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Effect of Eucalyptus Oil Inhalation on Pain and Inflammatory Responses after Total Knee Replacement: A Randomized Clinical Trial


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Eucalyptus oil has been reported effective in reducing pain, swelling, and inflammation. This study aimed to investigate the effects of eucalyptus oil inhalation on pain and inflammatory responses after total knee replacement (TKR) surgery. Participants were randomized 1 : 1 to intervention group (eucalyptus inhalation group) or control group (almond oil inhalation group). Patients inhaled eucalyptus or almond oil for 30 min of continuous passive motion (CPM) on 3 consecutive days. Pain on a visual analog scale (VAS), blood pressure, heart rate, C-reactive protein (CRP) concentration, and white blood cell (WBC) count were measured before and after inhalation. Pain VAS on all three days (P < .001) and systolic (P < .05) and diastolic (P = .03) blood pressure on the second day were significantly lower in the group inhaling eucalyptus than that inhaling almond oil. Heart rate, CRP, and WBC, however, did not differ significantly in the two groups. In conclusion, inhalation of eucalyptus oil was effective in decreasing patient's pain and blood pressure following TKR, suggesting that eucalyptus oil inhalation may be a nursing intervention for the relief of pain after TKR.
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Evidence-Based Complementary and Alternative Medicine
Volume , Article ID , pages.//
Research Article
Effect of Eucalyptus Oil Inhalation on Pain and
Inflammatory Responses after Total Knee Replacement:
A Randomized Clinical Trial
Yang Suk Jun,1Purum Kang,1Sun Seek Min,2Jeong-Min Lee,3
Hyo-Keun Kim,3and Geun Hee Seol1
1Department of Basic Nursing Science, School of Nursing, Korea University, Anam-dong, Seongbuk-gu, Seoul 136-713, Republic of Korea
2Department of Physiology and Biophysics, School of Medicine, Eulji University, Daejeon 301-746, Republic of Korea
3KT&G Research Institute, Daejeon 305-805, Republic of Korea
Correspondence should be addressed to Geun Hee Seol;
Received  April ; Revised  June ; Accepted  June 
Academic Editor: Vincenzo De Feo
Copyright ©  Yang Suk Jun et al. is is an open access article distributed under the Creative Commons Attribution License,
which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Eucalyptus oil has been reported eective in reducing pain, swelling, and inammation. is study aimed to investigate the eects
of eucalyptus oil inhalation on pain and inammatory responses aer total knee replacement (TKR) surgery. Participants were
randomized  :  to intervention group (eucalyptus inhalation group) or control group (almond oil inhalation group). Patients
inhaled eucalyptus or almond oil for  min of continuous passive motion (CPM) on  consecutive days. Pain on a visual analog
scale (VAS), blood pressure, heart rate, C-reactive protein (CRP) concentration, and white blood cell (WBC) count were measured
before and aer inhalation. Pain VAS on all three days (𝑃 < .001) and systolic (𝑃 < .05)anddiastolic(𝑃 = .03) blood pressure
on the second day were signicantly lower in the group inhaling eucalyptus than that inhaling almond oil. Heart rate, CRP, and
WBC, however, did not dier signicantly in the two groups. In conclusion, inhalation of eucalyptus oil was eective in decreasing
patient’s pain and blood pressure following TKR, suggesting that eucalyptus oil inhalation may be a nursing intervention for the
relief of pain aer TKR.
1. Introduction
Osteoarthritis, the most prevalent musculoskeletal disorder
throughout the world, is a common chronic disease that
causes pain, restricts activity, and reduces quality of life
[]. Osteoarthritis may occur in all joints, but the knee
is the most frequent site []. e most common clinical
features of osteoarthritis include pain, stiness, swelling, and
inammation. Surgery may be considered in patients who do
not show symptom improvements on nonsurgical treatments,
especially when severe pain interferes with daily life []. Total
knee replacement (TKR) is a surgical procedure in which
deformed knee cartilage is resected and replaced by a metal
structure lled with polyethylene, resulting in a new joint
structure. TKR has been shown to improve the quality of life
of patients with severe arthritis by relieving knee pain and
increasing knee function []. Inammation by infection aer
TKR has a negative impact on patient prognosis, with deep
infection requiring a second operation []. us, inamma-
tion control as well as pain management are required for rapid
recovery and functionality. Eucalyptus (Eucalyptus globulus)
oil has been widely used as a folk medicine to treat upper
respiratory infections, gastritis, and diabetes [].
