aromatherapy presentation final 1

Aromatherapy

History & Indications

What is aromatherapy ? • Aromatherapy is the use of concentrated

Aromatherapy can be defined essential oils extracted from herbs,
as the intentional use of flowers, roots, and plants extracted
Essential Oils (EO) to through a process of steam distillation or
maintain, promote or cold expression, also known as cold
pressing. (Smith & Kyle, 2008)
improve health, well being,
and hygiene.

The History of Aromatherapy

Medical treatment using herbal Aromatic plants such as During the Renaissance, these
medicine can be traced back to rosemary, thyme, clove, nutmeg, herbs were used to eliminate the
and rose were used in the Middle
ancient Egypt, India, stench from sick rooms and
Mesopotamia, China and Greece Ages. plague vinegar was concocted
for inhaled protection (Smith &
(Cooke & Ernst, 2000).
Kyle, 2008)

Early innovators of aromatherapy

The first nurse to use essential oils in The first aromatherapist was born in The term aromatherapy was not used
nursing care was Florence Nightingale, Austria, Madame Marguerite Maury until 1936, until a French Chemist,
who applied lavender oils to the foreheads (1895-1968), classified essential oils and
of her patients in the Crimean War (Smith established the first aromatherapy clinics Gattefosse, wrote about the topic in his
in Paris, England and Switzerland. book. According to the literature, he
& Kyle, 2008). burned his hand during an experiment,
and plunged his hand into lavender oil,
the only liquid available to him. He
reported feeling immediate relief and very

little scaring (Gnatta, 2015).

The nausea and vomiting reflex is comprised of peripheral Post-
mechanisms in the gastrointestinal tract and central mechanisms Operative
in the chemoreceptor trigger zone (CTZ). Complications
Post-operative
Stimulation of these pathways result in PONV as a result of; type Nausea and
of surgery, type of anesthesia, post-operative opioids, and Vomiting
previous history of PONV. Patient characteristics that increase (PONV)
likelihood of PONV include; individuals with a history of
motion sickness, migraines, female gender, non-smoking status.
The propensity for PONV is cumulative with each additional risk
factor.

Current State of Practice

PONV occurs in approximately one Currently, multimodal antiemetic Adverse affects of these modalities
third of the 75 million patients who therapy is used post-operatively to include: sedation, hypotension, dry
undergo surgery annually (Sites et decrease the occurrence of PONV.
mouth, electrocardiographic
al, 2014). changes, delayed recovery time,
headache, dizziness, drowsiness,
and recently, Emend, has been
found to decrease the effectiveness

of birth control pills.

Post-Operative Complications
Pain Management

Complications from opioids in the These complications are
PACU include; reintubation in compounded by obstructive sleep
PACU, change in status and
unexpected transfers to ICU and apnea in certain populations,
especially in the obese patient,
PCU, prolonged stays in the PACU, decreased metabolism in the elderly,
and the use of reversal agent, over sedation in the opioid naive
Narcan. patient and individuals who are

suffering from addiction.

Current State of Practice

Opioid overdose kills 78 people Effective January 1st, 2018, the
a day in this country. Currently, Joint Commission states;
the mainstay treatment for pain
hospitals must provide non-
management in the post- pharmacological pain treatment
operative care unit (PACU) is
modalities.
opioid based narcotics.

How Does
Aromatherapy Work

• Hertz (2009) proposed two

hypothetical mechanisms for the
effects of odors on mood, behavior
and physiology, pharmacological
and psychological mechanisms (Lau
& Zakaria, 2012).

This Photo by Unknown Author is licensed under CC BY-NC-ND

Pharmacological Mechanisms

Essential oils deliver direct effects on Following inhalation, EO molecules These molecules produce a system
the central/autonomic nervous system pass to the olfactory receptors, in the capable of releasing neurotransmitters
nose, which recognize their molecular
and endocrine system. characteristics, and send signals to the stimulus, such as encephalin and
brain via the olfactory nerve, which in endorphins, which generate an
turn have a direct link to the Limbic analgesic effect and produce a sense
of wellness and relaxation (Gnatta,
system, responsible for emotions,
feelings and motivational impulses 2016).

(Lau & Zakaria, 2012).

