The effect of aromatherapy with clove essential on anxiety and pain after cesarean section: A controlled randomized clinical trial

Document Type : Original Article

Authors

1 M.Sc. Student of Midwifery, Student Research Committee, School of Nursing and Midwifery, Lorestan University of Medical Sciences, Khoramabad, Iran.

2 Assistant Professor, Department of Midwifery, Social Determinants of Health Research Center, School of Nursing and Midwifery, Lorestan University of Medical Sciences, Khorramabad, Iran.

3 Associate Professor, Department of Midwifery, Social Determinants of Health Research Center, School of Nursing and Midwifery, Lorestan University of Medical Sciences, Khorramabad, Iran.

4 Assistant Professor, Department of Epidemiology and Statistics, Research Center for Social Determinants of Health, School of Health and Nutrition, Lorestan University of Medical Sciences, Khorramabad, Iran.

10.22038/ijogi.2025.83036.6225

Abstract

Introduction: Women experience severe and intolerable pain following cesarean delivery, which can lead to excessive anxiety in mothers. Due to the side effects of analgesic drugs, non-pharmacological methods such as aromatherapy have recently gained attention for pain management, and the effect of various essences has been investigated for this purpose. Therefore, this study was conducted with aim to assess the effect of aromatherapy with clove essential oil on anxiety and pain after cesarean delivery.
Methods: This controlled clinical trial study with a pretest-posttest design was conducted in 2023 on 72 women cadidate for cesarean delivery at Taleghani Hospital in Ilam, Iran. Aromatherapy was performed using normal saline in the control group and clove essential oil in the intervention group. Anxiety and pain levels were assessed using questionnaire. Data were analyzed using SPSS statistical software (version 22) and independent t-tests, repeated measures analysis of variance, and, if necessary, analysis of covariance (ANCOVA). P<0.05 was considered statistically significant.
Results: The levels of state and trait anxiety before and 4 hours after the intervention showed no significant difference between the two groups (p>0.05). However, at 8 and 12 hours post-intervention, the mean anxiety scores differed significantly between the two groups (p<0.001). Additionally, the mean pain scores showed a significant difference between the groups at 4, 8, and 12 hours post-intervention (p<0.001).
Conclusion: Aromatherapy with clove essential oil can effectively reduce anxiety and pain after cesarean section.

