group was (8.45
� 2.30) and before the intervention there was no significant
difference between the two groups in mean score of
quality of sleep (P > 0.05). Four weeks after the intervention,
the result showed the mean of quality of sleep in
aromatherapy group was (7.59 � 2.53) and placebo group
was (8.06 � 2.20), and finally, the average of the quality
of sleep after eight weeks in the intervention group was
Table 1. Demographic Data of Women and Their Husbands Participating in the Study a
Variables Group
Table 2. Comparison of the Quality of Sleep in Postpartum Women Between Case and
Control Groups Before and After the Intervention
Independent t test.
Table 3. Comparison of the Quality of Sleep Between Postpartum Women in Control and
Case Groups After the Intervention a , b
time
8.50
group
.00
8.50
1.00
4.00
8.00
2.00
8.00
7.50
7.00
6.50
1.00 2.00
group
there were no significant differences between the intervention
and control groups (P > 0.05). However, eight
weeks after intervention, a significant difference was observed
between two groups (P < 0.05). To examine differences
in sleep quality means between mothers in both
groups over time, repeated measures tests have been
performed. Before performing this analysis, assumptions,
including homogeneity of variances and normal
response variables were examined, which confirmed the
5. Discussion
The present study was conducted with the purpose of
investigating the effects of aromatherapy on sleep quality
of the women during their postpartum period. Comparing
two groups of intervention and control showed
the effectiveness of aromatherapy on mothers� sleep
quality. Inhaling this aroma affected some aspects of
sleep quality, including sleep latency and duration, while
it had no statistically significant impact on other aspects
(P < 0.05).
Acknowledgements
Funding/Support
Authors� Contributions
Financial Disclosure
References
1.
Li CY, Chen SC, Li CY, Gau ML, Huang CM. Randomised controlled
trial of the effectiveness of using foot reflexology to improve
quality of sleep amongst Taiwanese postpartum women. Midwifery.
2011;27(2):181�6.
2.
Imura M, Misao H, Ushijima H. The psychological effects of aromatherapy-
massage in healthy postpartum mothers. J Midwifery
Womens Health. 2006;51(2):e21�7.
3.
Okun ML. Sleep in Pregnancy and the Postpartum. Encyclopedia
Sleep. 2013:674�9.
4.
Reza H, Kian N, Pouresmail Z, Masood K, Sadat Seyed Bagher M,
Cheraghi MA. The effect of acupressure on quality of sleep in Iranian
elderly nursing home residents. Complement Ther Clin Pract.
2010;16(2):81�5.
5.
Fismer KL, Pilkington K. Lavender and sleep: A systematic review
of the evidence. Eur J Integr Med. 2012;4(4):e436�e47.
6.
Ko YL, Lee HJ. Randomised controlled trial of the effectiveness of
using back massage to improve sleep quality among Taiwanese
insomnia postpartumwomen. Midwifery. 2014;30(1):60�4.
7.
Goyal D, Gay CL, Lee KA. Patterns of sleep disruption and de-
Iran Red Crescent Med J. 2015;17(4):e25880
Keshavarz Afshar M et al.
8.
National Sleep Foundation.. Sleep in America Poll. Washington,
DC: National Sleep Foundation; 2007. Available from: http://
sleepfoundation.org/.
9.
Dennis CL, Ross L. Relationships among infant sleep patterns,
maternal fatigue, and development of depressive symptomatology.
Birth. 2005;32(3):187�93.
10.
Posmontier B. Sleep quality in women with and without postpartum
depression. J Obstet Gynecol Neonatal Nurs. 2008;37(6):722�35.
11.
Lee SH. Effects of aroma inhalation on fatigue and sleep quality
of postpartum mothers. Women Health Nurs . 2004;10(3):235�43.
12.
Gunderson EP, Rifas-Shiman SL, Oken E, Rich-Edwards JW, Klein-
man KP, Taveras EM, et al. Association of fewer hours of sleep at 6
months postpartum with substantial weight retention at 1 year
postpartum. Am J Epidemiol. 2008;167(2):178�87.
13.
Signal TL, Gander PH, Sangalli MR, Travier N, Firestone RT, Tuohy
JF. Sleep duration and quality in healthy nulliparous and multiparous
women across pregnancy and post-partum. Aust N Z J
Obstet Gynaecol. 2007;47(1):16�22.
14.
Rychnovsky J, Hunter LP. The relationship between sleep characteristics
and fatigue in healthy postpartum women. Womens
Health Issues. 2009;19(1):38�44.
15.
Moeini M, Khadibi M, Bekhradi R, Mahmoudian SA, Nazari F. Effect
of aromatherapy on the quality of sleep in ischemic heart
disease patients hospitalized in intensive care units of heart hospitals
of the Isfahan University of Medical Sciences. Iran J Nurs
Midwifery Res. 2010;15(4):234�9.
16.
Conrad P, Adams C. The effects of clinical aromatherapy for anxiety
and depression in the high risk postpartum woman - a pilot
study. Complement Ther Clin Pract. 2012;18(3):164�8.
17.
Chien LW, Cheng SL, Liu CF. The effect of lavender aromatherapy
on autonomic nervous system in midlife women with insomnia.
Evid Based Complement Alternat Med. 2012;2012:740813.
18.
Lee IS, Lee GJ. [Effects of lavender aromatherapy on insomnia and
depression in women college students]. Taehan Kanho Hakhoe
Chi. 2006;36(1):136�43.
19.
Arzi A, Sela L, Green A, Givaty G, Dagan Y, Sobel N. The influence
of odorants on respiratory patterns in sleep. Chem Senses.
2010;35(1):31�40.
20.
Jahdi F, Behboodi Moghadam Z, Hagani H. The impact of Health
Behavior Education on the Sleep Quality in the Pregnant Women
with sleep disorder: A Randomized Control Trial 2011-2012. Int Res
J Applied Basic Sci. 2013;7(12):921�8.
21.
Sullivan KM, Dean A, Soe MM. OpenEpi: a web-based epidemiologic
and statistical calculator for public health. Public Health
Rep. 2009;124(3):471�4.
22.
Malekzadegan A, Moradkhani M, Ashaeri H, Haghani H. The effects
of Relaxation exercise training on the sleep disorders in
the third trimester of pregnancy, pregnant women referred to
health centers in Zanjan. Sch Nurs Midwifery Iran Univ Med Sci Iran.
2005;1385.
23.
Hirokawa K, Nishimoto T, Taniguchi T. Effects of lavender aroma
on sleep quality in healthy Japanese students. Percept Mot Skills.
2012;114(1):111�22.
24.
Pillitteri A. Maternal & child health nursing: care of the childbearing
and childrearing famil.: Lippincott Williams and Wilkins; 2010.
25.
Field T, Field T, Cullen C, Largie S, Diego M, Schanberg S, et al. Lavender
bath oil reduces stress and crying and enhances sleep in
very young infants. Early Hum Dev. 2008;84(6):399�401.
Iran Red Crescent Med J. 2015;17(4):e25880
PENURUNAN INTENSITAS NYERI AKIBAT LUKA POST SECTIO
CAESAREA SETELAH DILAKUKAN LATIHAN TEKNIK RELAKSASI
PERNAPASAN MENGGUNAKAN AROMATERAPI LAVENDER DI
RUMAH SAKIT AL ISLAM BANDUNG
ABSTRAK
�
Juni 2012. Analisa data menggunakan uji Wilcoxon. Hasil penelitian
menunjukkan intensitas skala nyeri sebelum dilakukan intervensi adalah 6.6
dimana nilai tersebut masuk dalam kategori nyeri berat tertahankan. Sedangkan
sesudah dilakukan adalah 3.6 dimana nilai tersebut masuk dalam kategori sedang.
Hasil analisis lebih lanjut didapatkan bahwa p= 0.000 dengan taraf signifikan <
0.05, yang berarti ada perbedaan yang signifikan dari intensitas nyeri sebelum dan
setelah dilakukan latihan teknik relaksasi pernapasan menggunakan aromaterapi
lavender.
Kata Kunci : Sectio Caesarea, Nyeri, Relaksasi Pernapasan, Aromaterapi
ABSTRACT
Ratna Pratiwi
Email: pratiwiratna21@yahoo.com
Key words : Sectio Caesarea, Pain, Breathing Relaxation, Aromatheray
PENDAHULUAN
Persalinan normal merupakan proses dari mulai mulesnya ibu sampai pada
keluarnya bayi dengan kondisi kepala dahulu melalui vagina, dengan lama
persalinan kurang dari 24 jam (Whalley, 2008). Proses ini kadang tidak berjalan
semestinya dan janin tidak dapat lahir secara normal karena beberapa faktor, yaitu
komplikasi kehamilan, disproporsi sefalo-pelvik, partus lama, ruptur uteri, cairan
ketuban yang tidak normal, kepala panggul. Keadaan tersebut perlu tindakan
medis berupa operasi sectio caesarea (Padilla, et al.,2008). Sectio caesarea adalah
melahirkan janin melalui insisi pada dinding abdomen (laparotomi) dan dinding
uterus (histerotomi) (Cunningham, 2006).
Ratna Pratiwi
Email: pratiwiratna21@yahoo.com
Nyeri tersebut akan menimbulkan berbagai masalah, salah satunya
masalah laktasi. Menurut Hillan (1992) dalam Anggorowati, dkk 2007 bahwa
68% ibu post sectio caesarea mengalami kesulitan dengan perawatan bayi,
bergerak naik turun dari tempat tidur dan mengatur posisi yang nyaman selama
menyusui akibat adanya nyeri. Rasa nyeri tersebut akan menyebabkan pasien
menunda pemberian ASI sejak awal pada bayinya, karena rasa tidak nyaman
selama proses menyusui berlangsung atau peningkatan intensitas nyeri setelah
operasi (Batubara dkk, 2008).
Ratna Pratiwi
Email: pratiwiratna21@yahoo.com
dapat berkurang serta masa pemulihan tidak memanjang (Bobak, 2004). Metode
non farmakologi tersebut bukan merupakan pengganti untuk obat-obatan,
tindakan tersebut diperlukan untuk mempersingkat episode nyeri yang
berlangsung hanya beberapa detik atau menit. Dalam hal ini, terutama saat nyeri
hebat yang berlangsung selama berjam-jam atau berhari-hari, mengkombinasikan
metode non farmakologi dengan obat-obatan mungkin cara yang paling efektif
untuk mengontrol nyeri. Pengendalian nyeri non-farmakologi menjadi lebih
murah, simpel, efektif dan tanpa efek yang merugikan (Potter, 2005).
