Effect of Verbascum Thapsus cream on intensity of episiotomy pain in primiparous women

Document Type : Original Article

Authors

1 M.Sc. of Midwifery, School of Nursing and Midwifery, Shahid Beheshti University of Medical Science, Tehran, Iran.

2 Assistant professor, Department of Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Science, Tehran, Iran.

3 Professor, Department of Pharmacognosy, School of Pharmacy, Shahid Beheshti University of Medical Science, Tehran, Iran.

4 Assistant professor, Department of Biostatistics, School of Paramedics, Shahid Beheshti University of Medical Science, Tehran, Iran.

5 M.Sc. of Plant Systematic, Medicinal Plants Research Center, Institute of Medicinal Plants, ACECR, Karaj, Iran.

Abstract

Introduction: Episiotomy is the most common surgery in midwifery to facilitate the expulsion of the fetus. The pain resulting from episiotomy affects mother's quality of life. Verbascum Thapsus has been used for a long time to cure different diseases. Since no study has been conducted which evaluate the effects of Verbascum on pain relief in human models, therefore, this study was performed with aim to investigate the effect of Verbascum Thapsus cream on episiotomy pain intensity.
Methods:This clinical trial study was performed on 93 primiparous mothers in Fatima Zahra Hospital, Saveh in 2015. They were randomly allocated to two groups of Verbascum cream and placebo. The women in experimental groups used Verbascum and placebo cream twice per day for 10 days. Pain intensity was assessed before intervention, 1, 3 and 10 day after intervention using NAS scale. Data were analyzed using SPSS software (version 16), and Mann-Whitney, t-test, and Chi-square tests. PResults: The score of pain intensity before intervention was not significantly difference in two groups of Verbascum cream and placebo (P=0.947).  This score showed significant difference in two groups on 1, 3 and 10 day after intervention (P<0.001).
Conclusion: Verbascum cream decreased pain intensity during 10 days after episiotomy. Since this study was the first which assessed the effects of Verbascum Thapsus cream on episiotomy pain intensity in human, further research is required to fully clarify the beneficial effects of Verbascum cream.