Keywords

Main Subjects

References

  1. Veef E, Van de Velde M. Post-cesarean section analgesia. Best Practice & Research Clinical Anaesthesiology 2022; 36(1):83-8.
  2. Antoine C, Young BK. Cesarean section one hundred years 1920–2020: the Good, the Bad and the Ugly. Journal of perinatal Medicine 2021; 49(1):5-16.
  3. Rafiei M, Ghare MS, Akbari M, Kiani F, Sayehmiri F, Sayehmiri K, et al. Prevalence, causes, and complications of cesarean delivery in Iran: A systematic review and meta-analysis. International journal of reproductive biomedicine 2018; 16(4):221.
  4. Pakseresht S, Jahandoost H, Khalesi ZB, Leilie EK. Effect of lavender aromatherapy on the pain level after cesarean section. Herbal Medicines Journal (Herb Med J) 2020: 11-20.
  5. Rosa F, Perugin G, Schettini D, Romano N, Romeo S, Podestà R, et al. Imaging findings of cesarean delivery complications: cesarean scar disease and much more. Insights into imaging 2019; 10:1-14.
  6. Rezaei R, Saatsaz S, Alipour A, Beheshti Z. Massage-therapy and post cesarean pain control. The Iranian Journal of Obstetrics, Gynecology and Infertility 2017; 20(4):34-43.
  7. Şi̇mşek HE, Alpar ŞE. The effect of aromatherapy and Su Jok interventions on post-cesarean pain. Complementary therapies in clinical practice 2022; 49:101642.
  8. Mostafa-Gharabaghi P, Delazar A, Gharabaghi MM, Shobeiri MJ, Khaki A. The view of cesarean pain after preemptive use of Rosa damascena extract in women with elective cesarean section. World Sci J 2013; 4:226-35.
  9. Rezaei N, Janani F, Sharifi N, Omidi F, Azadi A. Sexual function and quality of life among postpartum women: a cross-sectional study. International Journal of Womens Health and Reproduction Sciences. 2018;6(3):307-12.
  10. Farzan R, Firooz M, Ghorbani Vajargah P, Mollaei A, Takasi P, Tolouei M, et al. RETRACTED: Effects of aromatherapy with Rosa damascene and lavender on pain and anxiety of burn patients: A systematic review and meta‐analysis. International Wound Journal 2023; 20(6):2459-72.
  11. Kholmurodovich UF. Damage to the digestive system when using non-steroidal anti-inflammatory drugs. European journal of modern medicine and practice 2022; 2(1):6-16.
  12. Niazvand F, Asadi M, Kashefi M, Maghsoodi F. Pre-operation and post-operation anxiety in cesarean candidates. Comprehensive Health and Biomedical Studies 2022; 1(1):8-14.
  13. Abbasijahromi A, Hojati H, Nikooei S, Jahromi HK, Dowlatkhah HR, Zarean V, et al. 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 2020; 17(3).
  14. Asadi Mobarakeh M, Ziaeirad M. Comparing the Effect of Aromatherapy With Geranium and Lemon Essential Oil on Situational Anxiety and Physiological Indices of Patients After Coronary Angioplasty. Complementary Medicine Journal 2022; 11(4):316-29.
  15. Sangkum L, Thamjamrassri T, Arnuntasupakul V, Chalacheewa T. The current consideration, approach, and management in postcesarean delivery pain control: a narrative review. Anesthesiology Research and Practice 2021; 2021(1):2156918.
  16. Hadi N, Hanid AA. Lavender essence for post-cesarean pain. Pakistan journal of biological sciences: PJBS 2011; 14(11):664-7.
  17. Coleman JJ, Pontefract SK. Adverse drug reactions. Clin Med (Lond) 2016; 16(5):481-485.
  18. Jahan N, Went TR, Sultan W, Sapkota A, Khurshid H, Qureshi IA, et al. Untreated depression during pregnancy and its effect on pregnancy outcomes: a systematic review. Cureus 2021; 13(8).
  19. Sharifipour F, Bakhteh A, Mirmohammad Ali M. Effects of Citrus aurantium aroma on post-cesarean anxiety. The Iranian Journal of Obstetrics, Gynecology and Infertility 2015; 18(170.169):12-20.
  20. Lee EL, Richards N, Harrison J, Barnes J. Prevalence of use of traditional, complementary and alternative medicine by the general population: a systematic review of national studies published from 2010 to 2019. Drug safety 2022; 45(7):713-35.
  21. Farrar AJ, Farrar FC. Clinical aromatherapy. The Nursing Clinics of North America 2020; 55(4):489-504.
  22. Rafii F, Ameri F, Haghani H, Ghobadi A. The effect of aromatherapy massage with lavender and chamomile oil on anxiety and sleep quality of patients with burns. Burns 2020; 46(1):164-71.
  23. Haro-González JN, Castillo-Herrera GA, Martínez-Velázquez M, Espinosa-Andrews H. Clove essential oil (Syzygium aromaticum L. Myrtaceae): Extraction, chemical composition, food applications, and essential bioactivity for human health. Molecules 2021; 26(21):6387.
  24. Parvizi F, Mehrabi S, Naghizadeh A, Kamalinejad M, Goudarzi S, Farahmandfar M. Comparison of intranasal and intraperitoneal administration of Eugenia caryophyllata (clove) essential oil on spatial memory, anxiety-like behavior and locomotor activity in a pilocarpine-induced status epilepticus rat model. BMC Complementary Medicine and Therapies 2022; 22(1):231.
  25. Shieh G, Jan SL. The effectiveness of randomized complete block design. Statistica Neerlandica 2004; 58(1):111-24.
  26. Zsido AN, Teleki SA, Csokasi K, Rozsa S, Bandi SA. Development of the short version of the spielberger state—trait anxiety inventory. Psychiatry research 2020; 291:113223.
  27. Babatabar-darzi H, Babajani-Vafsi S, Mahmoudi H, Ebadi A, Vahedian-azimi A, Karimi L. The Effect of Foot Reflexology Massage on Patient's Anxiety during Chest Tube Removal after open Heart Surgery: A Randomized Controlled Trial. Journal of Critical Care Nursing 2020; 12(4):35-45.