Ratna Pratiwi
Email: pratiwiratna21@yahoo.com
dalam darah (Handerson, 2005). Teori relaksasi pernapasan ini menjelaskan
bahwa pada spinal cord, sel-sel reseptor yang menerima stimulasi nyeri periferal
dihambat oleh stimulasi dari serabut-serabut saraf yang lain. Stimulasi yang
menyenangkan dari luar juga dapat merangsang sekresi endorfin, sehingga
stimulasi nyeri yang dirasakan oleh klien menjadi berkurang (Priharjo, 2003).
Periode relaksasi pernapasan yang teratur dapat membantu untuk melawan
keletihan, ketegangan otot yang terjadi akibat meningkatkan nyeri (Smeltzer dan
Bare, 2002).
Ratna Pratiwi
Email: pratiwiratna21@yahoo.com
menjalani persalinan menggunakan minyak lavender dapat mengurangi rasa nyeri
pada daerah perineum dan mengurangi kegelisahan.
METODE PENELITIAN
Ratna Pratiwi
Email: pratiwiratna21@yahoo.com
latihan teknik relaksasi pernapasan terhadap nyeri akibat post sectio caesarea
dalam penelitian ini adalah skala ordinal. Pengumpulan data ini dilakukan pada
ibu post sectio caesarea di ruang nifas Rumah Sakit Al Islam Bandung.
Pelaksanaan dan pengumpulan data dilakukan oleh peneliti dan dibantu oleh
kolektor data seorang perawat. Pengumpulan data dilaksanakan pada tanggal 14
Mei � 7 Juni 2012.
Ratna Pratiwi
Fakultas Ilmu Keperawatan Universitas Padjadjaran (Jl.Raya Bandung-Sumedang KM.21
Jatinangor-Sumedang)
Email: pratiwiratna21@yahoo.com
Tabel 2 Frekuensi Intensitas Nyeri Sebelum dan Sesudah Dilakukan Latihan
Teknik Relaksasi Pernapasan Menggunakan Aromaterapi Lavander
(n=30)
Tabel 3 Tingkat Nyeri Sebelum dan Sesudah dilakukan Latihan Teknik Relaksasi
Pernapasan Menggunakan Aromaterapi Lavander (n=30)
Penurunan intensitas nyeri pada responden ini terjadi karena ibu post sectio
caesarea dapat mempraktekkan latihan teknik relaksasi pernapasan menggunakan
aromaterapi lavender dengan benar dan lama waktu latihan kurang lebih 15 menit,
dilakukan pada saat ibu merasakan nyeri pada luka bekas sectio caesarea.
Menurut Indiarti (2009) menggunakan relaksasi dengan induksi latihan relaksasi
pernapasan selama 15 -20 menit secara teratur dapat mengurangi rasa nyeri.
Latihan teknik relaksasi pernapasan dengan aromaterapi lavender dapat dilakukan
sebelum keluhan nyeri terasa. Ibu post sectio caesarea dapat mempraktekkan
latihan pernapasannya untuk mengatasi rasa nyeri pada saat memiringkan badan
dan mengatur posisi. Latihan teknik relaksasi pernapasan bisa berhasil jika pasien
kooperatif (Potter dan Perry, 2006).
Ratna Pratiwi
Email: pratiwiratna21@yahoo.com
Hasil penelitian ini hampir sama dengan hasil penelitian yang telah
dilakukan oleh Priyani (2009) yang menyatakan bahwa ada pengaruh yang
signifikan antara pemberian teknik relaksasi napas dalam terhadap penurunan
nyeri dismenore pada remaja putri di Panti Asuhan Yatim Putri Islam Yogyakarta
dengan nilai signifikansi (p) = 0.000. Nyeri merupakan perasaan emosional yang
bersifat subjektif dan hanya seseorang dengan kondisi tersebut yang dapat
mendeskripsikan besarnya nyeri yang dirasakan. Sehingga akan berpengaruh
terhadap penurunan skala intensitas nyeri pada tiap responden. Nyeri sendiri
muncul karena adanya kiriman impuls yang memasuki medulla spinalis dan
berinteraksi dengan sel �
sel saraf inhibitor, sehingga akan ditransmisi mencapai
ke korteks serebral untuk diinterpretasikan sensasi nyeri (Potter dan Perry, 2005).
Nyeri yang dirasakan ibu post sectio caesarea dapat dikendalikan dengan
metode penatalaksanaan nyeri seperti yang dilakukan peneliti terhadap
penelitiannya. Metode penatalaksanaan nyeri tersebut dapat dikelompokkan
menjadi metode farmakologi dan metode non farmakologi. Penelitian yang sudah
Ratna Pratiwi
Email: pratiwiratna21@yahoo.com
dilakukan Kim pada tahun 2007 menyebutkan bahwa penggunaan terapi aroma
untuk perawatan post operasi anastesi dengan pemakaian aromaterapi lavender
memiliki pengaruh yang signifikan dan lebih efektif dibandingkan dengan
pemakaian sedatif. Selain itu, hasil yang diperoleh mengenai kegiatan penelitian
ini yaitu pemakaian terapi aroma lavender lebih efektif dalam proses penurunan
nyeri dibandingkan dengan pemakaian analgesik (P= 0.007). Kedua jenis metode
tersebut dapat dikombinasikan satu sama lain sehingga lebih cepat dalam proses
penurunan tingkat intensitas nyeri. Namun demikian, metode non farmakologi
memiliki kelebihan yaitu proses pelaksanaannya relatif sederhana, efektif, dan
tidak menimbulkan efek yang merugikan (Perry dan Potter, 2005).
Ratna Pratiwi
Email: pratiwiratna21@yahoo.com
mempengaruhi organ tubuh dan menimbulkan efek kuat terhadap emosi (Shinobi,
2008). Prinsip dasar teori penurunan nyeri oleh teknik relaksasi pernapasan
menggunakan aromaterapi lavender adalah teori gate control yang terletak pada
fisiologis sistem saraf otonom yang merupakan bagian dari sistem yang
mempertahankan homeostatis. Menurut Melzack dan Wall (1965) teori gate
control menjelaskan mekanisme pertahanan dan impul di saraf pusat.
Ratna Pratiwi
Email: pratiwiratna21@yahoo.com
meletakkan sedikit air dan aromaterapi di atas alat pemanas yang dibakar oleh
lilin aroma sehingga menimbulkan wewangian.
Ratna Pratiwi
Email: pratiwiratna21@yahoo.com
menggunakan aromaterapi lavender terhadap intensitas nyeri akibat luka post
sectio caesarea dengan p-value < 0.05 baik terhadap intensitas skala nyeri dan
berkurangnya nyeri yang dialami ibu post sectio caesarea dapat diatasi.
SARAN
Diharapkan bagi ibu post sectio caesarea dapat memahami tentang latihan
teknik relaksasi pernapasan menggunakan aromaterapi lavender terhadap
intensitas nyeri akibat luka post sectio caesarea. Informasi yang telah diterima
dapat dipraktekkan secara mandiri oleh ibu dalam kehidupan sehari �
hari
sehingga ketika terjadi nyeri, ibu dapat mengontrol sensasi nyeri dan aktivitas ibu
tidak terganggu.
Ratna Pratiwi
Email: pratiwiratna21@yahoo.com
Ucapan terima kasih penulis sampaikan kepada Rumah Sakit Al Islam
DAFTAR PUSTAKA
terhadap Nyeri Post Sectio Caesarean (SC) pada RS Sultan Agung dan RS
Roemani Semarang. Journal Media Ners Vol 1, No 1, Tahun 2007: 10 � 15.
Atkinson, R,et al. 2003. Penghantar Psikologi edisi 8 jilid 2. Jakarta: Penerbit
Erlangga.
Kim
T et al. ( 2007). Treatment with Lavender Aromatherapy in the Post-
Anesthesia Care Unit reduces. Opioid Requirements of Morbidly Obese
Patients Undergoing Laparoscopic Adjustable. Gastric Banding. Obesity
Surgery 2007; 17: 920-925.
Ratna Pratiwi
Email: pratiwiratna21@yahoo.com
Padilla, et al. 2008. Risk Factors in Cesarean Section. Ginecol Obstet Mex Article
in Spanish. 2008 Jul;76(7):392-7.
Smeltzer, S. C, & Bare, B.G. (2001). Buku ajar keperawatan medikal bedah
Brunner and Suddarth. (8 th edition). Jakarta: EGC.
Walley, J., Simkin, P., dan Keppler, A. (2008). Panduan Praktis Bagi Calon Ibu :
Kehamilan dan Persalinan. Jakarta : PT. Bhuana Ilmu Populer.
Ratna Pratiwi
Email: pratiwiratna21@yahoo.com
ISSN 2354-7642
Jurnal Ners dan Kebidanan Indonesia JOURNAL NERS
Tersedia online pada: AND MIDWIFERY INDONESIA
http://ejournal.almaata.ac.id/index.php/JNKI
Aromaterapi Lavender dapat Menurunkan Intensitas Nyeri Perineumpada Ibu Post Partum
Wiwin Widayani
Jalan Pajajaran No.56, Pasir Kaliki, Cicendo, Kota Bandung, Jawa Barat 40171
Email: wiwinbidbdg@gmail.com
Abstrak
Nyeri perineum dapat memengaruhi kemampuan wanita untuk mobilisasi sehingga dapat
menimbulkan
komplikasi seperti perdarahan post partum. Trauma pada perineum juga menimbulkan
rasa tidak nyaman
dan nyeri saat melakukan hubungan seksual. Karena itu, penanganan nyeri perineum
ini penting dilakukan.
Saat ini penanganan yang sering digunakan yaitu terapi komplementer aromaterapi
dengan minyak essensial
lavender, karena lavender mempunyai sifat antikonvulsan, antidepresi, anxiolytic,
dan menenangkan.
