Evaluation of the Effect of Oral Saffron Capsules on Pain Intensity during the Active Phase of Labor

Document Type : Original Article

Authors

1 Lecture of Midwifery, Evidence-based Care Research Center, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.

2 M.Sc. Student of Midwifery, Student Research Committee, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.

3 Assistant Professor, Department of Pharmacology, Pharmacological Research Center of Medicinal Plants, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

4 Assistant Professor, Department of Gynecology, School of Medicine, Islamic Azad University of Mashhad, Mashhad, Iran.

5 Lecture of Nursing, Evidence-Based Care Research Center, Department of Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.

Abstract

Background: For many women, childbirth is considered the most painful experience of their lives. Fear of natural delivery is the main cause of women’s inclination towards cesarean section. Effects of saffron and its active ingredients have been shown to alleviate a variety of neurological and inflammatory pains; however, the effect of saffron on labor pain has not been yet investigated. This study was performed to determine the effect of oral saffron capsules on pain during the active phase of labor.
Methods: This triple-blind clinical trial was conducted on 60 eligible women, who were candidates for normal vaginal delivery at 17 Shahrivar Hospital of Mashhad, Iran in 2013-2014. The subjects were randomly divided into intervention (using saffron capsules, 250 mg) and control (receiving placebo capsules) groups. At the beginning of the active phase of labor, one capsule (the saffron or placebo capsule) was used by the subject. Pain intensity was measured at the beginning of the study and then every hour until the end of the active phase of labor, using a visual analog scale. For data analysis, Chi-square, t-test, Mann-Whitney, and variance analysis were performed, using SPSS version 11.5. P-value less than 0.05 was considered statistically significant.
Results: The mean overall pain intensity was 85.9±8.4 in the intervention group and 97.4±2.9 in the control group; the difference was statistically significant (P<0.001). Before the intervention, the mean anxiety score in the intervention group was not significantly different from that observed in the placebo group (P=0.824). Maternal/neonatal complications were observed in none of the subjects of the two groups.
Conclusion: Considering an 11.8% reduction in the pain intensity of nulliparous women using saffron capsules and the absence of any associated complications, these capsules can be used as a mild analgesic for labor pain

