芳香療法是否可以緩解術後病人噁心嘔吐之程度Can aromatherapy relieve postoperative nausea and vomiting?

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2020-07-27 已刊登
新刊登 綜 整 預防/治療/介入類型

作  者

吳思霈*

實證知識類別

A 類:實證健康照護綜整

PICO

治療/預防性問題

治療/介入措施

一般外科醫學 General Surgery

科別

  • 臨床指引/實證照護成效 Clinical Guidelines/Evidence Based Outcomes

中文關鍵詞

術後病人 芳香療法 噁心 嘔吐 PONV

英文關鍵詞

postoperative patient aromatherapy nausea vomiting PONV

機構名稱

臺北榮民總醫院

申請單位

護理部A073

中文摘要

形成臨床提問:
術後噁心嘔吐是常見的術後合併症之一,若是未妥善處理,可能影響到病人術後恢復的品質。在臨床上多半以藥物治療做為處理,然而藥物治療並非適用於每一位病人,有時甚至會有副作用的產生。因此筆者思考除了藥物,有什麼處置是護理可以介入的呢?閱讀文獻中發現,許多文獻皆提及芳香療法可以緩解術後噁心嘔吐之情形,由此引發臨床問題,藉由實證為依據,來探討芳香療法是否可以緩解術後噁心嘔吐之情形?
文獻搜尋的方法與分析:
1. 確立PICO問題:芳香療法是否可以緩解術後病人噁心嘔吐之程度。 2. 搜尋策略:設定關鍵字:P(Postoperative patient)、I(Aromatherapy)、O(nausea/ vomiting)。運用步林邏輯(OR,、AND及NOT),設定條件:時間介於2015年至2020年之間、語言設定為英語、個案為成人且必須為Systematic Reviews或是Randomized Controlled Trial之文章,在PubMed、CINAHL、Medline (Ovid)中搜尋。符合條件共六篇,刪除重複及題目內容不符者,最後共三篇,兩篇RCT及一篇SR納入文獻評讀,使用Oxford center for EBM(2011)進行評讀。
文獻的品質評讀:
1. Karaman, et al. (2019):將受試者依使用之精油分為安慰劑組、生薑組、薰衣草組、玫瑰組,研究結果顯示使用薰衣草和生薑的芳香療法與噁心的改善顯著相關,且生薑組及薰衣草組發生嘔吐之比例以及使用止吐藥物之比例皆較安慰劑組及玫瑰組低。(Level 2) 2. Adib-Hajbaghery & Hosseini. (2015):使用生薑精油芳療之受試者,比較術後兩小時及六小時噁心之強度明顯降低。使用生薑精油芳療之受試者,術後兩小時及六小時嘔吐之次數明顯低於使用安慰劑之受試者。(Level 2) 3. Asay, et al. (2019):適合精油的芳香療法可減緩術後噁心之強度及減少止吐藥的次數。(Level 1)
結論與建議:
綜合三篇文章,使用適合的精油的芳香療法可減緩術後噁心之強度以及減少術後嘔吐發生之次數,在部分文獻中也提及可減少術後病人止吐藥物的使用

英文摘要

Ask an answerable question (PICO):
Postoperative nausea and vomiting is one of the common postoperative complications. Without proper management, it may affect the quality of recovery. Clinically, most of them are treated with antiemetic, however, antiemetic is not effective for every patient, and sometimes it may has side effects on patients’ health. Therefore, I wonder is there any treatment nurses can do? After literature review, I found that many studies mentioned that aromatherapy can relieve postoperative nausea and vomiting. Thus, I would like to discuss whether aromatherapy can relieve postoperative nausea and vomiting by using evidence-based methods.
The Method and Analysis of Literature Review:
1. We set PICO questions to answer whether aromatherapy can relieve postoperative nausea and vomiting. 2. We set key word: P(Postoperative patient), I(Aromatherapy), and O(nausea/ vomiting), and limitation: in English, from 2015 to 2020, adult, RCT or SR. We used Bollean logic to search database in PubMed, CINAHL, Medline (Ovid). Totally 6 studies were recruited. After reading them, 3 studies were included, including 2 RCTs and 1 SR, and we used Oxford center for EBM in 2011 to analysis their level of evidence.
Critical Appraisal:
1. Karaman, et al. (2019): Patients were divided into placebo group, ginger group, lavender group, and rose group according to the essential oils they used. The study results showed that aromatherapy by using lavender and ginger was significantly related to the relief of nausea, and there was less proportion of people in ginger group and lavender group using antiemetic drugs than people in placebo group and rose group. 2. Adib-Hajbaghery & Hosseini. (2015): Patients using ginger essential oil aromatherapy, their intensity of nausea was significantly reduced two hours and six hours after surgery, and the frequency of vomiting two hours and six hours after surgery was lower than those using placebo. 3. Asay, et al. (2019): With appropriate essential oils, aromatherapy can reduce the intensity of postoperative nausea and the use of antiemetic drugs.
Conclusions and Recommendations:
In conclusion, with appropriate essential oils, aromatherapy can reduce the intensity of postoperative nausea and reduce the incidence of postoperative vomiting. Some studies also mentioned that it can reduce the use of antiemetic drugs in postoperative patients.