Aromaterapi akan menstimulasi hipotalamus untuk mengeluarkan mediator kimia yang
berfungsi sebagai
penghilang rasa sakit dan menimbulkan perasaan bahagia. Tujuan penelitian ini
adalah untuk mengetahui
pengaruh aromaterapi lavender terhadap intensitas nyeri luka jahitan perineum pada
ibu post partum. Penelitian
ini merupakan quasi eksperiment pre and post control pada ibu nifas yang berada di
Bidan Praktik Mandiri
Wilayah Kota Bandung. Pengambilan sampel penelitian ini menggunakan teknik
consecutive sampling. Data
diambil dengan menggunakan instumen yang diadaptasi dari Visual Analog Scale (VAS)
dengan analisis uji
wilcoxon. Hasil penelitian menunjukkan ada penurunan nyeri sebelum dan setelah
pemberian aromaterapi
lavender secara inhalasi (Z=-3,77) dengan p-value 0,001. Aromaterapi lavender dapat
menjadi alternatif
terapi komplementer untuk menurunkan nyeri pada ibu post partum akan tetapi
diperlukan penelitian lebih
lanjut dengan responden yang lebih banyak.
Abstract
Perineals pain affects woman ability to mobilize so that it can cause complications
such as post-partum
serve as pain relievers and give rise to feelings of happiness. The purpose of this
study was to determine the
experiment pre and post non random control in postpartum women at Bidan Praktik
Mandiri in Bandung. This
study used was consecutive sampling technique. The data were taken using the
instrument adapted from a
Visual Analog Scale (VAS) and analyzed by the wilcoxon signed rank test. The result
showed that there was
postpartum women but more research necessary is needed with more respondents.
Info Artikel:
Artikel dikirim pada 21 September 2016
Artikel diterima pada 31 Oktober 2016
DOI : http://dx.doi.org/10.21927/jnki.2016.4(3).123-128
Aromaterapi Lavender dapat Menurunkan Intensitas Nyeri Perineum pada Ibu Post
Partum 123
PENDAHULUAN
Padabeberapaorang,nyeridapatmengganggu
dibanding gangguan akibat penyakit yang lain.
Setelah melahirkan secara pervaginam, seorang
ibu sering melaporkan nyeri dan trauma pada
perineum. Nyeri perineum merupakan hal yang
fisiologis pada ibu post partum, akan tetapi
nyeri ini memengaruhi kemampuan wanita untuk
mobilisasi sehingga dapat menimbulkan komplikasi
seperti perdarahan post partum. Nyeri perineum
akibat adanya trauma seperti adanya laserasi
perineum dapat menyebabkan rasa tidak nyaman
dan dispareunia. Di Rumah Sakit Royal Victoria
Australia dilaporkan bahwa 90% wanita mengalami
nyeri perineum. Nyeri dirasakan ketika berjalan
(33%), duduk (39%), dan tidur (45%) (2).
124 Wiwin Widayani, 2016. JNKI, Vol. 4, No. 3, Tahun 2016, 123-128
10, 30 dan 60, aromaterapi diberikan selama 10
menit. Kemudian dilakukan posttest seiring dengan
observasi masa nifas 2 jam, dengan cara memeriksa
luka jahitan perineum menggunakan pinset anatomis.
Saat diperiksa luka jahitan, peneliti melihat reaksi
wajah responden.
Karakteristik n %
Usia
< 20 Tahun 7 25
20-35 tahun 20 71,4
>35 tahun 1 3,6
Pekerjaan
Tidak bekerja 26 92,9
Bekerja 2 7,1
Pendidikan
SD 3 10,7
SMP 8 28,6
SMA 11 39,3
Perguruan Tinggi 6 21,4
Paritas
Melahirkan 1 kali 12 42,9
Melahirkan > 2 kali 16 57,1
Jumlah 28 100
Tabel 3. Perbedaan Intensitas Nyeri Luka Jahitan Perineum Sebelum dan Sesudah
Intervensi
Sebelum Sesudah
Skor Intensitas
Nyeri Perineum
(n=28) (n=28)
Aromaterapi Lavender dapat Menurunkan Intensitas Nyeri Perineum pada Ibu Post
Partum 125
Pada Tabel 3 dapat diketahui bahwa nilai
median dan rentang dari skor intensitas nyeri luka
perineum setelah perlakuan menjadi lebih rendah
dibandingkan sebelum perlakuan. Berdasarkan
hasil uji statistik nilai p<0,05 sehingga terdapat
perbedaan skor pada kelompok responden sebelum
perlakuan dan setelah perlakuan. Oleh karena itu
dapat diasumsikan bahwa pemberian aromaterapi
lavender berpengaruh terhadap penurunan intensitas
nyeri luka perineum.
126 Wiwin Widayani, 2016. JNKI, Vol. 4, No. 3, Tahun 2016, 123-128
intensitas nyeri persalinan fisiologis kala satu fase
RUJUKAN
1.
Fraser DM, Cooper MA. Myles Buku Ajar Bidan.
Jakarta: EGC; 2009.
2.
East CE, Sherburn M, Nagle C, Said J, Forster
D. Perineal pain following childbirth: Prevalence,
effects on postnatal recovery and analgesia usage.
Midwifery [Internet]. 2012 Feb [cited 2015 Sep
10];28(1):93�7. Available from: http://linkinghub.
elsevier.com/retrieve/pii/S0266613810001889.
3.
Koensoemardiyah. Aromaterapi untuk Kesehatan
dan Kecantikan. Yogyakarta: Lily Publisher;
2009.
4.
Tournaire M, Theau-Yonneau A. Complementary
and Alternative Approaches to Pain Relief during
Labor. Evidence-Based Complement Altern Med
[Internet]. 2007 [cited 2015 Jan 1];4(4):409�17.
Available from: http://www.hindawi.com/journals/
ecam/2007/256475/abs/
5.
Woollard AC, Tatham KC, Barker S. The influence
of essential oils on the process of wound healing:
a review of the current evidence. J Wound Care
[Internet]. 2007 Jun;16(6):255�7. Available
from: http://www.magonlinelibrary.com/doi/
abs/10.12968/jowc.2007.16.6.27064.
6.
Vakilian K, Atarha M, Bekhradi R, Chaman
R. Healing advantages of lavender essential
oil during episiotomy recovery: A clinical trial.
Complement Ther Clin Pract [Internet]. 2011
Feb;17(1):50�3. Available from: http://linkinghub.
elsevier.com/retrieve/pii/S1744388110000381
7.
Dochterman J. Nursing intervention Classification
(NIC) fourth edition. USA: Mosby; 2004.
8.
Stea S, Beraudi A, De Pasquale D. Essential
Oils for Complementary Treatment of Surgical
Patients: State of the Art. Evidence-Based
Complement Altern Med [Internet]. 2014;2014:1�6.
Available from: http://www.hindawi.com/journals/
ecam/2014/726341/
9.
Salamati A, Mashouf S, Sahbaei F, Mojab F.
Effects of Inhalation of Lavender Essential Oil on
Open-heart Surgery Pain. Iran J Pharm Res IJPR
[Internet]. 2014;13(4):1257�61. Available from:
http://www.ncbi.nlm.nih.gov/pubmed/25587315.
10. Koulivand PH, Khaleghi Ghadiri M, Gorji A.
Lavender and the Nervous System. Evidence-
Based Complement Altern Med [Internet].
2013;2013:1�10. Available from: http://www.
hindawi.com/journals/ecam/2013/681304/
11. Kristanti EE. Pengaruh Aropmaterapi Lavender
Terhadap Penurunan Derajat Kecemasan pada
Lansia di Panti Wredha St Yoseph Kediri. J Penelit
Stikes RS Baptis Kediri [Internet]. 2010;3(2):94�
100. Available from: http://puslit2.petra.ac.id/
ejournal/index.php/stikes/article/view/18399.
12. Pratiwi R, Ermiati, Widiasih R. Penurunan Intensitas
Nyeri Akibat Luka Post Sectio Caesarea Setelah
Dilakukan latihan Teknik Relaksasi Pernapasan
Menggunakan Aromaterapi Lavender di Rumah
Sakit Al Islam Bandung. Students e-journals
[Internet]. 2012;1(1):1�15. Available from: http://
jurnal.unpad.ac.id/ejournal/article/view/711.
13. Karlina SD, Reksohusodo S, Widayati A.
Pengaruh Aromaterapi Lavender secara Inhalasi
terhadap Penurunan Intensitas Nyeri Persalinan
Fisiologis pada Primipara Inpartu Kala Satu Fase
Aktif di BPM Fetty Fathiyah Kota Mataram. Maj
Kesehat Fak Kedokt Univ Brawijaya [Internet].
Aromaterapi Lavender dapat Menurunkan Intensitas Nyeri Perineum pada Ibu Post
Partum 127
2015;2(2). Available from: http://majalahfk.ub.ac.
id/index.php/mkfkub/article/view/59.
128 Wiwin Widayani, 2016. JNKI, Vol. 4, No. 3, Tahun 2016, 123-128
PERBEDAAN TINGKAT NYERI SEBELUM DAN SESUDAH PEMBERIAN
AROMATHERAPI LAVENDER PADA IBU POST SECTIO CAESAREA
DI RSUD AMBARAWA
Prita Swandari
ABSTRACT
Method: This was a quasi-experimental study with the samples of 26 patients with
post-SC sampled by
using accidental sampling technique. The levels of pain were measured by using
numerical scales. The
bivariate analysis used the Wilcoxon test.
Results: The results of this study indicated that there were 21 respondents (80.8%)
who have pain in
the category of medium, and 5 respondents (19:20%) who had pain in the category of
mild, whereas
after the lavender aromatherapy given indicated that there were 20 respondents
(76.92%) who have
pain in the category of mild, and 6 respondents (23.1%) who had pain in the
category of medium. The
bivariate analysis indicated that there was a difference in the levels of pain in
the patients with post-
SC before and after getting lavender aromatherapy with p-value of 0.000 < a = 0.05.
Advice: From the research that can be used as reference to to condiser aromatherapi
of lavender as
therapi to reduce pain in patients post sectio caesarea.