Eucalyptus oil contains 𝛼-pinene and ,-cineole and acts
as an antioxidant, with strong radical scavenging activity [].
In a mouse model of pain-causing edema in the feet, oral
administration of ,-cineole, which accounts for –%
(w/w) of the contents of eucalyptus oil, suppressed edema
formation and reduced inammation and pain []. is eect
of ,-cineole is due to its inhibition of cytokine secretion
by T-lymphocytes []. Electromyography has shown that
application of eucalyptus oil to a healthy subject had a
myorelaxant eect, as well as promoting emotional stability
[]. Moreover, in a rat model of susceptibility to pain from
a hot plate, eucalyptus oil was not only analgesic but reduced
edema formation and had an anti-inammatory eect [].
Evidence-Based Complementary and Alternative Medicine
Although eucalyptus oil has been found to reduce pain
and suppress edema and inammation in animal models, its
eects on pain in patients who have undergone TKR have not
been determined. We therefore assessed whether eucalyptus
oil inhalation could eectively reduce pain and inammatory
responses in patients who have undergone TKR.
2. Materials and Methods
2.1. Study Design and Sample Size. Patients were randomly
assigned using table of random numbers to inhalation of
eucalyptus oil or almond oil (used as solvent, control) during
continuous passive motion (CPM) aer TKR, with both
investigators and subjects blinded to treatment assignment.
a signicance level of ., the minimum number of patients
required to compare dierences between the experimental
and control group was estimated to be  patients per group.
Twenty-eight subjects were originally assigned to each group,
with  completing the study,  in the experimental and 
in the control group.
2.2. Participants. Patients diagnosed with osteoarthritis by
the same physician and who underwent TKR were invited
to participate. All subjects () had been prescribed pain
medications, including oxycodone hydrochloride, fentanyl,
nonsteroidal anti-inammatory drugs (NASID), and antibi-
otic pills, () had no complications or other inammatory
diseases aer surgery, () were not being treated with any
antidepressant, hormone, or aroma therapy, () did not
smoke, () were conscious and oriented, and () had a
pain score on a visual analog scale (VAS) >beforearoma
inhalation. e study design and protocol were approved by
the Ethical Review Committee of the Korea University Med-
ical Center (Code: ED), and all participants provided
written informed consent.
2.3. Gas Chromatography-Mass Spectrometry Analysis. Gas
chromatography-mass spectrometry (GC-MS) was per-
formed to analyze compositions of eucalyptus oil. GC-
MS analysis was performed using an Agilent  gas
chromatograph with a  inert mass spectrometer (USA),
and analytical capillary column was performed on HP-
Innowax ( m ×. mm i.d., . 𝜇mlmthickness,
Agilent, USA). Carrier gas was helium and owrate was
. mL/min. e injector temperature was increased to
C. And samples (. 𝜇L) were injected at a split ratio of
 : . e column temperature was initially maintained at
C/min, and nally
held for  min. e ion source and transfer line temperature
were set at Cand
C. e mass spectrometer was
operated in the electron impact ionization mode ( eV).
2.4. Intervention. Eucalyptus oil and almond oil were sup-
plied by Aromarant Co. Ltd. (Rottingen, Germany). Euca-
lyptus oil was dissolved at a concentration of % (v/v) in
almond oil. In experimental group, eucalyptus oil (dissolved
in almond oil) was placed onto a 4×2inch gauze pad,
which was positioned between the nose and philtrum for
 minutes of CPM on  consecutive days, beginning on
same treatment of experimental group except for eucalyptus.
Eucalyptus oil and almond oil have a similar color and were
packed same-shaped bottles. All experiments were carried
out separately. e compounder was the only one who knows
which participant aliated to which group according to the
assigned number on bottle. Patients and investigator were not
informed about the types and eects of aroma oil.
2.5. Outcome Measurement. Pain was measured using the
VAS pain score. It is also used in most studies of anxiety,
consists of a horizontal scale, ranging from  (no pain) on
the le side and  (extreme pain) on the right side [].
