The Effect of Chamomile Scent on the Pain Intensity After Caesarean Section in Primiparous Mothers

Authors
1 Neishabur University of Medical Sciences
2 دانشگاه علوم پزشکی گناباد، گناباد، ایران
3 , Shirvan University of Medical Sciences, North Khorasan, Bojnord, Iran
Abstract
Introduction: Cesarean section is one of the most common surgical procedures in women, and postoperative pain at the surgical incision site is a major concern for patients. Due to the potential side effects of analgesic medications, complementary methods such as aromatherapy can be considered a safe alternative for pain management. This study aimed to determine the effect of chamomile aroma on the intensity of postoperative pain in primiparous women after cesarean section.

Methods: This randomized clinical trial was conducted on 86 women who underwent cesarean section in 2017 at Hakim Hospital in Neyshabur, Iran. Six hours after surgery and at least four hours after the last injectable analgesic, pain intensity was measured using the Visual Analogue Scale (VAS). In the intervention group, a 10% chamomile solution was dropped onto a piece of sterile gauze and attached to the participant’s collar to be inhaled. In the control group, distilled water was used in the same manner. Pain intensity was reassessed ten minutes after inhalation. Data were analyzed using SPSS version 20, an independent t-test, and the Spearman correlation coefficient. A significance level of p<0.05 was considered.

Results: Following the intervention, there was a significant reduction in pain intensity in the intervention group (p = 0.04). The mean pain score decreased from 5.9 before the intervention to 4.1 after it.

Conclusion: Inhalation of chamomile aroma after cesarean section is effective in reducing pain intensity in primiparous women. Therefore, its use is recommended as a complementary method by nurses for postoperative pain relief after cesarean delivery.
Keywords