Keywords


  1. Dutta DC. Text book of obestetrics. 6th ed. Calcutta: New Central Book Agency; 2006. P. 568-71.
  2. Robinson JN. Approach to episiotomy. UpToDate. Available at: URL: http:// www.uptodate.com; 2016.
  3. AL-Ghammari K, AL-Riyami Z, AL-Moqbali M, AL-Marjabi F, AL-Mahrouqi B, AL-Khatri A, et al. Predictors of routine episiotomy in primigravida women in Oman. Appl Nurs Res 2016; 29:131-5.
  4. Shojae KK, Davati A, Zayeri F. Frequency and side effect of episiotomy in primiparous women: a three-month longitudinal survey. Qom Univ Med Sci J 2009; 3(2):47-50. (Persian).
  5. Khani S, Zare K, Ramezannezhad SE. The frequency of episiotomy and its related factors. Iran J Nurs 2012; 24(74):45-52. (Persian).
  6. East CE, Sherbum M, Nagle C, Said J, Forster D. Perineal pain following childbirth: Prevalence, effects on postnatal recovery and analgesia usage. Midwifery 2012; 28(1):93-7.
  7. Karacam Z, Eroglu K. Effects of episiotomy on bonding and mothers' health. J Adv Nurs 2003; 43(4):384-94.
  8. Sheikhan F, Jahdi F, Khoei EM, Shamsalizadeh N, Sheikhan M, Haghani H. Episiotomy pain relief: use of lavender oil essence in primiparous Iranian women. Complement Ther Clin Pract 2012; 18(1):66-70.
  9. Ahmadi Z. Review of effective methods to reduce damage to the perineum during delivery and its recovery. Iran J Obstet Gynecol Infertil 2015; 18(155-156):19-30. (Persian).
  10. Karacam Z, Ekmen H, Calisir H, Seker S. Prevalence of episiotomy in primiparas, related conditions, and effects of episiotomy on suture materials used, perineal pain, wound healing 3 weeks postpartum, in Turkey: a prospective follow-up study. Iran J Nurs Midwifery Res 2013; 18(3):237-45.
  11. Navvabi Rigi SH, Kerman-Saravi F, Saroneh Rigi M, Abedian Z. Cold and reduced episiotomy pain interfere with mood and daily activity. Shiraz E Med J 2011; 12(2):87-92.
  12. Venkadalakshmi V, Venkatesan L, Perdita HM. Effect of infrared therapy on episiotomy pain and wound healing in postnatal mothers. Nurs J India 2010; 101(9):212-4.
  13. Masumi Z, Keramat A, Hajiaghaee R. Systematic review on effect of herbal medicine on pain after of episiotomy and cesarean cutting. J Med Plants 2011; 4(40):1-16. (Persian).
  14. Balekar N, Katkam NG, Nakpheng T, Jehtae K, Srichana T. Evaluation of the wound healing potential of Wedelia trilobata (L.) leaves. J Ethnopharmacol 2012; 141(3):817-24.
  15. Süntar I, Tatlı II, Küpeli Akkol E, Keleş H, Kahraman Ç, Akdemir Z. An ethnopharmacological study on Verbascum species: from conventional wound healing use to scientific verification. J Ethnopharmacol 2010; 132(2):408-13.
  16. Shakeri AR, Farokh A. Phytochemical evaluation and antioxidant activity of Verbascum sublobatum Murb. Leaves. Res J Pharm 2015; 2(3):43-7.
  17. Turker AU, Gurel E. Common mullein (Verbascum Thapsus L.): recent advances in research. Phytother Res 2005; 19(9):733-9.
  18. Riaz M, Zia-Ul-Haq M, Jaafar HZ. Common mullein, pharmacological and chemical aspects. Rev Brasil Farm 2013; 23(6):948-59.
  19. Mirhaidar H. Plant sciences. Tehran: Nashre Farhang Eslami; 2005. P. 418-23. (Persian).          
  20. Panchal MA, Murti K, Lambole V. Pharmacological properties of Verbascum thapsus-a review. Int J Pharm Sci Rev Res 2010; 5(2):73-7.
  21. Kumar B, Vijayakumar M, Govindarajan R, Pushpangadan P. Ethnopharmacological approaches to wound healing--exploring medicinal plants of  India. J Ethnopharmacol 2007; 114(2):103-13.
  22. Sohrabi-Haghdost RV, Safarmashaei S. Comparison of in-vivo wound healing activity of Verbascum thapsus flower extract with zinc oxide on experimental wound model in rabbits. Adv Environ Biol 2011; 5(7):1501-9.
  23. Akdemir Z, Kahraman Ç, Tatli I, Kupeli Akkol E, Suntar I, Keles H. Bioassay-guided isolation of anti-inflammatory, antinociceptive and wound healer glycosides from the flowers of Verbascum mucronatum Lam. J Ethnopharmacol 2011; 136(3):436-43.
  24. Akkol EK, Tatli II, Akadmir ZS. Antinociceptive and anti-inflammatory effects of saponin and iridoid glycosides from Verbascum pterocalycinum var. mutense Hub-Mor. Z Naturforsch C 2007; 62(11-12):813-20.