Patients were asked to indicate VAS pain score by number
at each determination. Blood pressure and heart rate were
measured on each day of oil inhalation, before and aer CPM,
as indicators of the reaction of the autonomic nervous system
to pain. Blood pressure was measured in the brachial artery
using a Deluxe Aneroid Sphygmomanometer (Mac-check,
Japan) aer a -minute rest in a lying position. Pulse was
measured at the radial artery for  minute.
In this study, CRP was measured by a Latex Immunoassay
with LX- (Eiken Inc., Japan) and WBC was measured
by semiconductor ow cytometry with an XE- (Sysmex,
Inc., Japan).
2.6. Data Collection. Blood samples were collected before
breakfast on the rst day of aroma inhalation and on days
 and  for measurements of C-reactive protein (CRP)
concentrations and white blood cell (WBC) count. Pain VAS,
blood pressure, and heart rate were measured before and aer
each  min inhalation session.
2.7. Statistical Analysis. All statistical analyses were per-
formed using the Statistical Package for the Social Sciences,
SPSS .. e demographic and clinical characteristics of the
two groups were compared using t-tests, Fisher’s exact tests,
and Chi-square tests, as appropriate. All data are presented
as frequency, percentages, and standard error of the mean
(SEM) or standard deviation (SD). Dierences in the VAS
pain scores before and aer aroma inhalation within each
paired t-test, and dierences between groups were analyzed
using Mann-Whitney U-tests and unpaired t-tests.
3. Results
3.1. Compositions of Eucalyptus Oil. A total of  compounds
were identied (Tab l e  ). e major volatile avor com-
pounds of eucalyptus oil were ,-cienol (.%), limonene
(.%), 𝜌-cymene (.%), 𝛾-terpinene (.%), and 𝛼-
pinene (.%).
3.2. Characteristics of the Participants and Test of Homo-
geneity. Fiy-two individuals were randomized,  to the
eucalyptus oil and  to the almond oil (control) group.
Evidence-Based Complementary and Alternative Medicine
T : Chemical compositions of the eucalyptus oil determined by
RTa(min) KIbCompound Area %c
.  𝛼-pinene .
.  𝛼-fenchene .
.  Camphene .
.  𝛽-pinene .
.  o-cymene .
.  b-myrcene .
.  𝛼-phellandrene .
.  𝛼-terpinene .
.  Limonene .
.  ,-cineole .
.  trans-𝛽-ocimene .
.  𝛾-terpinene .
.  𝜌-cymene .
.  𝛼-terpinolen .
.  Isoamyl isovalerate .
.  o-menthone .
.  𝛼-pinene epoxide .
.  Dehydro-𝜌-cymene .
.  cis-Limonene oxide .
.  Linalool .
.  Fenchyl alcohol .
.  -Terpineol .
.  trans-pinocarveol .
.  cis-Citral .
.  Crypton .
.  𝛼-terpineol .
.  𝛼-terpinyl acetate .
.  Borneol .
.  Carvone .
.  cis-Carveol .
.  trans-Geraniol .
aRT: retention time. bKI: Kovatsindices. cCalculated with peak area obtained
from GC/MS.
Demographic and disease-associated characteristics were
similar in the two groups, including type of surgery, duration
of osteoarthritis, and treatments with oral antihypertensive
and antidiabetic agents (Ta b l e  ). e mean age of the 
participants was . years (range, – years), and most
were female. eir average body mass index (BMI) was
26.4 ± 3.1kg/m2, and all  were overweight/obese (BMI
 kg/m2). irty-seven patients (.%) underwent a unilat-
eral TKR and  (.%) underwent a simultaneous, bilateral
TKR. e mean durations of osteoarthritis in the eucalyptus
and almond oil groups were 8.5 ±5.7 years and 6.0 ±5.2 years,
respectively. Before aroma inhalation, VAS pain score, sys-
tolic blood pressure, diastolic blood pressure, heart rate, CRP,
and WBC count were similar in the two groups (Table  ).
3.3. Eects of Eucalyptus Oil on VAS Pain Score. VA S p a i n
scores aer aromatherapy on days – decreased 1.1 ± 0.2,
1.2 ± 0.2,and.2 ± 0.2 points, respectively, from the scores
before inhalation (Figure (a)). In the control group, however,
VASpainscoresondaysincreased0.4 ± 0.2,0.3 ± 0.2,
and 0.1 ± 0.1 points, respectively, from the scores before
inhalation. Overall, VAS pain scores were signicantly lower
in the eucalyptus oil group than in the control group (𝑃<
.001,Figure (a)).
