- For patients who experience postoperative nausea and vomiting (P),
- does the use of aromatherapy and medication combination (I),
- compared with medications use only (C),
- improve the reduction of the unpleasant symptoms that the patient experience and acceleration of his or her recovery (O),
- in one week (T)?
For this systemic review, the PubMed and Cochrane databases were used to search the keywords “aromatherapy,” “postoperative,” and “randomized clinical trial. Based on the PICOT question, the main criteria for selection was a focus on postoperative patients, interventions in the form of aromatherapy or medication, and clinical outcomes. The main criteria for the articles were the publication date, which was set to display studies from 2016 till 2020 to ensure that the most relevant and up-to-date information on postoperative aromatherapy is located. In total, 30 articles were found, which matched the initial search criteria. The preference was given to randomized clinical trials and articles that provided a quantitative assessment of data.
Error analysis is a crucial part of any systemic review because of systematic bias, which is a reoccurring problem associated with a flawed design of a study. With random error, statistical methods can be used to overcome the issue, such as standard deviation or correlation between variables. The main characteristic of this type of error is that a researcher cannot account for it or mitigate it by increasing the number of observations since the same mistake is repeated. To avoid these errors, the studies where researchers acknowledge other possible sources of relief for patients, as well as those that present statistical data with correlation analysis were used. In total, four articles were chosen, one of which is a randomized control trial.
An evidence-based quantitative article, which contains a randomized control trial, is by Karaman, Karaman, Tapar, Dogru, and Suren (2019), and it focuses on the use of essential oils. Other articles that fit the criteria described above are by Abbasijahromi (2019), Dimitriou, Mavridou, Manataki, and Damigos (2017), and Fearrington, Qualls, and Carey (2019) however, they do not contain quantifiable data on the effects of aromatherapy. Those, however, are observational studies that provide some evidence for the examined impact of aromatherapy compared to standard treatment. An article by Dimitrou et al. (2017) is a systemic review of randomized controlled trials that were conducted from 1990 till 2015, which also helps substantiate the evidence from the chosen randomized controlled trial.
The evidence from the selected case study suggests that there is statistical significance in the severity of symptoms between the different tested groups, depending on the type of oil used. Notably, 43.5% of the placebo group reported an improvement, while out of the three groups using essential oils, the minimum improvement was 47.8% (Karaman et al., 2019). In total, 184 participants were a part of this experiment.
All of the participants were changed through randomization, and the main criteria for selection were that each should be a postoperative patient. The most significant improvement was experienced by the group where lavender essential oil, with 38 reporting mitigation of symptoms, which is 86.2% of this group (Karaman et al., 2019). Another alternative that displayed an improvement within 15 minutes of use is ginger oil, with 62.5% of participants reporting improvement. In general, this randomized control trial suggests that essential oils can be used as an alternative method for postoperative vomiting or nausea treatment.
This randomized trial tests a variety of oils and their impact on postoperative symptoms, which is beneficial for practitioners. The design of the study is a “randomized 4-armed placebo-controlled study” (Karaman et al., 2019, p. 417). Therefore, there were two groups of patients, and one was administered with standard medication used to mitigate postoperative vomiting. However, this group also had a placebo in the form of water instead of essential oils. The other group was separated into three categories, and each received one of the following oils as treatment – lavender rose, or ginger.
To quantifiably assess the results, the researchers used two Likert-type scales for nausea and vomiting, each containing a scale for determining the severity of symptoms. Additionally, the researchers assessed the symptoms of antiemetic medication requirements in each group.
In general, the outcomes of this study are positive, since the researchers proved that there is statistically significant improvement within patients who experience symptoms of vomiting after operations when ginger and lavender oils are used. Moreover, they provided evidence that rose oil has no significant impact on these symptoms together with the purified water. Thus, this study helps understand the effects and implications of using aromatherapy, and ginger or lavender oils in particular, on a patient experiencing postoperative vomiting.
In regards to validity, it was tested using statistical methods and IBM SPSS Statistics for Windows software. The normal distribution was measured using the Kolmogorov-Smirnov test, and for normally distributed variables, the variance analysis was used. For other variables, the researchers applied a Kruskal-Wallis test. Next, Pearson’s chi-squared, together with Fisher’s exact tests, were applied to the data. For measuring correlation, the Bonferroni method was used. Therefore, the researchers used a variety of statistical methods to test the validity and reliability of this aromatherapy randomized control trial. This suggests that the outcomes of the trial are valid and can be used in clinical practice for managing postoperative symptoms.
The limitations of this trial do not mention any possible bias. Moreover, no conflict of interest or bias was present. Therefore, one can conclude that this research does not contain bias that would have a significant impact on the results of this study. One issue is that this study does not account for the specific content of essential oils or the components that were used to produce them, which can impact the outcomes. The level of evidence in this review is Level II since it is obtained from one well-designed randomized control trial focusing on aromatherapy use in a clinical setting.
In the context of my practice, I would argue that the use of aromatherapy is beneficial for patients, and I would recommend it to those individuals who do not experience relief from standard medication. Since nausea and vomiting can affect the recovery process, it is vital for nurses and other medical practitioners to address this problem. Moreover, these symptoms lead to significant discomfort, which is also an inconvenience that can adversely impact the recovery process. Hence, in my practice, I can use the results from the examined literature to address postoperative discomfort by offering patients aromatherapy with lavender or ginger oils.
Overall, this systemic review aimed to locate evidence regarding the use of aromatherapy to mitigate the symptoms of vomiting and nausea with patients after operations. The randomized clinical trial examined in this paper provides sufficient evidence that the use of lavender and ginger oils has a positive impact on a patient’s symptoms. The reliability, validity, and level of evidence of this review suggest that it can be implemented in one’s medical practice.
Abbasijahromi, A., Hojati, H., Nikooei, S., Jahromi, H. K., Dowlatkhah, H. R., Zarean, V., … Kalavani, A. (2019). Compare the effect of aromatherapy using lavender and Damask rose essential oils on the level of anxiety and severity of pain following C-section: A double-blinded randomized clinical trial. Journal of Complementary and Integrative Medicine, 0(0). Web.
Dimitriou, V., Mavridou, P., Manataki, A., & Damigos, D. (2017). The use of aromatherapy for postoperative pain management: A systematic review of randomized controlled Trials. Journal of PeriAnesthesia Nursing, 32(6), 530–541. Web.
Fearrington, M. A., Qualls, B. W., & Carey, M. G. (2019). Essential oils to reduce postoperative nausea and vomiting. Journal of PeriAnesthesia Nursing, 4(5):1047-1053. Web.
Karaman, S., Karaman, T., Tapar, H., Dogru, S., & Suren, M. (2019). A randomized placebo-controlled study of aromatherapy for the treatment of postoperative nausea and vomiting. Complementary Therapies in Medicine, 42, 417–421. Web.