PENDAHULUAN
Perbedaan Tingkat Nyeri Sebelum dan Sesudah Pemberian Aromatherapi Lavender pada
Ibu Post Sectio Caesarea
di RSUD Ambarawa
SC akan menimbulkan berbagai masalah, salah
satunya masalah laktasi. Rasa nyeri tersebut
akan menyebabkan pasien menunda pemberian
ASI sejak awal pada bayinya, karena rasa tidak
nyaman dan peningkatan tingkat nyeri setelah
operasi (Batubara dkk, 2008).
Perbedaan Tingkat Nyeri Sebelum dan Sesudah Pemberian Aromatherapi Lavender pada
Ibu Post Sectio Caesarea
di RSUD Ambarawa
fisik tetapi juga tingkat emosi (Balkam, 2004).
Kandungan lavender oil yang terdiri dari
linalool, linalyl acetate, dan 1,8 -cincole dapat
menurunkan, mengendorkan, dan melemaskan
secara spontan ketegangan pada tikus yang
mengalami spasme pada otot intestinalnya.
Mekanisme massage pada tubuh dapat
menstimulasi produksi endhorpin di otak,
sehingga dapat memblokir transmisi stimulus
nyeri. Sedangkan apabila minyak aromatherapi
masuk ke rongga hidung melalui penghirupan
langsung akan bekerja lebih cepat karena
molekul-molekul minyak esensial mudah
menguap oleh hipotalamus karena aroma
tersebut diolah dan dikonversikan oleh tubuh
menjadi suatu aksi dengan pelepasan subtansi
neurokimia berupa zat endorphin dan serotinin
sehingga berpengaruh langsung pada organ
penciuman dan dopersepsikan oleh otak untuk
memberikan reaksi yang membuat perubahan
fisiologis pada tubuh., pikiran, jiwa, dan
menghasilkan efek menenangkan pada tubuh
(Nurachman, 2004).
METODOLOGI PENELITIAN
Desain Penelitian
pretest-posttest
mempertimbangkan
jumlah subyek peneliti, dan biaya.
design
keterbatasan
dengan
waktu,
Populasi dan Sampel
Populasi
Sampel
Perbedaan Tingkat Nyeri Sebelum dan Sesudah Pemberian Aromatherapi Lavender pada
Ibu Post Sectio Caesarea
di RSUD Ambarawa
jumlah responden yang digunakdigunakan dalam
penelitian ini adalah sejumlah 26 ibu post
sectio caesaria di RSUD Ambarawa barawa.
digunakan dalam
penelitian ini adalah sejumlah 26 ibu post
sectio caesaria di RSUD Ambarawa barawa.
Pengumpulan Data
Data primer
Data sekunder
Alat Ukur
GambarGambar 1.
Skala penilaian numerik merik (Numerical Rating
Scale, NRSNRS)
Analisa Data
Analisa Univariat
Analisa Bivariat
Analisis Univariat
Tabel 1.
Distribusi Frekuensi Berdasarkan Nyeri
Sebelum Pemberian Aromatherapi
Lavender
Nyeri sebelum
No pemberian n %
aromatherapi lavender
1. Ringan 5 19.2
2. Sedang 21 80.8
Jumlah 26 100,0
Sumber: Data Primer diolah (2014)
Tabel 2.
Distribusi Frekuensi Berdasarkan Nyeri
Sesudah Pemberian Aromatherapi
Lavender
Nyeri sesudah
No pemberian n %
aromatherapi lavender
1. Ringan
20 76.92
2.
Sedang 6 23.1
Jumlah 26 100,0
Sumber : Data Primer diolah (2014)
Analisis Bivariat
Tabel 3.
Hasil uji normalitas didapatkan semua p berdistribusi tidak normal, maka uji
bivariat
value < 0,05 sehingga dapat disimpulkan data menggunakan uji wilcoxon.
Tabel 4.
Test Statistics Perbedaan Nyeri Sebelum Dan Sesudah Pemberian Aromatherapi Lavender
Pada
Ibu Post Sectio Caesar Di RSUD Ambarawa
PEMBAHASAN
Analisis Univariat
Perbedaan Tingkat Nyeri Sebelum dan Sesudah Pemberian Aromatherapi Lavender pada
Ibu Post Sectio Caesarea
di RSUD Ambarawa
responden yang mengalami nyeri berat ataupun
sangat berat.
Perbedaan Tingkat Nyeri Sebelum dan Sesudah Pemberian Aromatherapi Lavender pada
Ibu Post Sectio Caesarea
di RSUD Ambarawa
sesudah diberikan aromatherapi lavender pada
mahasiswa DIII Kebidanan semester II Stikes
Ngudi Waluyo.
Perbedaan Tingkat Nyeri Sebelum dan Sesudah Pemberian Aromatherapi Lavender pada
Ibu Post Sectio Caesarea
di RSUD Ambarawa
Keterbatasan Penelitian
KESIMPULAN
SARAN
DAFTAR PUSTAKA
Ina Rahmawati �, Dr. Heni Setyowati E. R., S. Kp., M. Kes�, Ns. Rohmayanti, M.
Kep�
Abstrak
Latar belakang: Nyeri merupakan suatu keadaan yang tidak nyaman yang sering
dirasakan oleh
pasien post sectio caesarea. Aromaterapi dapat digunakan untuk mengatasi nyeri post
sectio
caesarea. Tujuan:Penelitian ini bertujuan untuk mengetahui efektivitas antara
aromaterapi
lavender dan aromaterapi lemon di Rumah Sakit Budi Rahayu Kota Magelang.
Metode:penelitian
ini menggunakan metodequasy experimentdengan rencangan two group pre-test and post-
test
designdengan sampel 56 responden, 28 responden kelompok aromaterapi lavender dan 28
Kata Kunci : Aromaterapi Lavender, Aromaterapi Lemon, Nyeri Post Sectio Caesarea
1. PENDAHULUAN
caesarea 24,6%. Selain itu angka
Section caesarea suatu tindakan kejadian sectio caesarea di Australia
pembedahan atau suatu persalinan pada tahun 1998 sekitar 21% dan
buatan yang tujuannya untuk pada tahun2007 sekitar 31%. Di
mengeluarkan bayi dengan cara Indonesia angka kejadian sectio
5,5 per 100 kelahiran pada tahun perubahan kontinuitas sehingga ibu
1970 menjadi 22,7 per 100 kelahiran merasa nyeri karena adanya
pada tahun 1985.Di Inggris, pada pembedahan ( Asamoah, 2011).
tahun 2008-2009 angka sectio
Penanganan yang sering
digunakan untuk menurunkan nyeri
post sectio caesarea berupa
penanganan farmakologi dan non
farmakologi. Salah satu terapi non
farmakologi yang dapat digunakan
yaitu aromaterapi. (Anggorowati,
2007).
2. METODOLOGI PENELITIAN
Penelitian ini merupakan penelitian
quasi eksperiment dengan desain
rancangan two group pre test and
post test design. Instrumen yang
digunakan dalam penelitian ini
berupa data karakteristik dan
kuesioner. Pada data karakteristik
data berupa lembaran demografi
yang berisi data karakteristik
responden yang meliputi usia,
pendidikan terakhir, dan pekerjaan.
Pada kuesioner skala numeric Rating
Scale adalah suatu garis lurus yang
digunakan untuk mengukur intensitas
nyeri dan pendeskripsi verbal pada
setiap ujungnya dengan rentang nyeri
Aromaterapi Aromaterapi
variabel
Lavender (n=28) Lemon (n=28)
P
Mean Sd Jumlah Mean Sd Jumlah
value
% %
Usia 21,36 1,890 21,25 2,238 2,238 0,059
18-25
Tingkat
pendidikan
SD
25,0
28,6
17,9
42.9
0,310
SMP 35,7 28,6
SMA 10,7 10,7
Perguruan
Tinggi
Pekerjaan 0,261
IRT 64,3 64,3
PNS 28,6 10,7
KARYAWAN 7,1 25,0
Tabel 1 menunjukkan bahwa hasil uji varian yang sama sehingga dapat
homogenitas pada kedua kelompok disimpulkan bahwa kelompok
pada masing-masing karakteristik intervensi aromaterapi lavender dan
menunjukkan P value >0.05 yang kelompok aromaterapi lemon
artinya kedua kelompok memiliki memiliki karakteristik yang sama.
Tabel 2
Uji Normalitas Nyeri Post Sectio Caesarea Sebelum dan Setelah Dilakukan
Tindakan Pada Kelompok Aromaterapi Lavender
Shapiro-Wilk
Statistik df sig
AT lavender ke 1 ,605 28 ,000
Pre test
AT lavender ke 2
AT Lavender ke 3
,800
,774
28
28
,000
,000
AT Lavender ke 4 ,867 28 ,002
AT Lavender ke 1 ,926 28 ,049
Post test
AT Lavender ke 2
AT Lavender ke 3
,786
,904
28
28
,000
,014
AT Lavender ke 4 ,861 28 ,002
aromaterapi lavender ke 3
didapatkan hasil P=0, 000, pada
kelompok aromaterapi lavender ke 4
didapatkan hasil P=0,002. Dan
setelah diberikan aromaterapi
lavender, pada kelompok
aromaterapi lavender ke 1
didapatkan hasil P=0,049, pada
kelompok aromaterapi lavender ke 2
didapatkan hasil P=0,000, pada
kelompok aromaterapi lavender ke 3 kelompok aromaterapi lavender ke 4
didapatkan hasil P=0,014, pada didapatkan hasil P=0,002
Tabel 3
Uji Normalitas Post Sectio Caesarea Setelah Dilakukan Tindakan Pada
Kelompok Aromaterapi Lemon
Shapiro-Wilk
Statistik df sig
AT Lemon ke 1 ,842 28 ,001
Pre test AT Lemon ke 2 ,734 28 ,000
AT Lemonke 3 ,833 28 ,000
AT Lemonke 4 ,879 28 ,002
AT Lemon ke 1 ,915 28 ,026
Post test AT Lemon ke 2 ,871 28 ,003
AT Lemonke 3 ,920 28 ,034
AT Lemon ke 4 ,858 28 ,001
Tabel 4
Perbedaan Skor Nyeri Post Sectio caesareaSebelum dan Setelah Dilakukan
Terapi Aromaterapi Lavender pada Tindakan 1, 2, 3 dan 4
*Uji Wilcoxon
Tabel 4 menunjukan bahwa terdapat aromaterapi lavender pada tindakan
penurunan signifikan skor nyeri ke 4 sebesar 5,54 dan setelah
sebelum dan setelah diberikan diberikan aromaterapi lavender pada
aromaterapi lavender pada kelompok tindakan ke 4 sebesar 3,39 dengan
aromaterapi lavender dengan hasil p=0,000
rata-rata nyeri sebelum diberikan
Untuk Memperjelas perbedaan skor nyeri post sectio caesarea sebelum dan
sesudah pemberian aromaterapi lavender peneliti gambarkan dengan histrogram.