3.4. Eects of Eucalyptus Oil on Heart Rate and Blood
Pressure. Relative to pretreatment heart rate, heart rate in the
eucalyptus oil group increased 0.3±1.6beats/min on day  of
CPM and decreased 1.7±1.7beats/min and 0.6±1.0beats/min
on days  and , respectively (Figure (b)). e heart rate in
the control group, however, showed increases aer CPM of
2.1±0.7,1.5±0.9,and0.8±0.7 beats/min on days – of CPM,
respectively. Between-group dierences in heart rate did not
dier signicantly.
Systolic blood pressure on days – decreased 0.8 ±
1.9mmHg, 4.8±2.2 mmHg, and 2.0±2.0 mmHg, respectively,
in the eucalyptus oil group, while increasing 0.4 ±1.7 mmHg,
3.3 ± 2.2 mmHg, and 1.9 ± 1.6mmHg, respectively, in the
control group (Figure (c) ). On day , SPB was signicantly
.05,Figure (c)). Similarly, diastolic blood pressure in the
eucalyptus oil group decreased 0.4 ± 1.5mmHg, 0.8 ±
1.5mmHg, and 0.0 ± 1.2mmHg, respectively, on days –
, while increasing 1.1 ± 1.5mmHg, 3.7 ± 1.4mmHg, and
2.6±1.1 mmHg, respectively, in the control group on the same
days. Diastolic blood pressure on day  was signicantly lower
intheeucalyptusoilgroupthaninthecontrolgroup(𝑃 = .03,
Figure (d)).
3.5. Eects of Eucalyptus Oil on Inammatory Responses.
Serum CRP concentrations before inhalation and on days
andwere7.2 ± 3.9,53.5 ± 6.8,and48.8 ± 11.0 mg/L,
respectively, in the eucalyptus oil group, and 4.89±2.0,68.2±
8.2,and46.8 ± 7.7 mg/L, respectively, in the control group
(Figure (a)). Although CRP concentrations in both groups
tended to increase gradually aer surgery and then decrease,
no between-group signicant dierences were observed.
WBC counts before inhalation and on days  and  were
,513.2 ± 417.0 × 103/𝜇L, 7,062.0 ± 377.9 × 103/𝜇L, and
7,450.0 ± 383.5 × 103/𝜇L, respectively, in the eucalyptus oil
group, and 6,793.3±268.8×103/𝜇L, ,112.6±336.9×103/𝜇L,
and 7,970±502.4×103/𝜇L, respectively, in the control group
(Figure (b)). None of these dierences reached statistical
4. Discussion
Since eucalyptus oil has been reported eective in reducing
pain and suppressing inammation in the various animal
models, we tested whether inhalation of eucalyptus oil
aected pain, blood pressure, heart rate, CRP concentration,
and WBC count following TKR in patients with osteoarthri-
Pain is an emotion which is quintessentially subjective
and personal [,]. To assess patient’s subjective pain, we
Evidence-Based Complementary and Alternative Medicine
T : General characteristics of the eucalyptus oil and control groups (𝑁=52).
Characteristics Tota l
Eucalyptus oil
(𝑛=25)𝑡or 𝜒2P-value
Age (years) . (.) . (.) . (.) . .a
Female  (.)  (.)  () . .b
Male  (.)  (.)  (.)
Surgical classication
Unilateral  (.)  (.)  (.) . .c
Bilateral  (.)  (.)  (.)
BMI (kg/m). (.) . (.) . (.) . .a
Elementary  (.)  (.)  (.) . .b
Middle  (.)  (.)  ()
High  (.)  (.)  (.)
Marital status
Married  ()  ()  ()
Ye s  (.)  (.)  (.) . .c
No  (.)  (.)  (.)
Duration of osteoarthritis (years) . (.) . (.) . (.) . .a
Hypertension medication
Ye s  (.)  (.)  () . .c
No  (.)  (.)  ()
Diabetes medication
Ye s  (.)  (.)  () . .c
No  (.)  (.)  ()
Data reported as mean (SD) or 𝑛(%).
Abbreviations: SD: standard deviation, BMI: body mass index.
bFisher’s exact test.
cChi-square test.
