According to results from a new preliminary study, aromatherapy reduces post-surgical opioid use by half in hip replacement patients who were also anxious before their operation. The study, which is being presented at the annual meeting of the European Society of Anaesthesiology and Intensive Care (ESAIC) in Milan, Italy, is one of the first to look at whether aromatherapy reduces anxiety, and in turn, reduces the need for opioids.
To better understand the outcomes and implications of this study, let’s first take a closer look at what aromatherapy is, and how researchers believe it can help with pain management.
What Is Aroma Therapy?
If you live with chronic pain, it’s probably safe to assume you’re no stranger to aromatherapy. Even if you haven’t given it a try yourself, chances are someone you know has recommended you try it. But, what exactly is it, and how can it help with pain management?
Aromatherapy is a holistic approach to healing that uses natural plant extracts to promote health and well-being. Sometimes referred to as essential oil therapy, aromatherapy uses aromatic oils medicinally to improve the health of the body, mind, and spirit. Aromatherapy is thought of as a cross between science and art, but in recent years has gained more recognition in the field of medicine.
Traditionally, aromatherapy works by using your sense of smell and skin absorption using various products. These can include things like diffusers, aromatic spritzers, inhalers, bathing salts, and topical lotions or creams. There are hundreds of different types of essential oils, all of which have specific claims and uses. Typically, aromatherapy tends to stick to the more popular essential oils, such as lavender, eucalyptus, peppermint, tea tree, and lemon.
Essential oils are available online, in health foods stores, or anywhere else you may find health-related products. With that said, since essential oils are not regulated by the Food and Drug Administration (FDA), it’s important to buy from reputable sellers, and stick to products with no additives or synthetic ingredients.
How Can Aroma Therapy Help Manage Pain?
Previous research has shown anxiety, depression, and catastrophizing (patients who believe they are going to die during surgery) increase postoperative pain and opioid use by up to 50%. In the past, aromatherapy, specifically lavender and peppermint, has been found to help reduce feelings of anxiety. These studies, however, have looked at a series of patients, rather than having a more rigorous randomized, placebo-controlled design, which has made it difficult to draw firm conclusions from the results.
This recent study, led by Professor Jacques Chelly and colleagues at the Department of Anaesthesiology, University of Pittsburgh, Pittsburgh, USA, is one of the first to employ a randomized, placebo-controlled design to look at whether aromatherapy reduces anxiety.
Since January of 2020, patients undergoing primary total hip replacements at UPMC Presbyterian-Shadyside Hospital, Pittsburgh, who also consented to take part in the study, have filled out a survey that screens them for potential anxiety disorders.
To date, more than 350 patients have been screened using this survey. Those with scores indicating a moderate level of anxiety or higher were enrolled in the study, which is still currently ongoing and has a goal of 60 total patients.
After screening, participants were randomly assigned to either an active aromatherapy or placebo group. Those who were assigned to the active treatment group were given lavender and peppermint “aromatabs,” to administer aromatherapy. These aromatabs are an adhesive patch that slowly releases essential oils when applied to clothes or a hospital gown, which the participants then wore for at least one hour before their operation.
Patients in the placebo group were given a patch that emitted sweet almond oil, which is a type of oil that has not been credited with reducing anxiety.
For all patients, the patches were changed every 12 hours, and they were instructed to wear them for 72 hours post-operation as well. So, how well did these patches perform? Let’s take a look at the results from the study next.
Results From the Study on Aromatherapy for Pain Management
Preliminary data from the first 25 study participants have been presented by Chelly and his colleagues. Of the 25, the average age was 60.0 years, and the group consisted of 13 males and 12 females. Researchers examined the primary outcome of aromatherapy on anxiety in the first 48 hours after surgery.
The baseline (pre-surgery) score for anxiety was similar in both the placebo and control groups ( 22.9 and 23.5 respectively). In the 48 hours following surgery, the anxiety scores for both groups dropped, but Chelly noted that this drop was far more significant in the aromatherapy group than in the placebo group, with scores of 13.5 in the aromatherapy group vs. 16.2 in the placebo group.
Where results were even more compelling was in the observed use of opioids. Total opioid use in the first 48 hours after surgery was nearly 50% lower in the aromatherapy group (12 oral morphine equivalent [OME]) than in the placebo group (24.75 OME).
Chelly and his colleagues concluded: “Our results suggest that, by controlling anxiety, aromatherapy can help control pain and reduce opioid consumption. This is important, given the established role of the use of opioids in surgical patients in the overall opioid crisis in the US.”
Bottom Line on Aromatherapy for Pain Management
So, what does all this mean? Can aromatherapy actually be used to help manage pain, and in doing so reduce opioid consumption? While results from this study are compelling, more evidence is needed to corroborate these findings.
With that said, researchers like Chelly remain confident that aromatherapy does have its place in medicine, especially if it could have an impact on reducing the use of opioids. Since 1999, drug overdoses involving opioids have increased more than six-fold in the United States, and in the last two decades, more than 600,000 people in the U.S. and Canada have died from opioid-related overdoses.
“The pandemic has made the situation even worse, with over 100,000 drug overdose deaths reported in 2021,” said Chelly.
It has recently been estimated that, without urgent intervention, including public health policy reform and stricter corporate regulations, there will be an additional 1.2 million opioid deaths in North America by 2029.
“Evidence supports the concept that routine operations can be a gateway to long-term opioid use and addiction (opioid use disorder) and it is, therefore, important to consider techniques that may reduce the perioperative use of opioids and therefore the development of opioid-use disorders following surgery,” stated Chelly.
“Aromatherapy is a simple and cost-effective technique which can minimize the impact of anxiety on postoperative pain and opioid consumption. We hope that providing objective evidence about the benefits of aromatherapy will help address the concerns of those who are skeptical about its value.”
Have You Heard of Using Aroma Therapy for Pain?
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