Histrogram 1
Perbedaan Skor Nyeri Post Sectio Caesarea Sebelum Dan Sesudah
Dilakukan Aromaterapi Lavender
0
1
2
3
4
5
6
7
8
9
Tindakan ke1 tindakan ke 2 Tindakan ke 3 Tindakan ke 4
pre
post
Tabel 4.5
Perbedaan Skor Nyeri Post Sectio caesarea Sebelum dan Setelah Dilakukan
Terapi Aromaterapi Lemon pada Tindakan 1, 2, 3 dan 4
*Uji Wilcoxon
Tabel 5 menunjukan bahwa terdapat rata nyeri sebelum diberikan
penurunan signifikan skor nyeri aromaterapi lemon pada tindakan ke
sebelum dan setelah diberikan 4 sebesar 5,39 dan setelah diberikan
aromaterapi lemon pada kelompok aromaterapi lavender pada tindakan
aromaterapi lemon dengan hasil rata-ke 4 sebesar 1,39 dengan p=0,000
Untuk Memperjelas perbedaan skor nyeri post sectio caesarea sebelum dan
sesudah pemberian aromaterapi lavender peneliti gambarkan dengan histrogram.
Histrogram 4.2
Perbedaan Skor Intensitas Nyeri Post Sectio Caesarea Sebelum Dan Sesudah
Dilakukan Aromaterapi Lemon
0
1
2
3
4
5
6
7
8
9
Tindakan ke 1 Tindakan ke 2 Tindakan ke 3 Tindakan ke 4
pre
post
Tabel 4.6
Perbedaan penurunan Skor Nyeri Post Sectio Caesarea sebelum dan setelah
diberikan tindakan Aromaterapi Lavender dan Aromaterapi Lemon Pada
Tindakan 1, 2, 3 dan 4
8,14
6,71
7,50
5,75
6,68
3,89
5,54
3,39
7,93
5,50
7,46
4,32
6,18
3,14
5,39
1,39
0,257
0,028
1,39
0,019
0,25
0,009
1,85
1. Bagi
Ibu Post Sectio Caesarea
dan Masyarakat
Dengan penelitian ini diharapkan ibu
post sectio caesarea dan masyarakat
dapat menjadikan aromaterapi
sebagai salah satu pengobatan
alternatif bagi masyarakat yang
mengalami nyeri post sectio caesrea
agar menggunakan aromaterapi
lavender dan aromaterapi lemon
sebagai terapi non farmakologi
dalam mengatasi nyeri.
2. Pelayanan Keperawatan
Dengan penelitian ini diharapkan
pelayanan keperawatan bukan hanya
memberikan terapi farmakologis
dalam mengatasi nyeri post sectio
caesarea pada ibu post sectio
caesarea, namun dapat memberikan
terapi komplementer yang berupa
aromaterapi laveder dan aromaterapi
lemon untuk menangani nyeri post
sectio caesarea dalam melaksanakan
perannya sesuai undang-undang
keperawatan.
3. Penelitian Selanjutnya
Dengan penelitian ini diharapkan
penelitian selanjutnya dapat
menjadikan penelitian ini sebagai
referensi bagipeneliti lain untuk
melakukan penelitian dengan
intervensi yang berbeda. selain itu
penelitian selanjutnya diharapkan
dapat meneliti jenis-jenis
aromaterapi yang lainnya, dalam
mengatasi nyeri post sectio caesarea.
DAFTAR PUSTAKA
1.
Alexander, M. (1994).
Biodegradation and
Bioremediation. Academic
Press, New York.
2.
Anggorowati. (2007).
Efektifitas pemberian
3.
Arifin, L. (2008). Tekhnik
Akupresur pada Persalinan.
Jakarta: EGC.
4.
Asamoah. (2011).
Distribution of Causes of
Maternal Mortality among
Different Socio-demographic
Groups in Ghana; A
Descriptive Study. BMC
Public Health
5.
Asmadi. (2008). Teknik
prosedural keperawatan :
Konsep dan aplikasi
kebutuhan dasar klien.
Jakarta: Salemba Medika.
6.
A, Tamsuri, (2007), Konsep
Dan Penatalaksanaan Nyeri
EGC, Jakarta.
7.
Atkinson, R. L., Atkinson, R.
C., Smith, E. E. (2009).
Pengantar Psikologi jilid 2
ed: 11. Alih Bahasa: Widjaja
Kusuma. Jakarta: Interaksara.
8.
Basuki, (2007). Anatomi
Terapan Sistem Respirasi,
Akademi Fisioterapi
Surakarta
9.
Batbual, B. (2010). Hypnosis
Hypnobirthing : Nyeri
Persalinan Dan Berbagai
Metode Penanggulangannya.
Yogyakarta : Gosyen
Publishing.
10. Bobak,
L. 2005. Buku Ajar
Keperawatan Maternitas.
Edisi 4. Jakarta: EGC.
11. Brunner, L dan Suddarth, D.
(2002). Buku Ajar
Keperawatan Medical Bedah
(H. Kuncara, A. Hartono, M.
Ester, Y. Asih, Terjemahan).
(Ed. 8) Vol 1. Jakarta: EGC
12. Cunningham
FG. (2005). Obstetri
Williams. Edisi 21. Jakarta,
EGC.
13. Decherney,
AH, Goodwin
TM, Nathan L, Laufer N.
(2007). Lange
Current Diagnosis and
Treatment Obstetric and
Gynecology, 7th edition. Mc
Graw Hill
14. Dewi,
Y. (2007). Operasi
Caesar. Jakarta : EDSA
Mahkota
15. Dwijayanti, Patricia Febrina.
(2013). �Penyebab, Dampak,
16. Firdayanti.
(2009). Terapi
Nyeri Persalinan Non
Farmakologis. Jurnal
Kesehatan;Vol-11, No. 4
17. Hidayat,
A. Aziz Alimul,
(2008), Pengantar Konsep
Dasar Keperawatan,
Jakarta:Salemba Medika.
18. Hidayat. A.A.A. (2007).
Metode Penelitian
30. Notoatmodjo,s.
2010. Ilmu
Perilaku Kesehatan. Jakarta :
PT Rineka Cipta
31. Patasik
C. K, Tangka J,
Rottie J. (2013). Efektifitas
Teknik Relaksasi Nafas
Dalam Dan Guided Imegery
Terhadap Penurunan Nyeri
Pada Pasien Post Operasi
Sectio Caesare Di Irina D
BLU RSUP Prof. Dr. R. D.
Kandau Manado. Ejurnal
Keperawatan, volume 1, 1-8.
32. Perez,
C. (2003). Clinical
Aromatherapy Part I: An
Introduction Into Nursing
Practice. Clinical Journal Of
Oncologi Nursing. Volume 7,
Number 5. [accessed 20
januari 2016]
33. Poerwadi, R. (2006).
Aromaterapi Sahabat Calon
Ibu. Jakarta: Dian Rakyat.
35. Potter,
P,A and Perry, A,G.
(2009).Fundamentals of
Nursing, Fundamental
Keperawatanbuku 1 Edisi
7 Jakarta: Salemba Medika
36. Prawirohardjo,
S.
(2009). Pelayanan Kesehatan
Maternal Dan Neonatal.
Jakarta: PT Bina Pustaka
37. Price,
Shirley.& Price Len.
(2007). Aromaterapi Bagi
Profesi Kesehatan. Jakarta:
EGC
38. Price, Sylvia A dan Lorraine
M. Wilson.
(2006). Patofisiologi :
Konsep Klinis Proses-Proses
Penyakit. Jakarta : EGC
39. Rukiyah,
ai yeyeh & Lia
Yulianti. (2010). Asuhan
kebidanan IV (patologi
kebidanan ). jakarta: trans
info media
40. Rohani, Reni S, dan Marisah.
(2013). Asuhan Kebidanan
pada MasaPersalinan.
Jakarta: Salemba Medika
41. Sarjono,
H. dan Julianita,
Winda. (2010). SPSS Vs
BISREL: Sebuah Pengantar
Aplikasi Untuk Riset. Jakarta:
Salemba Empat
42. Sastroasmoro, S. (2011).
Dasar-dasar Metodologi
Penelitian Klinis. Jakarta:
Sagubg Seto
44. Smeltzer
C. Suzanne,
Brunner & Suddarth.
(2002). Buku Ajar Keperawatan
Medikal Bedah. EGC : Jakarta
45. Sudoyo,
Aru W, dkk.
(2006).Buku Ajar Ilmu
Penyakit Dalam jilid 1 edisi
IV.Jakarta: Pusat Penerbitan
Ilmu Penyakit Dalam FKUI
46. Sugiyono. (2011). Metode
Penelitian Kuantitatif,
kualitatif dan R & D.
Bandung: Alfabeta.
47. Sulistyowati,
2009,
Farmakologi dan Terapi,
EKG. Yogyakarta
48. Suroso
dan Sri M. T.
(2014).Penerapan Tehnik
Akupresur Titik Pada Tangan
Terhadap Intensitas Nyeri
Persalinan Kala I. Jurnal
Terpadu Ilmu Kesehatan,
februari 2016,Vol.3, No 1
49. Tamsuri,
A. (2007). Konsep
dan penatalaksanaan
nyeri. Jakarta : EGC.
50. Tara
E, 2005, Kesehatan
Kehamilan, Jakarta, Ladang
Pustaka dan Intimedia
51. Turana,
Y. (2004).
Akupresur. From
http//www.medikaholistik.co
m
52. Wong. 2010. Easing anxiety
with aromatherapy.
about.com
alternativemedicine [Jurnal
Online]. Diperoleh tanggal 2
februari 2016 dari
http://altmedicine.about.com/
od/anxiety/a/anxiety_acupunc
ture.htm
54. Yunita.
(2010). Clinical
Psychology. Jakarta : Yayasan
Bina Pustaka.