Keywords

References

  1. Asghari Moghaddam MA. Pain measurement, study of new approaches to the psychology of pain.1th ed. Tehran: Roshd;2011:120- 126.(Persian)
  2. Jooybari L. Check the live experience of labor pain in women referred to hospitals affiliated to Tehran University of Medical Sciences. Proceedings of the congress on pain with emphasis on aspects of the Nursing and Midwifery, Faculty of Nursing and Midwifery Shahed;1381.
  3. Reddy B, Edwards T. Management of acute pain: a practical guide.Translated by: Sharifi M, Ordookhani A. 1st ed: World Association of pain; 2002: 105 - 106.
  4. Murray SH. Foundation of maternal newborn nursing. New York: St. Louis; 2002: 365-366
  5. Simkin P, Ancheta R. The Labor Progress Handbook: Early Interventions to Prevent and Treat Dystocia. Translated by: Kodi M, Golmakani A, Seyed Alavi Gh. Mashhad University of Medical Sciences.2005; pp.100- 15( Persian)
  6. Derenzo G. A new indication for cesarean delivery?. Journal of Maternal-Fetal & Neonatal Medicine 2003; 13(4): 217.
  7. Cunningham FG, Leveno KJ, Bloom SL, Hauth JC, Rouse DJ, Spong CY. Williams obstetrics. 23rd ed. New York:McGraw-Hill; 2010. pp:400-6.
  8. Azizi M, Salari P. C-section in request: an ethical approach. Journal of medical ethics and history of medicine 2009;2(2): 55-66.
  9. Mohamadbeigi A, Tabatabaee S, Mohammad salehi N, Yazdani M. Factors Influencing Cesarean Delivery Method in Shiraz Hospitals. Iran Journal of Nursing 2009; 56(21): 37-45. (persian).
  10. Badiee aval SH, Ravanshad Y, Azarfar A, Dastfan F, Babaii S, Mirzaii N. Evaluation of cesarean deliveries in hospitals and their causes Areas covered in Mashhad University of Medical Sciences. IJOGI. 2013; 16(66): 10-17.(Persian)
  11. Neshat P, Joneydi E. The association between cesarean section and perception of pain relieving methods. Medical Science Journal of Islamic Azad University of Mashhad.2011; 6 (3): 201- 207..
  12. Negahban, A. Ansari Jaberi, M. Kazemi. Preference Method of Delivery and It's Relevant Causes in View of Pregnant Women Referring to Public and Private Clinics in Rafsanjan City. Journal of Rafsanjan University of Medical Sciences 2006;3(5): 161-8. (persian)
  13. Mirhaghjoo N, Faramarzi M. Manual of Clinical Problems in Medicine. Gilan: Gilan Research Publications; 2000.pp: 178.(Persian)
  14. Myles M, Ruth B, Linda B. Myles text book for midwives.16th ed. London: Churchill Livingstone ; 2010: 458-463.
  15. Hosseinzadeh H. Saffron herbal medicine of the third millennium - the anti-cancer effects of Cancer (Volume I). First published Smblh Mashhad; 2010.
  16. Melnyk JP, Wang SN, Marcone MF. Chemical and biological properties of the world’s most expensive spice saffron. Food Res Int 2010; 43(8): 1981–1989.
  17. Mousavi SZ, Bathaei SZ. Historical uses of saffron: identifying potential new avenues for modern research. Avicenna J Phytomed 2011;1: 57–66.
  18. Hosseinzadeh H, Nassiri-Asl M. Avicenna’s (Ibn Sina) the Canon of Medicine and Saffron (Crocus sativus): A Review.Phytother Res 2013; 27(4):475-483.
  19. Schmidt M, Betti G, Hensel A. Saffron in phytotherapy: pharmacology and clinical uses. Wien Med Wochenschr 2007; 157: 315–319.
  20. Zargari A. Medical plants. Tehran: Tehran University Press; 2011. (Persian)
  21. Bathaie SZ, Mousavi SZ. New applications and mechanisms of action of saffron and its important ingredients. Crit Rev Food Sci Nutr. 2010; 50(8):761–786.
  22. Bhargava VK. Medicinal uses and pharmacological properties of crocus sativus Linn. (saffron). Int J Pharm Pharm Sci 2011; 3(3):22–26.
  23. Hosseinzadeh H, Karimi G, Niapoor M. Antidepressant effect of Crocus sativus L. stigma extracts and their constituents, crocin and safranal, in mice. Acta Horticul 2003; 650:435– 445.
  24. Karimi G, Hosseinzadeh H, Khaleghpanah P. Study of antidepressant effect of aqueous and ethanolic extract of Crocus sativus in mice. Iran J Basic Med Sci 2001; 4: 11–15.
  25. Wang Y, Han T, Zhu Y, et al. Antidepressant properties of bioactive fractions from the extract of Crocus sativus L. J Nat Med 2010; 64: 24–30.
  26. Noorbala AA, Akhondzadeh S, Tamacebi-Pour N, Jamshidi AH. Hydroalcoholic extract of Crocus sativus L. versus fluoxetine in the treatment of mild to moderate depression: a double-blind, randomized pilot trial. J Ethnopharmacol 2005; 97(2): 281–284.
  27. Agha-Hosseini M, Kashani L, Aleyaseen A, et al. Crocus sativus L. (saffron) in the treatment of premenstrual syndrome: a double-blind, randomised and placebo-controlled trial. Br J Obstet Gynaecol 2008; 115(4): 515–519.
  28. Fukui H, Toyoshima K, Komaki R. Psychological and neuroendocrinologicaleffects of odor of saffron (Crocus sativus). Phytomedicine 2011; 18(8):726–730.