  28. Price DD, McGrath PA, Rafii A, Buckingham B. The validation of visual analogue scales as ratio scale measures for chronic and experimental pain. Pain 1983; 17(1):45-56.
  29. Randall DJ, Zhang Y, Li H, Hubbard JC, Kazmers NH. Establishing the minimal clinically important difference and substantial clinical benefit for the pain visual analog scale in a postoperative hand surgery population. The Journal of hand surgery 2022; 47(7):645-53.
  30. Ferreira-Valente MA, Pais-Ribeiro JL, Jensen MP. Validity of four pain intensity rating scales. Pain® 2011; 152(10):2399-404.
  31. Nasiriani K, Kahdoui S, Nasrabadi SN. Psychometric properties of pain intensity scales in isfahanian geriatric population. Elderly Health Journal 2019.
  32. Muzzarelli L, Force M, Sebold M. Aromatherapy and reducing preprocedural anxiety: A controlled prospective study. Gastroenterology Nursing 2006; 29(6):466-71.
  33. Setzer WN. Essential oils and anxiolytic aromatherapy. Natural product communications 2009; 4(9):1934578X0900400928.
  34. Ozgoli G, Torkashvand S, Salehi Moghaddam F, Borumandnia N, Mojab F, Minooee S. Comparison of Peppermint and Clove essential oil aroma on pain intensity and anxiety at first stage of labor. The Iranian Journal of Obstetrics, Gynecology and Infertility 2016; 19(21):1-11.
  35. Tabatabaeichehr M, Mortazavi H. The effectiveness of aromatherapy in the management of labor pain and anxiety: A systematic review. Ethiopian journal of health sciences 2020; 30(3).
  36. Gong M, Dong H, Tang Y, Huang W, Lu F. Effects of aromatherapy on anxiety: A meta-analysis of randomized controlled trials. Journal of affective disorders 2020; 274:1028-40.
  37. Karadag E, Samancioglu S, Ozden D, Bakir E. Effects of aromatherapy on sleep quality and anxiety of patients. Nursing in critical care 2017; 22(2):105-12.
  38. Wilkinson SM, Love SB, Westcombe AM, Gambles MA, Burgess CC, Cargill A, et al. Effectiveness of aromatherapy massage in the management of anxiety and depression in patients with cancer: a multicenter randomized controlled trial. Journal of clinical oncology 2007; 25(5):532-9.
  39. Eren NB, Oztunc G. The effects of aromatherapy on the stress and anxiety levels of nurses working in intensive care units. Int J Care Sci 2017; 10(3):1615-23.
  40. Guo P, Li P, Zhang X, Liu N, Wang J, Yang S, et al. The effectiveness of aromatherapy on preoperative anxiety in adults: A systematic review and meta-analysis of randomized controlled trials. International Journal of Nursing Studies 2020; 111:103747.
  41. Thangaleela S, Sivamaruthi BS, Kesika P, Bharathi M, Kunaviktikul W, Klunklin A, et al. Essential oils, phytoncides, aromachology, and aromatherapy—a review. Applied Sciences 2022; 12(9):4495.
  42. Nasiri Lari Z, Atarzadeh F, Ghoreishi PS, Hosseinkhani A, Jaldat AM. Effects of aromatherapy on sexual dysfunction: A review of Persian traditional medicine. The Iranian Journal of Obstetrics, Gynecology and Infertility 2018; 21(4):79-86.
  43. Barati F, Nasiri A, Akbari N, Sharifzadeh G. The effect of aromatherapy on anxiety in patients. Nephro-urology monthly 2016; 8(5):e38347.
  44. Nanji JA, Carvalho B. Pain management during labor and vaginal birth. Best Practice & Research Clinical Obstetrics & Gynaecology 2020; 67:100-12.
  45. Ηλιάδου ΜΧ. Labour pain and pharmacological pain relief practice points. Health sci J 2009; 3(4):197-201.
  46. Liao CC, Lan SH, Yen YY, Hsieh YP, Lan SJ. Aromatherapy intervention on anxiety and pain during first stage labour in nulliparous women: a systematic review and meta-analysis. Journal of Obstetrics and Gynaecology 2021; 41(1):21-31.
  47. Nascimento JC, Gonçalves VS, Souza BR, Nascimento LD, Carvalho BM, Ziegelmann PK, et al. New approaches to the effectiveness of inhalation aromatherapy in controlling painful conditions: A systematic review with meta-analysis. Complementary Therapies in Clinical Practice 2022; 49:101628.
  48. Nourimonfared B, Parang S, Mansoori K, Farhadifar F, Zaheri F. The effect of the two methods of massage and aromatherapy with salvia essence on labor pain severity in nulliparous women. The Iranian Journal of Obstetrics, Gynecology and Infertility 2022; 25(1):83-92.
  49. Roozbahani N, Attarha M, Akbari Torkestani N, Amiri Farahani L, Heidari T. The effect of rose water aromatherapy on reducing labor pain in primiparous women. Complementary Medicine Journal 2015; 5(1):1042-53.
  50. Nehbandanii Z, Rezayee Kahkha Galeh M, Bordbari M, Koochakzai M. Comparison the effects of aromatherapy with rose extract and lavender on the pain of the active phase of labor in primipara women. Scientific Journal of Kurdistan University of Medical Sciences 2018; 23(5):45-54.
  51. Nasiri M, Torkaman M, Feizi S, Shamloo MB. Effect of aromatherapy with Damask rose on alleviating adults’ acute pain severity: A systematic review and meta-analysis of randomized controlled trials. Complementary therapies in medicine 2021; 6:102596.
  52. Nan Lv X, Jun Liu Z, Jing Zhang H, Tzeng CM. Aromatherapy and the central nerve system (CNS): therapeutic mechanism and its associated genes. Current drug targets 2013; 14(8):872-9.
  53. Halcón LL, Buckle J. Aromatherapy. Complementary and alternative therapies in nursing. 7th edition. New York: Springer; 2014:323â.
The Iranian Journal of Obstetrics, Gynecology and Infertility
Volume 27, Issue 12
February 2025
Pages 31-42

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