...................................................................................
.......................
..................................
...................................................................................
.p
..........................................................................a
...................................................................................
...................
...................................................................................
...
................
...................................................................................
.........................................
...................................................................................
.......................................
...................................................................................
...........................................
...................................................................................
.............................
...................................................................................
...............................
...................................................................................
...........................................
...................................................................................
.......................................
............................................................................
...................................................................................
.....................................
...................................................................................
.............................
...................................................................................
...........................
...................................................................................
.....................................
...................................................................................
.......................................
...................................................................................
.......................................
................................................................................
...................................................................................
.....................................
...................................................................................
.......................................
...................................................................................
.............................................
...................................................................................
.............................................
...................................................................................
...
...................................................................................
.....................................
...................................................................................
.......................................
...................................................................................
.......................
..........................................................................
...................................................................................
.................................................
....................N
...................................................................................
...................
...................................................................................
.................
..
...................................................................................
...........................
...................................................................................
.........................
...................................................................................
.........................
...................................................................................
.....
...................................................................................
.
..................
...................................................................................
.................................................
...................................................................................
.......................................
...................................................................................
.............................................
...................................................................................
...................................
...................................................................................
.....................................
...................................................................................
.........................................................
...................................................................................
.................................................
..............................................
...................................................................................
.........................................
...................................................................................
.....................................
...................................................................................
.................................
...................................................................................
.......................................
...................................................................................
...............................................
...................................................................................
.................................
...................................................................................
...................................
...................................................................................
.............................................
...................................................................................
...............................................
...................................................................................
.........................................
...................................................................................
.....................................
...................................................................................
.................................................
...................................................................................
.................................
...................................................................................
...................................................
................................................................................
...................................................................................
.....................................
............................
..
...................................................................................
...................................
...................................................................................
.....................
...................................................................................
.............................
...................................................................................
.............
...................................................................................
.................................
...................................................................................
.............
...................................................................................
.......................
...................................................................................
...................................................................................
...................................................................................
.......................
...................................................................................
.....................
...................................................................................
...............................
...................................................................................
...............
...................................................................................
.........................
...................................................................................
...............................
...................................................................................
...........................
...................................................................................
.........................
...................................................................................
...................
...................................................................................
.........................
...................................................................................
.................
...................................................................................
.................
...................................................................................
...................
...................................................................................
.................
...................................................................................
.............
...................................................................................
.................
...................................................................................
...................
...................................................................................
.....................
...................................................................................
...........................................
...................................................................................
.............
................................................................................
...................................................................................
.............
...................................................................................
...................
...................................................................................
.......................
...................................................................................
.........
...................................................................................
...............
...................................................................................
.................
...................................................................................
...........................
...................................................................................
...............................
...................................................................................
...................
...................................................................................
.....
...................................................................................
.......................
...................................................................................
.............
...................................................................................
.........................
...................................................................................
.........................
...................................................................................
...........................
...................................................................................
.............................
...................................................................................
.........................
...................................................................................
.....................
...................................................................................
...............................
..................................................
...................................................................................
...
...................................................................................
.............
...................................................................................
...............
...................................................................................
.....................
...................................................................................
.............
...................................................................................
...........
...................................................................................
.......................
...................................................................................
.....................
...................................................................................
.......
...................................................................................
.........................
...................................................................................
...............................
...................................................................................
.......................
...................................................................................
...........
...................................................................................
...
...................................................................................
.........
...................................................................................
.......
...................................................................................
...............................
...................................................................................
...........................
...................................................................................
...................
...................................................................................
.......................
...................................................................................
...........................
...................................................................................
.............................
...................................................................................
...........................
..........
...................................................................................
.........................
...................................................................................
.......
...................................................................................
.
...................................................................................
.....................
...................................................................................
...........................
...................................................................................
...............
...................................................................................
.................................
...................................................................................
.................
...................................................................................
...................
...................................................................................
...
...................................................................................
.........................
...................................................................................
...................
...................................................................................
.................
...................................................................................
...........................
...................................................................................
.....................
...................................................................................
.....................
...................................................................................
...................
...................................................................................
...............................
........................................................................
...................................................................................
...........
...................................................................................
.....
...................................................................................
.......................................
...................................................................................
...............................
...................................................................................
...........................
...................................................................................
.........................
............................................................
...................................................................................
.........
...................................................................................
.............................
...................................................................................
...............
...................................................................................
...
...................................................................................
.....................
...................................................................................
.................
...................................................................................
...................................
...................................................................................
...............................
...................................................................................
...........................
....................
...................................................................................
.....
...................................................................................
.............
...................................................................................
.......
...................................................................................
...................
...................................................................................
.................................
...................................................................................
.......................
...................................................................................
.....................
...................................................................................
...........................
...................................................................................
...........................
...................................................................................
.........................
...................................................................................
...................
...................................................................................
.............................
...................................................................................
.....
...................................................................................
.............................
...................................................................................
...........
...................................................................................
.....................
...................................................................................
...............
...................................................................................
.............
...................................................................................
.
...................................................................................
.......
...................................................................................
.......
...................................................................................
...................
...................................................................................
.....................
...................................................................................
...................
...................................................................................
.......
...................................................................................
.....................
....................................................................
..........E
...................................................................................
...........
...................................................................................
.............................
....................................
...................................................................................
.......
...................................................................................
...................
...................................................................................
.............
...................................................................................
.............................
...................................................................................
...................................
...................................................................................
...................
...................................................................................
.......................
...................................................................................
...................................
...................................................................................
...........................
...................................................................................
...............
...................................................................................
.........................
...................................................................................
.............
......................
...................................................................................
.....
...................................................................................
...................
...................................................................................
.....................
...................................................................................
...................
...................................................................................
.....................
...................................................................................
...............
...................................................................................
.........
...................................................................................
.....................
...................................................................................
.........
...................................................................................
...............................
...................................................................................
...............
...................................................................................
.............
...................................................................................
.......
...................................................................................
.....
..............................................................................
...................................................................................
...............
...................................................................................
...
............................................
...................................................................................
.......
...................................................................................
...................................
...................................................................................
.........................
......................................
........L
...................................................................................
.............................
...................................................................................
...
...................................................................................
...........................
...................................................................................
.............
...................................................................................
.......................
...................................................................................
.................................
...................................................................................
...........................
...................................................................................
.....................
...................................................................................
...............
...................................................................................
.....................................
...................................................................................
...........................
...................................................................................
...............................
...................................................................................
.....
...................................................................................
...........................
..............................................................
...................................................................................
...........
...................................................................................
...............................
...................................................................................
...............................
................
..........................................................................
...................................................................................
.
...................................................................................
...........
......................
........................................................
................................................
....
....
....
....
....
....
....
....
....
......
....
....
....
....
......
....
....
....
....
....
........
........
........
..........
..........
..........
........
..........
........
........
....
....
....
......
....
....
....
....
....
....
........
........
..........
..........
..........
..........
........
........
........
........
........l
..2
....0
..2
....0
........................................
................
...................................................................................
.........
...................................................................................
.
......................
............
....................................
........................................................
......................................
...................................................................................
...................................................................................
...................................................................................
.....
............................................................................
...................................................................................
.......................
...................................................................................
...............
...................................................................................
...................
...................................................................................
.......................
......................................................................
...................................................................................
.............................
...................................................................................
.......................
...................................................................................
.....................
...................................................................................
.............
...................................................................................
.........
................................................
................................................................................
...................................................................................
.............
...................................................................................
...................
...................................................................................
.....................
...................................................................................
.........
...................................................................................
...................
...................................................................................
.....................
...................................................................................
.......................
............................................
...................................................................................
.........
...................................................................................
.......................
...................................................................................
.........
...................................................................................
...........................
...................................................................................
.........................
...................................................................................
.....................
...................................................................................
...............
...................................................................................
.....................
...................................................................................
...........
...................................................................................
...........
...................................................................................
.................
...................................................................................
...................
...................................................................................
.....................
...................................................................................
.............
...................................................................................
...............
...................................................................................
.........................
...................................................................................
.......................
...................................................................................
.....................
...................................................................................
.........
...................................................................................
.......................
...................................................................................
...........................
...................................................................................
...........
..........
...................................................................................
...........
...................................................................................
.................
..............
...................................................................................
.....
...................................................................................
.......................
...................................................................................
...............
...................................................................................
.......................
...................................................................................
.......................
...................................................................................
.............
...................................................................................
...............
...................................................................................
...........
...................................................................................
.........................
...................................................................................
.................
...................................................................................
...
...................................................................................
.....................
........................................................
............................................................................
...................................................................................
...................................
...................................................................................
...........
...................................................................................
.....................
...................................................................................
.................................
...................................................................................
.................................................
...................................................................................
.................
...................................................................................
...................
...................................................................................
.........................
...................................................................................
.....
...................................................................................
.................................
...................................................................................
...................
..........................................................................
...................................................................................
.....
...................................................................................
.............................
...................................................................................
.....
...................................................................................
.................................
...................................................................................
.................
...................................................................................
.....................
...................................................................................
.....
...................................................................................
...............
...................................................................................
.......................
...................................................................................
.............
...................................................................................
...........
...................................................................................
.....................
...................................................................................
.................
...................................................................................
...............
...................................................................................
...................
...................................................................................
...................
...................................................................................
.......................
...................................................................................
.......................
...................................................................................
.....................
...................................................................................
.....................
...................................................................................
.................
...................................................................................
.....................
...................................................................................
...................
...................................................................................
...........
...................................................................................
...................
...................................................................................
.........................................
...................................................................................
.......
...................................................................................
...............
...................................................................................
.............................
...................................................................................
.........................
...................................................................................
.........
...................................................................................
.........................
...................................................................................
.........................
...................................................................................
...............
...................................................................................
.....................
...................................................................................
.........................
...................................................................................
.................................
...................................................................................
.......
...................................................................................
.................
...................................................................................
.....
...................................................................................
.....
..............................................................
...................................................................................
.............
...................................................................................
.................
...................................................................................
...............
...................................................................................
.....
...................................................................................
.....................
...................................................................................
...............
...................................................................................