  29. Khodakrami N. The Effect of an Iranian Herbal Drug on Primary Dysmenorrhea: A Clinical Controlled Trial. Journal of Midwifery & Women’s Health. 2009; 54( 5): 401-404.
  30. Shadipour M, Simbar M, Salamzadeh J, Nasire N. Acomparative study on the effects of Menstrogol and Mefenamic acidon postpartum after-pain. ISMJ 2011; 16(6): 401-409.
  31. Hosseinzadeh H, Noraei NB. Anxiolytic and hypnotic effectof Crocus sativus aqueous extract and its constituents, crocinand safranal, in mice. Phytoter Res. 2009; 23(6):768–774.
  32. Hosseinzadeh H, Younesi HM. Antinociceptive and anti-inflammatory effects of Crocus sativus L. stigma and petal extracts in mice. BMC Pharmacol 2002; 2(1): 7.
  33. Shams J, Molavi S, Marjani S, Kamalinejad M, Zardooz H, Sahraei H, et al. The aqueous extract of Crocus sativus stigma reduces morphine tolerance. Physiol Pharmacol. 2009;13(2):170-8. [Persian]
  34. Nasri S, Hosseini S. Y, Sahraei H, Zardooz H. Inhibition of pain and inflamation induced by formalin in male mice by ethanolic extract of saffron (Crocus sativus) and its constituents; crocin and safranal. Kowsar Medical Journal 2011; 15( 4): 189-195.
  35. Amin B, Hosseinzadeh H. Evaluation of aqueous and ethanolic extracts of saffron, Crocus sativus L., and its constituents, safranal and crocin in allodynia and hyperalgesia induced by chronic constriction injury model of neuropathic pain in rats. Fitoterapia 2012; 83:888–895.
  36. Vahidi AR, Bashardost N and Akhondi H. Theanalgesic effect of saffron extract in rats ascompared with morphine sulfate. Planta Med 2007; 73(9):995.
  37. Zeinali F, Anvari M, Dashti RMH, Hosseini SM. The effectsof different concentrations of saffron (Crocus sativus) decoctionon preterm delivery in mice. Planta Med 2009;75(9): 1026–1026.
  38. Al-Qanun fil-Tibb, (Arabic) Book, (original Author-Avicenna), Vol: 1. Al-kotob Alilmiyah Publication: Lebanon1999;548.
  39. Azhari S, Khalilian MovahedH, Tara F, Esmaili HA. Comparison of upright and bend at the second stage of labor on pain experienced during the second stage of labor in nulliparous women. IJOGI 2012;15(33): 7-11. (Persian).
  40. Guide state hospitals providing obstetric loving mother.Ministryof Health and Medical Education Department Bureau of Population, Family Health and Maternal Health., Second Edition. Firstreviewed;1390.
  41. Arbabian S and coworker. Effect of aqueous extract of saffron (Crocus Sativus)on formalininduced pain of small laboratory rats. Kowsar Medical Journal 2009; 14(1): 11- 18.
  42. Samuelsson G. Drugs of natural origin. 4th ed;1999. pp:227-228, 341-342.
  43. Fanton JC, Ward PA, Rubin E, Farber JL. InflammationIn Pathology. 2nd ed. Philadelphia: J.B. Lippicott Company; 1994. pp:34-66.
  44. Simpson KR, Greehan PA.Perinatal Nursing. 2nd ed. Philadelphia: Lippincot.2001; pp: 73 ,312- 14,328-29.
  45. Otte T. The Illustrated Guide to Pregnancy And Birth. London: New Holland publishers(UK).1998; pp: 53, 62, 77, 84.
  46. Hosseinzadeh H,N.B Noraei. Anxiolytic and Hypnotic Effect of Crocus sativus Aqueous Extract and its Constituents,Crocin and Safranal, in Mice. Phytotherapy Re 2009; 23(6): 498 - 503.
  47. Boskabady MH, Aslani MR. Relaxant effect of Crocus sativus (saffron) on guinea pig tracheal chains and its possible mechanisms. J Pharm. Pharmacol. 2006; 58 (10): 1385 - 1390.
  48. Hosseinzadeh H, Talebzadeh F. Anticonvulsant evaluation of safranal and crociri from Crocus sativus in mice. Fitoterapia (2005); 76(7-8):722- 724.
  49. Liu N, Yang Y, Mo S, Liao J and Jin J. Calcium antagonist effects of Chinese crude drugs: preliminary investigation and evaluation by 45Ca. Appl Radiat Isotopes 2005; 63 (2): 151 - 5.
  50. Ai J, Dekermendjian K, Wang X, Nielsen M, Witt MR. 6-Methylflavone, a benzodiazepine receptor ligand with antagonistic properties on rat brain and human recombinant GABA(A) receptors in vitro. Drug Dev Res 1997;41: 99 – 106 .
  51. Marder M, Estiu G, Blanch LB et al. Molecular modeling and QSAR analysis of the interaction of flavone derivatives with the benzodiazepine binding site of the GABA(A) receptor complex. Bioorg Med Chem 2001;9: 323–335.
  52. Tiran D, Chummun H. Complementarytherapies to reduce physiological stress in pregnancy. J. Complementary Therap NM 2004; 10(3): 162 - 7.
  53. Eravani M. Study of trial effects thymus vulgaris on first dysmenorrhia. Journal of Herbal Medicine 2009; 30(8,2): 54-61.
  54. Hekmatzadeh SF, Mirmolaei ST, Hoseini N.The Effect of Boiled Dill (Anethum graveolens) Seeds on the Long Active Phase and Labor Pain Intensity. Armaghane-danesh 2012; 17(1): 50- 59.
  55. Rosen MA. Nitrous oxide for relief of labor pain: a systematic review. Am J Obstet. Gynecol 2002; 186 (5): 110 - 126.

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