Physiological Parameters

• Blood Pressure
• Pulse rate
• Muscle tension
• Pupil dilation
• Body temperatures
• Blood flow
• Electrodermal activities
• Cerebral activities

Psychological Hypothesis

• Nightingale Nursing Care- grounded in attention to aspects of the

environment
1. Ventilation & cleanliness
2. Rest & relaxation
3. Changes in environmental conditions

• Lavender oils contribute to relaxation and improve sleep
• Peppermint oils have a calming effect

This Photo by Unknown Author is licensed under CC BY-NC-SA Psychological
Hypothesis continuation

• Watson’s Theory of Human

Caring- defines health as harmony
within the whole person-
environment-essential oils create a
sense of harmony with the
environment.

• Healing is enhanced with

transpersonal care, through gentle
application directly to the skin.

Martha Roger’s Humanistic and
Humanitarian Science Theory

A person and their environment are one.
Nursing seeks to promote symphonic interaction between the environment and man.
Aromatherapy reflects the interrelationships between plants and people and a dynamic exchange with the energy pattern of the
plant, which is encoded in the essential oil.
This process must be produced by the active participation of the nurse and the patient.
This interaction produces maximum health potential.

Aromatherapy is one of three rescue interventions categories Evidence
contained in the ASPAN guideline for postoperative Based Practice
management of PONV (Sites et al, 2013).
The Society for Ambulatory Anesthesiology recognizes
aromatherapy, in their newest consensus guidelines, as a
treatment that achieves a faster reduction of PONV severity.
Anderson and Gross (2004) found aromatherapy reduced
patients’ perceived severity of PONV, leading to a 50% reduction
in pharmacological use.
Kim et al. (2006) found postoperative lavender oil 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.

Main Line Health Policy

• Main Line Health’s policy of aromatherapy

states; aromatherapy is an integrative
therapy, and is utilized to increase comfort
or relaxation, maintaining, improving, or
restoring health and harmony of the body,
mind, and/or improving coping
mechanisms, reducing stress, relieving pain
and/or increasing the client’s sense of
wellbeing

• A physician order is not needed, however,

a discussion with the patient’s health-care
provider is encouraged.

• Verbal consent from the patient is needed.

References

• Cronin, S. N., Forren, J. O., Roberts, H., Thomas, M., Williams, S., & Wright, M. I. (2015). Effects of Controlled Breathing, With or Without

Aromatherapy, in the Treatment of Postoperative Nausea. Journal of Peri Anesthesia Nursing, 30(5), 389-397.
https://doi.org/10.1016/j.jopan.2015.03.010

• Gnatta, J. R., Kurebayashi, L. F., Turrini, R. N., & Paes da Silva, M. J. (2016). Aromatherapy and nursing: historical and theoretical conception.

Journal of School of Nursing, 50(1), 127-133. https://doi.org/10.1590/S0080-6234201600001000017

• Hodge, N. S., McCarthy, M. S., & Pierce, R. M. (2014). A Prospective Randomized Study of the Effectiveness of Aromatherapy for Relief of

Postoperative Nausea and Vomiting. Journal of Peri Anesthesia Nursing, 29(1), 5-11. https://doi.org/10.1016/j.jopan.2012.12.004

• Joint Commission Enhances Pain Assessment and Management Requirements for Accredited Hospitals. (2017). The Official Newsletter of the Joint

Commission. Retrieved from www.jointcommision.org

• Kim, J. T., Wajda, M., Cuff, G., Serlta, D., Schlame, M., Axelrod, D. M., Bekker, A. Y. (2006). Evaluation of Aromatherapy in Treating

Postoperative Pain: Pilot Study. Pain Practice, 6(4), 273-277. https://doi.org/10.1111/j.1533-2500.2006.00095.x

• Lua, P. L., & Zakaria, N. S. (2012). A Brief Review of Current Scientific Evidence Involving Aromatherapy Use for Nausea and Vomiting. The

Journal of Alternative and Complementary Medicine, 18(6), 534-540. https://doi.org/10.1089/acm.2010.0862

• Sites, D. S., Johnson, N. T., Miller, J. A., Torbush, P. H., Hardin, J. S., Knowles, S. S., ... Tart, R. C. (2014). Controlled Breathing With or

Without Peppermint Aromatherapy for Postoperative Nausea and/or Vomiting System Relief: A Randomized Controlled Trial. Journal of Peri
Anesthesia Nursing, 29(1), 12-19. https://doi.org/10.1016/j.jopan.2013.09.008