.........................
...................................................................................
.......
...................................................................................
.
...................................................................................
...........................
...................................................................................
.........................
...................................................................................
.......................
...................................................................................
.....................
...................................................................................
.........
...................................................................................
.................
...................................................................................
...........................
...................................................................................
.............
...................................................................................
...................................
...................................................................................
...........
...................................................................................
.....................
...................................................................................
.........................
...................................................................................
.............
............................................
..................
...................................................................................
...............
...................................................................................
.....................................
...................................................................................
...........................
...................................................................................
...........................
..............................................
................................................................................
...................................................................................
.....................
...................................................................................
.......................
...................................................................................
.................................
..................................................................................
...................................................................................
.....
...................................................................................
...................
...................................................................................
...................
...................................................................................
.............................
...................................................................................
.......................................
...................................................................................
.......
................................................................................
...................................................................................
.....................
...................................................................................
.................
...................................................................................
.....................
...................................................................................
.............................
...................................................................................
.........
...................................................................................
.
...................................................................................
.....
...................................................................................
...................................
...................................................................................
.........................
...................................................................................
.
..............................................................................
...................................................................................
.................
...................................................................................
.......................
..................................................................................
...................................................................................
...........................
..........................................................................
...................................................................................
.......
...................................................................................
.....................
...................................................................................
.............
...................................................................................
.
...................................................................................
.....................
...................................................................................
.................
...................................................................................
.........................
..........................................
............................T
...
...................................................................................
...........
...................................................................................
...
...................................................................................
...
....................
...
...................................................................................
...........
..........................................
...
...................................................................................
...........
..............................................................
...
...................................................................................
.
...................................................................................
.................
....................................................
..............................
...
...................................................................................
.........................................
...
...................................................................................
.................................
..................................................................
...
...................................................................................
...............
...
...................................................................................
.................................
............................................
...
...................................................................................
...........................................
........................
...
...................................................................................
.................................
...................................................................................
...............................
........................
...
...................................................................................
.....................................
...................................................................................
.............................
...................................................................................
.........
...
...................................................................................
...............
...
...................................................................................
...................
..................................................................
.....
...................................................................................
...........................
......................................................
.....
...................................................................................
.............................
...................................................................................
.......................
...................................................................................
.................................
...................................................................................
.........................
...................................................................................
...........................................
...................................................................................
...............................
.....
...................................................................................
.......................
...................................................................................
...................................
..........................
.....
...................................................................................
.................................
................................................
...................................................................................
...................................................................................
.....
...................................................................................
.............................
..........................
.....
...................................................................................
.....................
...................................................................................
.......................
......................................
.....
...................................................................................
...................................
........................
.....
...................................................................................
...............................
...................................................................................
.....................
...................................................................................
.................................
...................................................................................
...........................
........................................
.....
...................................................................................
.......................................
...................................................................................
...........
.....
...................................................................................
...................
...................................................................................
.............................
............................
.....
...................................................................................
.........................
...................................................................................
.......................
.....
...................................................................................
.........................
...................................................................................
...................................
.....
...................................................................................
.............................................
..........................
AROMATERAPI LAVENDER SEBAGAI MEDIA RELAKSASI
ABSTRAK
Aromaterapi adalah salah satu teknik pengobatan atau perawatan menggunakan baubauan
dengan dengan air (direbus), penyulingan dengan air dan uap (dikukus), dan
penyulingan dengan uap (diuapkan). Salah satu aroma yang paling digemari adalah
lavender. Kandungan utama dari bunga lavender adalah linalyl asetat dan linalool
(C10H18O). Linalool adalah kandungan aktif utama yang berperan pada efek anti cemas
ABSTRACT
Tuntutan hidup yang semakin besar dan keinginan orang untuk mendapatkan
hidup yang lebih baik mendorong setiap orang untuk bekerja lebih keras sehingga
menimbulkan rasa lelah, baik itu dalam pikiran maupun fisik. Saat ini berwisata
juga
bertujuan untuk mendapatkan ketenangan yang dapat dilakukan dengan wisata spa. Bali
sebagai daerah tujuan wisata yang sangat diminati oleh para wisatawan juga
menyediakan fasilitas wisata spa tersebut. Wisata spa saat ini menjadi salah satu
trend
terbaru bagi wisatawan yang berlibur di Bali, banyak wisatawan yang memang sengaja
datang ke Bali dengan tujuan melakukan wisata spa. Bahkan salah satu spa terbaik di
Salah satu aroma untuk aromaterapi yang paling digemari adalah lavender.
Berasal dari bunga levender yang berbentuk kecil dan berwarna ungu. Bunga lavender
dapat digosokkan ke kulit, selain memberikan aroma wangi, lavender juga dapat
menghindarkan diri dari gigitan nyamuk4. Aromaterapi menggunakan minyak lavender
dipercaya dapat memberikan efek relaksasi bagi saraf dan otot-otot yang tegang
(carminative) setelah lelah beraktivitas5. Bunga lavender juga memiliki efek
5,6,7
Melalui tulisan ini, diharapkan dapat memberikan tambahan wawasan atau ilmu
pengetahuan bagi pembaca tentang gambaran umum dan zat yang terkandung dalam
bunga lavender, proses pengolahan minyak lavender, serta manfaat relaksasi bunga
lavender.
BUNGA LAVENDER
di seluruh dunia, tumbuhan ini sering ditemukan tumbuh liar di daerah di luar
daerah asalnya9 (Gambar 1).
Tanaman ini tumbuh baik pada daerah dataran tinggi, dengan ketinggian berkisar
antara 600-1.350 m di atas permukaan laut. Untuk mengembangbiakkan tanaman ini
tidaklah sulit, dimana menggunakan biji dari tanaman lavender yang sudah tua dan
disemaikan. Bila sudah tumbuh, dapat dipindahkan ke polybag. Bila tinggi tanaman
telah mencapai 15-20 cm, dapat dipindahkan ke dalam pot atau bisa ditanam di
halaman
4,10
rumah.
almond oil, apricot oil, dan grapeseed oil agar dapat diaplikasikan pada tubuh
untuk
massage aromaterapi1.
Minyak lavender memiliki banyak potensi karena terdiri atas beberapa kandungan.
Menurut penelitian, dalam 100 gram bunga lavender tersusun atas beberapa kandungan,
Diteliti efek dari tiap kandungan bunga lavender untuk mencari tahu zat mana
yang memiliki efek anti-anxiety (efek anti cemas/relaksasi) menggunakan Geller
conflict test dan Vogel conflict test. Cineol, terpinen-4-ol, alpha-pinene, dan
betamyrcene
tidak menghasilkan efek anti cemas yang signifikan pada tes Geller. Linalyl
asetat sebagai salah satu kandungan utama pada lavender tidak menghasilkan efek
anti
cemas yang signifikan pada kedua tes. Borneol dan camphene memberikan efek anti
cemas yang signifikan pada tes Geller, tapi tidak signifikan pada tes Vogel.
Linalool,
yang juga merupakan kandungan utama pada lavender, memberikan hasil yang
signifikan pada kedua tes. Dapat dikatakan, linalool adalah kandungan aktif utama
yang
berperan pada efek anti cemas (relaksasi) pada lavender7.
Proses Pembuatan Minyak Lavender
Pertama yang harus kita lakukan sebelum penyulingan adalah memotong bunga
lavender menjadi bagian yang lebih kecil. Hal ini bertujuan agar kelenjar minyak
pada
bunga dapat terbuka sebanyak mungkin sehingga memaksimalkan produksi minyak
esensial3.
Tahap selanjutnya adalah mengeringkan bunga lavender pada tempat yang teduh
atau ruang tertutup selama kurang lebih dua hari. Hal ini bertujuan untuk
mempercepat
proses penyulingan dan mendapatkan hasil yang lebih baik. Jangan langsung
mengeringkan di bawah sinar matahari karena dapat mengakibatkan sebagian minyak
dari bunga ikut menguap. Selain itu, pengeringan yang terlalu cepat dapat
mengakibatkan bunga menjadi rapuh dan sulit untuk disuling. Bila dua tahap di atas
telah dikerjakan, bunga lavender siap untuk disuling menjadi minyak esensial3.
Teknik ini adalah yang paling sederhana dan tidak memerlukan banyak modal,
namun teknik ini lebih cocok terhadap bahan yang jumlahnya tidak terlalu banyak.
Ada beberapa kelemahan dari teknik ini, yaitu kualitas minyak yang dihasilkan
cukup rendah, kadar minyak sedikit, dan produk minyak bercampur dengan hasil
sampingan.
sehingga tidak berhubungan langsung dengan air yang mendidih, tetapi nantinya
akan berhubungan dengan uap air. Oleh karena itulah, teknik ini disebut
penyulingan tidak langsung (indirect distilation). Pada teknik ini, air yang
menguap
akan membawa partikel-partikel minyak dan dialirkan melalui pipa ke alat
pendingin sehingga terjadi pengembunan dan uap air yang bercampur minyak akan
mencair kembali. Selanjutnya, campuran ini dialirkan ke alat pemisah untuk
memisahkan minyak dari air dengan membuka keran pada tabung pemisah.
Teknik ini cocok untuk penyulingan bahan yang jumlahnya lebih banyak
dibandingkan dengan teknik merebus. Teknik penyulingan ini sering dipakai petani
untuk mendapatkan minyak dengan kualitas baik untuk diekspor dan alat-alatnya
pun dapat dibuat sendiri oleh petani.
Prinsip kerja teknik ini sebenarnya hampir sama dengan teknik dikukus, namun
antara ketel uap dan ketel penyulingan harus dipisah. Ketel uap yang berisi air
dipanaskan, lalu uapnya dialirkan ke ketel penyulingan yang berisi bahan baku.
Suhu uap diusahakan tidak lebih dari 1000 celcius, agar tidak terlalu panas dan
dapat merusak hasil sulingan. Partikel-partikel minyak pada bahan baku terbawa
bersama uap dan dialirkan ke alat pendingin. Di dalam alat pendingin terjadi proses
pengembunan sehingga uap air yang bercampur minyak akan mengembun dan
mencair kembali. Setelah itu, campuran ini dialirkan ke alat pemisah yang akan
memisahkan minyak dari air. Dalam tabung pemisah, minyak akan berada di bagian
atas karena berat jenisnya lebih ringan daripada air. Selanjutnya, dengan membuka
keran pada tabung pemisah, air yang ada dalam tabung dapat dikeluarkan dan yang
tertinggal dalam tabung hanya minyak hasil penyulingan3 (Gambar 3).