1. Taghinezhad H, Sohrabi Z, Mahaki B. Comparison of pethidine hydrochloride and diclofenac sodium (Dykln) on pain after cesarean. J Ilam Med Sci. 2006;14(4):7-12.
2. Khoshtrash M, Ghanbari A, Yeganeh MR, Kazemnezhad E, Reza SP. Survey the effect of foot reflexology on pain and physiological parameters after cesarean section in patients referring to Alzahra educational center in Rasht. 2011.
3. Huang N, Cunningham F, Laurito CE, Chen C. Can we do better with postoperative pain management? Am J Surg. 2001;182(5):440-8.
4. Manz BD, Mosier R, Nusser-Gerlach MA, Bergstrom N, Agrawal S. Pain assessment in the cognitively impaired and unimpaired elderly. Pain Manag Nurs. 2000;1(4):106-15.
5. Shahrbanoo L, Omme Laila R, Shahram S. The effect of foot and hand massage on post-cesarean section pain. 2012.
6. Sarin A, Litonius ES, Naidu R, Yost CS, Varma MG, Chen L-l. Successful implementation of an Enhanced Recovery After Surgery program shortens length of stay and improves postoperative pain, and bowel and bladder function after colorectal surgery. BMC Anesthesiol. 2015;16:1-10.
7. Suresh M, Preston RL, Fernando R, Mason CL. Shnider and Levinson’s anesthesia for obstetrics. Philadelphia: Lippincott Williams & Wilkins; 2012.
8. Darvish H, Ardestani BM, Shali SM, Tajik A. Analgesic efficacy of diclofenac and paracetamol vs. meperidine in cesarean section. Anesthesiol Pain Med. 2014;4(1).
9. Pillitteri A. Maternal and Child Health Nursing: Care of the Childbearing and Childrearing Family. Philadelphia: Lippincott Williams & Wilkins; 2013.
10. Vadivelu N, Kai AM, Kodumudi V, Berger JM. Challenges of pain control and the role of the ambulatory pain specialist in the outpatient surgery setting. J Pain Res. 2016:425-35.
11. Olateju SO, Adenekan AT, Olufolabi AJ, Owojuyigbe AM, Adetoye AO, Ajenifuja KO, et al. Pentazocine versus pentazocine with rectal diclofenac for postoperative pain relief after cesarean section-a double blind randomized placebo controlled trial in a low resource area. Middle East J Anaesthesiol. 2016;23(4):443-8.
12. Habibabad HZ, Afrasiabifar A, Mansourian A, Mansourian M, Hosseini N. Effect of chamomile aromatherapy with and without oxygen on pain of women in post cesarean section with spinal anesthesia: A randomized clinical trial. Heliyon. 2023;9(4).
13. Fazlollahpour-Rokni F, Shorofi SA, Mousavinasab N, Ghafari R, Esmaeili R. The effect of inhalation aromatherapy with rose essential oil on the anxiety of patients undergoing coronary artery bypass graft surgery. Complement Ther Clin Pract. 2019;34:201-7.
14. Ziyaeifard M, Zahedmehr A, Ferasatkish R, Faritous Z, Alavi M, Alebouyeh MR, et al. Effects of lavender oil inhalation on anxiety and pain in patients undergoing coronary angiography. Iran Heart J. 2017;18(1):44-50.
15. Yoo O, Park S-A, editors. Anxiety-reducing effects of lavender essential oil inhalation: A systematic review. Healthcare. 2023;11(11):1634.
16. AlMohammed HI, A Alanazi N, Maghrabi EF, A Alotaibi M. [Retracted] Role of Aromatherapy as a Natural Complementary and Alternative Therapy in Cardiovascular Disease: A Comprehensive Systematic Review. Evid Based Complement Alternat Med. 2022;2022(1):4543078.
17. Tang SK, Tse MM. Aromatherapy: does it help to relieve pain, depression, anxiety, and stress in community‐dwelling older persons? BioMed Res Int. 2014;2014(1):430195.
18. Amir Ali Akbari S, Mojab F. Effect of Matricaria Camomilla aroma on severity of first stage labor pain. J Clin Nurs Midwifery. 2015;4(3):23-31.
19. Adibi P, Kalani N, Razavi BM, Mehrpour S, Zarei T, Malekshoar M, et al. Pharmacological and non-pharmacological methods of pain control in women undergoing caesarean section: a narrative review. 2022.
20. Aradmehr M, Azhari S, Ahmadi S, Azmoude E. The effect of chamomile cream on episiotomy pain in Primiparous women: a randomized clinical trial. J Caring Sci. 2017;6(1):19.
21. Ahmadi MS, Alipour M, Poorolajal J, Moradkhani S, Akbarpour M. Assessment of the effect of aromatherapy with lavender and chamomile essential oils on postadenotonsillectomy pain in paediatric patients: double blind, randomised clinical trial. J Herbal Med. 2023;41:100728.
22. Tabaraei Y, Khalili H. The effect of inhalation of Matricaria chamomile essential oil on patients’ anxiety before esophagogastroduodenoscopy. Govaresh. 2018;22(4).
23. Pourshaikhian M, Moghadamnia MT, Kazemnezhad Leyli E, Shafiei Kisomi Z. Effects of aromatherapy with Matricaria chamomile essential oil on anxiety and hemodynamic indices in patients with acute coronary syndrome, 2021: a randomized controlled trial. BMC Complement Med Ther. 2024;24(1):17.
24. Srivastava JK, Pandey M, Gupta S. Chamomile, a novel and selective COX-2 inhibitor with anti-inflammatory activity. Life Sci. 2009;85(19-20):663-9.
25. Saghafi N, Rhkhshandeh H, Pourmoghadam N, Pourali L, Ghazanfarpour M, Behrooznia A, et al. Effectiveness of Matricaria chamomilla (chamomile) extract on pain control of cyclic mastalgia: a double-blind randomised controlled trial. J Obstet Gynaecol. 2018;38(1):81-4.
26. Rahnavardi M, Heydarifard S, Mohammadi M. The effect of chamomile odor on anxiety and some consequences of delivery in primiparous women. J Health Care. 2018;20(3):235-43.
27. Najafi B, Mojab F, Ghaderi L, Farhadifar F, Roshani D, Seidi J. The Effect of Chamomile Flower Essence on Pain Severity after Elective Caesarean Section under Spinal Anaesthesia: A Randomized Clinical Trial. J Clin Diagn Res. 2017;11(11).
28. Zardosht R, Basiri A, Sahebkar A, Emami SA. Effect of chamomile oil on cesarean section pain in primiparous women: a randomized clinical trial. Curr Rev Clin Exp Pharmacol. 2021;16(4):369-74.
29. Eskandari F, Mousavi P, Valiani M, Ghanbari S, Iravani M. Investigating the effect of Swedish massage with chamomile oil on labor pain and anxiety of primiparous women: A clinical trial. J Educ Health Promot. 2023;12(1):157.
30. Davami B, Amini L, Kashanian M. Investigating the effect of chamomile-marigold ointment on episiotomy pain in nulliparous women. Complement Med J. 2018;8(2):2254-64.
31. Salarvand S, Heidari ME, Farahi K, Teymuri E, Almasian M, Bitaraf S. Effectiveness of massage therapy on fatigue and pain in patients with multiple sclerosis: a systematic review and meta-analysis. Mult Scler J Exp Transl Clin. 2021;7(2):20552173211022779.
32. Hasheminia A, Salehi S, Khaledifar A, Sedehi M. Effect of hand and foot surface stroke massage on pain intensity and anxiety level in hospitalized patients with acute coronary syndrome: a clinical trial. Int Cardiovasc Res J. 2021;15(4).
33. Karimian Z. Comparison of the effect of mefenamic acid and Matricaria chamomilla on primary dysmenorrhea in Kashan Medical University students [Thesis]. Kashan: Kashan University of Medical Sciences; 2013.
34. Shabani F, Zareian MA. Evaluation of the Synergism of Medicinal Effects of Chamomile and Ginger on Pain and Symptoms of Primary Dysmenorrhea: A Randomized Controlled Trial. Complement Med J. 2020;9(4):3852-67.
35. Modarres M, Mirmohhamad AM, Oshrieh Z, Mehran A. Comparison of the effect of mefenamic acid and matricaria camomilla capsules on primary dysmenorrhea. 2011.
36. Yazdani M, Shahriari M, Hamedi B. Comparison of fennel and chamomile extract and placebo in treatment of premenstrual syndrome and dysmenorrheal. 2004.
37. Burns EE, Blamey C, Ersser SJ, Barnetson L, Lloyd AJ. An investigation into the use of aromatherapy in intrapartum midwifery practice. J Altern Complement Med. 2000;6(2):141-7.
38. Bastard J, Tiran D. Aromatherapy and massage for antenatal anxiety: its effect on the fetus. Complement Ther Clin Pract. 2006;12(1):48-54.