The “Swiss Knife of Essential Oils” continues to surprise and delight! Lavender essential oil (Lavandula angustifolia) is known for being sedative and calming, as a gentle antiseptic and healing agent for burns and for its ability to reduce depression and increase alertness.
Iranian researchers from the Department of Anesthesiology, Golestan Hospital, Ahvaz Jundishapur University investigated lavender essential oil in another mode: that of pain reliever.
Dealing with pain after surgery can be complicated. Regarding post-operative pain relief, the researchers write that “many drugs that are used for this purpose, especially opioids and NSAIDS [Non-Steroidal Anti-Inflammatory Drugs], have side effects such as respiratory distress, nausea, itching, and gastrointestinal bleeding.”1
As an alternative, researchers looked to lavender essential oil since the “lipophilic monoterpenes [of] the plant are reacted to the cell membranes, and cause changes in the activity of ion channels, carriers and nervous receptors. Such [properties] can explain the soothing and anti-bacterial effects of Lavender oil.”2
This Iranian study was set up as a triple-blind, randomized, placebo-controlled trial with 60 pregnant women who were admitted to a general hospital for cesarean section and divided randomly into two groups. Women with coagulation disorders, migraines, chronic headaches, the medical condition anosmia (inability to perceive odor), and/or a history of allergies to medicinal plants were not included in the study.
The severity of post-surgical pain was documented based on the Visual Analog Scale (VAS), a standard rating tool of 0 to 10 (0 for no pain up to 10 for the most severe pain). The test subjects were to receive a 10 percent lavender essence provided by the Barji Essence Pharmaceutical Company of Kashan, Iran. This company also provided the placebo, which was a base of aromatherapy blend without lavender essence. The patients were monitored by an ECG, and their heart rates, blood pressure, and pulse rates were recorded.
Following the C-sections, opioids or benzodiazepines were not administered. Once post-operative pain was experienced, 4, 8, and 12 hours later, the inhalation of aromatherapy (lavender and placebo) was performed. Three drops were placed on a cotton ball, and the patients were asked to inhale it for five minutes at a distance of 10 centimeters while the VAS scale was measured. If the score was greater than 3, analgesic was given in accordance with the hospital protocol (the first time intra-muscular injection of Diclofenac sudume 75 mg and next times, Diclofenac suppositories 100 mg).
The researchers report that “Heart rate, blood pressure, nausea, vomiting, dizziness, and patients’ satisfaction were recorded before and after the aromatherapy. . . .”3
In the discussion section of this study, it is stated that the 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 the baby as well.” Then the researchers state, “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
How did just 10 percent lavender perform as an added analgesic in this study? First of all, the time of need for the Diclofenac was similar in both the lavender and the placebo groups. But after “using the drug comparing it with before, there was 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. In the Lavender group, the level of satisfaction from the drug was 90%, while in the placebo group, a 50% satisfaction was reported. In the Lavender group using Diclofenac suppository for completing analgesia was 43.3%, and in the placebo group was 76.7%. After using the drug comparing it with before, heart rate showed a greater reduction in the Lavender group compared with the placebo group. . . . However, no difference was observed in terms of 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.” 5
The researchers concluded that “Due to the lack of reported side effects such as nausea, vomiting and dizziness in the group treated with Lavandula in our study and other studies on this drug, it can be concluded that this drug does not have [the] serious and common side effects of the opioid analgesics and NSAIDs, and further studies could be used as part of a multimodal analgesic treatment of postoperative pain.”6
We like the conclusion of the Iranian study but have a difficult time with the researchers calling lavender essential oil a “drug.” It is not created in a pharmaceutical laboratory but in the great outdoors. And why the excessive dilution rate?
This study is available at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3821145/pdf/aapm-03-203.pdf.
We were pleased to see that the dilution rate is addressed. A study7 done at the Department of Anesthesiology, New York University Medical Center, is mentioned by the Iranians because lavender oil (not diluted) was applied to the oxygen mask of patients undergoing laparoscopic adjustable gastric banding (LAGB). The placebo group of this study received a nonscented baby oil applied to the oxygen mask. The NYU study discovered that “significantly more patients in the Placebo group (PL) required analgesics for postoperative pain (82%) than patients in the Lavender (LAV) group (46%). Moreover, the LAV patients required significantly less morphine postoperatively than PL patients: 2.38 mg vs 4.26 mg. . . . Our results suggest that lavender aromatherapy can be used to reduce the demand for opioids in the immediate postoperative period.”8
The Iranian study also reports on an earlier study from New York University Medical, where just “two drops of 2% lavender oil” were used on a face mask following breast biopsy surgery. A control group received supplemental oxygen with no lavender oil. This study showed that there were “no significant differences in narcotic requirements and recovery room discharge times between the two groups. Postoperative lavender aromatherapy did not significantly affect pain scores. However, patients in the lavender group reported a higher satisfaction rate with pain control than patients in the control group.”9 (Do you wonder what the outcome would have been if undiluted lavender had been used?)
And finally, the Iranians quoted a 2012 study by colleagues at Islamic Azad University in Khalkhjal, Iran, that used lavender oil following episiotomy procedures after childbirth, while a control group received only the usual hospital protocol. This study found a statistical difference in pain intensity scores between the two groups after four hours and after five days after the episiotomy. But differences in pain intensity between the two groups at 12 hours post-surgery were not significant. The REEDA scale (Redness, Edema, Ecchymosis, Discharge) score was significantly lower in the experimental group (Lavender oil group) 5 days after the episiotomy. This study’s conclusion is “It is suggested that Lavender oil essence may be preferable to the use of Betadine for episiotomy wound care.”10
Finally, we get back to the conclusion of the Iranian study. “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.”11 The Iranian researchers make sure they are clear on one point, lavender is not to be the sole analgesic following a C-section. Well, obviously! However, the supportive, supplemental use of lavender essential oil has been well documented as reported here and with an additional 53 studies found on PubMed. (A search for “lavender” and “pain” results in 102 research papers. However, 49 of those papers must be excluded because they have an author whose last name is Lavender.)
- Olapour A, et al. The Effect of Inhalation of Aromatherapy Blend containing Lavender Essential Oil on Cesarean Postoperative Pain. Anesth Pain Med. 2013 Summer;3(1):203-7.
- Kim JT, 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 Jul;17(7):920-5.
- Kim JT, et al. Evaluation of aromatherapy in treating postoperative pain: pilot study. Pain Pract. 2006 Dec;6(4):273-7.
- Sheikhan F, et al. Episiotomy pain relief: Use of Lavender oil essence in primiparous Iranian women. Complement Ther Clin Pract. 2012 Feb;18(1):66-70.
- Olapour, op cited.
Lavender essential oil may be purchased at: http://www.youngliving.com/grainsofhope
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