Indra penciuman memiliki peran yang sangat penting dalam kemampuan kita untuk
bertahan hidup dan meningkatkan kualitas hidup kita. Dalam sehari kita bisa mencium
lebih kurang 23.040 kali1. Bau-bauan dapat memberikan peringatan pada kita akan
adanya bahaya dan juga dapat memberikan efek menenangkan (relaksasi)1. Tubuh
dikatakan dalam keadaan relaksasi adalah apabila otot-otot di tubuh kita dalam
keadaan
tidak tegang. Keadaan relaksasi dapat dicapai dengan menurunkan tingkat stres, baik
stres fisik maupun psikis, serta siklus tidur yang cukup dan teratur.
dan sistem penciuman. Sistem ini juga dapat mengontrol dan mengatur suhu tubuh,
rasa
lapar, dan haus. Amygdala sebagai bagian dari sistem limbic bertanggung jawab atas
respon emosi kita terhadap aroma. Hipocampus bertanggung jawab atas memori dan
pengenalan terhadap bau juga tempat dimana bahan kimia pada aromaterapi
merangsang gudang-gudang penyimpanan memori otak kita terhadap pengenalan
baubauan1.
Minyak lavender adalah salah satu aromaterapi yang terkenal memiliki efek
menenangkan. Menurut penelitian yang dilakukan terhadap tikus, minyak lavender
memiliki efek sedasi yang cukup baik dan dapat menurunkan aktivitas motorik
mencapai 78%11, sehingga sering digunakan untuk manajemen stres. Beberapa tetes
minyak lavender dapat membantu menanggulangi insomnia, memperbaiki mood
seseorang, dan memberikan efek relaksasi.
Minyak lavender berwarna jernih sampai kuning pucat dengan bau wangi yang sangat
khas12 . Minyak lavender adalah salah satu aromaterapi yang terkenal memiliki efek
sedatif, hypnotic, dan anti-neurodepresive baik pada hewan maupun pada manusia6.
Karena minyak lavender dapat memberi rasa tenang, sehingga dapat digunakan sebagai
manajemen stres. Kandungan utama dalam minyak lavender adalah linalool asetat yang
mampu mengendorkan dan melemaskan sistem kerja urat-urat syaraf dan otot-otot yang
tegang. Dikatakan juga linalool menunjukkan efek hypnotic dan anticonvulsive pada
percobaan menggunakan tikus6. Karena khasiat inilah bunga lavender sangat baik
digunakan sebagai aromaterapi. Selain itu, beberapa tetes minyak lavender dapat
membantu menanggulangi insomnia, memperbaiki mood seseorang, menurunkan
tingkat kecemasan, meningkatkan tingkat kewaspadaan, dan tentunya dapat
memberikan efek relaksasi.
wisata yang nyaman. Oleh karena itu manfaat aromaterapi khususnya aroma lavender
dengan kandungan zat yang dimiliki akan dapat memberikan kenyamanan bagi para
wisatawan yang sedang melakukan perjalanan.
muntah, sakit kepala, dan menggigil. Dermatitis kontak dan phototoxicity juga
dilaporkan terjadi pada penggunaan minyak lavender secara topikal12 .
DISKUSI
Penelitian yang dilakukan oleh Jeffrey J. Gedney, Psyd., Toni L. Glover, MA.,
RN., dan Roger B, Fillingim, PhD. dengan judul �Sensory and Affective Pain
Discrimination After Inhalation of Esensial Oils�. Metode penelitian yang digunakan
retrospektif dari pengaruh aroma terhadap perubahan intensitas nyeri dan nyeri yang
laporan pasien mengenai rasa nyeri. Oleh karena itu kecenderungan efek samping yang
diperoleh dari penelitian ini adalah bahwa aroma terapi dapat membantu dalam terapi
Penelitian yang dilakukan oleh Miguel A. Diego, Nancy Aaron Jones, Tiffany
Field, Maria Hernandez-Reif, Saul Schanburg, Cynthia Kuhn, Virginia McAdam,
Robert Galamaga, dan Mary Galamaga, dengan judul �Aromatherapy Positively Affects
Mood, EEG Patterns of Alertness, and Math Computations�. Dengan melakukan
penelitian menggenakan aroma lavender dan rosemary pada 40 orang mahasiswa dan
staf dari Universitas Miami Medical School, yang terdiri dari 30 wanita dan 10
laki-laki.
Penelitian ini dibagi menjadi tiga tahap. Penelitian tahap pertama menggunakan data
yang mengalami perbaikan mood secara signifikan setelah pemberian aroma terapi,
yang diketahui dari penurunan score POMS (The Profile of Mood States), kedua
kelompok merasa lebih rileks, dan kelompok rosemary cenderung merasa lebih
waspada. Penelitian tahap kedua menggunakan math computations menunjukkan bahwa
kedua kelompok dapat mengisi math computations dengan lebih cepat setelah diberi
aroma terapi, tetapi hanya kelompok lavender yang mengalami peningkatan ketelitian
atau ketepatan dalam pengisian. Penelitian tahap ketiga menggunakan data EEG pada
saat sebelum, selama, dan setelah menggunakan aroma terapi, hasilnya menunjukkan
bahwa kelompok yang mengalami peningkatan gelombang alpha pada daerah frontal
secara signifikan adalah kelompok lavender ditandai adanya peningkatan rasa kantuk,
sementara kekuatan gelombang alpha pada daerah frontal menurun pada kelompok
rosemary ditandai adanya peningkatan kewaspadaan, (2) Kedua kelompok aroma terapi
mengalami peningkatan gelombang beta yang ditandai adanya rasa kantuk5.
RINGKASAN
Kandungan utama dari bunga lavender adalah linalyl asetat dan linalool (C10H18O).
Linalool adalah kandungan aktif utama yang berperan pada efek anti cemas
(relaksasi)
pada lavender. Minyak lavender dengan kandungan linalool-nya adalah salah satu
minyak aromaterapi yang banyak digunakan saat ini, baik secara inhalasi (dihirup)
ataupun dengan teknik pemijatan pada kulit. Minyak lavender adalah salah satu
aromaterapi yang terkenal memiliki efek menenangkan, sehingga dapat digunakan
sebagai manajemen stres. Menurut beberapa penelitian, minyak lavender lavender
sendiri berpengaruh secara signifikan terhadap penurunan tingkat kecemasan,
peningkatan relaksasi, dan peningkatan rasa kantuk, serta adanya perbaikan mood .
DAFTAR PUSTAKA
1.
Buckle J. Aromatherapy and Diabetes. Diabetes Spectrum 2001: vol. 4 no. 3;
124-126
2.
Gedney JJ, Glover TL, Fillingim RB. Sensory and Affective Pain Discrimination
After Inhalation of Esensial Oils. Psychosomatic Medicine 2004: 66; 599-606
3.
Taufiq T. 2007. Menyuling Minyak Atsiri. PT. Citra Pramana: Yogyakarta
4.
http://lilyflowers-8.blogspot.com/2009/05/bunga-lavender.html. Diakses tanggal 20
Januari 2011
5.
Diego AM, Jones NA, Field T, Hernandez-Reif M, Schanberg S, Kuhn C,
McAdam V, Galamaga R, Galamaga M. Arometherapy Positively Affects
Mood, EEG Pattern of Alertness and Math Computations. International Journal
of Neuroscience 1998: vol 96; 217-224
6.
Yamada K, Mimaki Y, Sashida Y. Effect Inhaling of the Vapor of Lavandula
burnatii super-Derrived Esensial Oil and Linalool on Plasma
Adrenocorticotropin Hormone (ACTH), Catecholamine and Gonadotropin Level
in Experimental Menopausal Female Rats. Pharmaceutical Society of Japan
2005: 28 (2); 378-379
7.
McLain DE. Chronic Health Effects Assessment of Spike Lavender Oil. Walker
Doney and Associates, Inc 2009; 1-18
8.
Barocelli E, Calcina F, Chiavarini M, Impicciatore M, Bruni R, Bianchi A,
Vallabeni V. Antinociceptive and Gastroprotective Effect of Inhaled and Orally
Administered Lavandulahybrida Reverchon �Grosso� Esensial oil. Science
Direct 2004: 76; 213-223
9.
http://en.wikipedia.org/wiki/Aromatherapy. Diakses tanggal 20 Januari 2011
10.
http://id.shvoong.com/social-sciences/counseling/2089560-khasiat-dan-manfaat-
bungalavender/.
Diakses tanggal 20 Januari 2011
11.
Snow AL, Hovanec L, Brandit J. A Controlled Trial of Aromatherapy for
Agitation in Nursing Home Patients with Dementia. The Journal of Alternatif
and Complementary Medicine 2004: vol. 10 no. 3; 431-437
12.
Sweetman SC. 2002. The Complete Drug Reference. Pharmaceutical Press:
London
13.
http://www.google.co.id/imglanding?q=alat+penyulingan+minyak&hl=en&gbv=2&tbs
=isch:1&tbnid=5CFKsGwLBh3FhM:&imgrefurl=http://business.dinomarket.com/ads/9
14452/Jual-DESTILATOR-PENYULING-MINYAKATSIRI/&
imgurl=http://media.dinomarket.com/docs/imgusr/mesindestilatorminyaknila
m_ll.jpg.jpg&ei=_2k5TcP8OoLSsAOGwOn8Ag&zoom=1&w=500&h=314&iact=hc&
oei=92k5TfyWDsysrAedj_2wCA&esq=2&page=2&tbnh=114&tbnw=182&start=20&n
dsp=18&ved=1t:429,r:5,s:20&biw=1280&bih=588. Diakses tanggal 20 Januari 2011
14.
http://www.google.co.id/images?hl=en&biw=1280&bih=588&gbv=2&tbs=isch%3A1&
sa=1&q=alat+penyulingan+lavender&aq=f&aqi=&aql=&oq=. Diakses tanggal 20
Januari 2011
Gambar 1. Bunga Lavender7