  25. Tatli II, Akkol EK, Yesilada E, Akdemir ZS. Antinociceptive and anti-inflammatory activities of seven endemic Verbascum species growing in Turkey. Pharm Biol 2008; 46(10-11):781-8.
  26. Escobar FM, Sabini MC, Zanon SM, Cariddi LN, Tonn CE, Sabini LI. Genotoxic evaluation of a methanolic extract of Vrebascum thapsus using micronucleus test in mouse bone marrow. Nat Prod Commun 2011; 6(7):989-91.
  27. Yahya S, Ozgoli G, Mojab F, Alavi Majd H, Shojaee A, Mirhaghjou N. The effect of hypericum perforatum cream on perineal pain after episiotomy in primiparous women. Iran J Obstet Gynecol Infertil 2015; 18(159):1-7. (Persian).
  28. Ag EM. Evaluation of medicines for human use: guidelines for hormone replacement therapy. European Medicines Agency. Science Medicines Health. Available at: URL: http://www.ema.europa.eu/docs/enl/2009/12/WC500017803.pdf; 2009.
  29. Ferreira-Valente MA, Pais-Riberio JL, Jensen MP. Validity of four pain intensity rating scales. Pain 2011; 152(10):2399-404.
  30. Phan NQ, Blome C, Fritz F, Gerss J, Reich A, Ebata T, et al. Assessment of pruritus intensity: prospective study on validity and reliability of the visual analogue scale, numerical rating scale and verbal rating scale in 471 patients with chronic pruritus. Acta Derm Venereol 2012; 92(5):502-7.
  31. Bhmani M, Shirzad H, Majlesi M, Shahinfard N, Rafeian-kopaei M. A review study on analgesic application of Iranian medicinal plants. Asian Pacific J Trop Med 2014; 7(1):S43-53.
  32. Georgiev M, Alipieva K, Orhan I, Abrashev R, Petko D, Andelova M. Antioxidant and cholinesterases inhibitory activities of Verbascum xanthopheniceum Griseb. and its phenylethanoid glycosides. Food Chem 2011; 128(1):100-5.
  33. Dalar A, Gue Y, konczak L. Phenolic composition and potential anti-inflammatory properties of Verbascum cheiranthifolium var. cheiranthifolium leaf. J Herbal Med 2014; 4(4):195-200.
  34. Hoodgar F, Nasri S, Amin G. Investigation of antinociceptive and anti-inflammatory effects of hydro-alcoholic extract of Securigera securidaca L. Horizon Med Sci 2011; 17(1):12-9. (Persian).
  35. Golabi S, Hassanpour-ezati M, Rohampour K. Effect of aqueous extracts of Drosera Spatulata on firing rate of paragigantocellularis nucleus neurons after pain induction by formalin in rats. Physiol Pharmacol 2010; 14(3):281-92. (Persian).
  36. Hejazizn SH, Fatahi AF, Mahdavi SM. The analgesic effects of aqueous part of Carum copticum (L.) CB clarke extract on chronic pain and comparison with oil part of extract in mice. Iran J Med Aromat Plants 2009; 25(1):104-12.
  37. Azhari S, Aradmehr M, Rakhshandeh H, Tara F, Shakeri MT. The effects of chamomilla cream on wound healing of episiotomy in primiparous women. Iran J Obstet Gynecol Infertil 2014; 17(93):16-26. (Persian).
  38. Rezaie A, Ebrahimi M, Issabeagloo E, Kumar M, Nazeri M, Rezaie S, et al. Study of sedative, pre-anesthetic, and anti-anxiety effects of verbascum thapsus L. extract compared with diazepam in rats. Adv Biores 2012; 3(4):84-9.
  39. Kupeli E, Tatli II, Akdemir ZS, Yesilada E. Bioassay-guided isolation of anti-inflammatory and antinociceptive glycoterpenoids from the flowers of Verbascum lasianthum Boiss. ex Bentham. J Ethnopharmacol 2007; 110(3):444-50.
  40. Pilehvarian A, Shirani M, Kheiri S, Taji F, Asgari A. Effect of Euphorbia helioscopia on acetic acid-induced abdominal constrictions in Balb/c mice. J Shahrekord Univ Med Sci 2010; 11(4):9-14. (Persian).
  41. Jahdie F, Eghdampour F, Naghizadeh S, Kheyrkhah M, Tagizade M. Effect of Aloe vera and Calandula persica ointment on pain intensity of episiotomy in primiparous women. Horizon Med Sci 2013; 19(1):23-8. (Persian).
  42. Heidari MR, Zahedi MJ, Rezvani H. Analgesic effect of Lavendula officinalis and histopathological studies in mice. Daneshvar Med 2000; 8(30):23-30. (Persian).
  43. Pazande F, Savadzadeh SH, Mojab Faraz A, Alavie Majd H. Effect of Aromotrapy with Chamomile in pain intensity of episiotomy among primiparous Iranian women. Shahid Beheshti Univ Med J 2009; 18(62):11-5. (Persian).
  44. Kashan Z, Arabi M, Delavari M, Hooshyar H, Taghizadeh M, Joneydy Z. Effect of Verbascum thapsus ethanol extract on induction of apoptosis in Trichomonas vaginalis in vitro. Inf Diso Drug Targ 2015; 15(2):125-30.