T : Outcomes in the eucalyptus oil and control groups (𝑁=
Variabl e s Control
Eucalyptus oil
VA S ( s c o r e ) 5.0 ± 1.0 5.0 ± 0.0 .
sBP (mm Hg) 120.0 ± 20.0 120.0 ± 20.0 .
dBP (mm Hg) 80.0 ± 10.0 80.0 ± 10.0 .
HR (beats/min) 78.0 ± 8.0 78.0 ± 10.0 .
CRP (mg/L) 4.9 ± 10.5 7.2 ± 19.3 .a
WBC (×/𝜇L) 6793.3 ± 1396.6 6513.2 ± 2084.9 .a
Abbreviations: VAS: visual analog scale; sBP: systolic blood pressure; dBP:
diastolic blood pressure; HR: heart rate; CRP: C-reactive protein; WBC:
white blood cell.
Wilcoxon’s rank sum test. Data presented as median ±interquartile range.
at-test. Data presented as mean ±standard deviation.
used a VAS measurement tools. We found that inhalation
of eucalyptus oil signicantly decreased VAS pain scores
compared with our control group. e major component of
eucalyptus oil is ,-cineole, which had a morphine-like eect
relieving pain in mice []. Another study also found that ,-
cineole exhibited antinociceptive properties in rats and mice
[]. ese ndings, taken together with our results, suggest
that subjective pain-reducing eects of eucalyptus oil are due,
at least in part, to ,-cineole.
Serotonin has been considered to have an important
role in the control of pain []. Activation of serotonin
receptor presents on C-bers has been shown mediating
serotonin-induced pronociceptive eects []. Recent studies
have shown that essential oils act via modulating of the
central neurotransmitter system. Hypericum perforatum is
considered to inhibit the synaptosomal uptake of serotonin
[]. Also, lemon oil reported to have an antixiolytic eects
via the suppression of monoamines dopamine and enhancing
serotonergic neurons []. erefore pain-relieving eects of
eucalyptus oil in the present results should be considered
an involvement of serotonergic system. Pain and stress aer
TKR and during CPM are thought to act on the central and
Evidence-Based Complementary and Alternative Medicine
Dierence in VAS (score)
1st 2nd 3rd
∗∗∗ ∗∗∗ ∗∗∗
Inhalation day
Dierence in HR (beats/min)
1st 2nd 3rd
Inhalation day
Dierence in sBP (mmHg)
1st 2nd 3rd
Inhalation day
Dierence in dBP (mmHg)
1st 2nd 3rd
Inhalation day
F : Eects of inhalation on (a) VAS, (b) HR, (c) sBP, and (d) dBP in the eucalyptus oil (𝑛=25) and control (almond oil; 𝑛=27)groups.
Results are expressed as mean ±SEM. 𝑃 < .05,∗∗∗𝑃 < .001 compared with the control group. Abbreviations: VAS, visual analog scale; HR,
heart rate; sBP, systolic blood pressure; dBP, diastolic blood pressure.
sympathetic nervous systems, increasing blood pressure and
pulse. In the present study, group treated with eucalyptus
oil inhalations showed statistically signicant reduction in
blood pressure, suggesting that eucalyptus oil could promote
relaxation by reducing sympathetic activity while augment-
ing parasympathetic during CPM aer TKR. A possible
pathway for this explanation may include the olfactory
system. Autonomic nervous system is aected by odorants,
thus inhalation of essential oil is direct actions on the auto-
nomic nervous system via olfactory system [,]. Recent
study has shown that olfactory stimulation with lavender
essential oil and its active component, linalool reduced the
sympathetic nerve activity in rats []. erefore, eucalyptus
oil also may modulate autonomic responses such as blood
pressure via central nervous system and autonomic nervous
system. e cardiovascular eects of ,-cineole were also
investigated in several research. ,-cineole decrease blood
pressure in normotensive rate and elicited a endothelium-
dependent vasorelaxation in rate aorta [,]. Other reports
have shown that the administration of ,-cineole reduces
contractile activity in rat []. us, there is a possibility that
,-cineole contributes to hypotensive eects of eucalyptus
essential oil.
Eucalyptus oil has been used to treat inuenza infection,
owing to its anti-inammatory and antibacterial eects [].
Moreover, ,-cineole was found to reduce cytokines that
Evidence-Based Complementary and Alternative Medicine
CRP (mg/L)
Day aer inhalation
Pre 4th 7th
WBC (×1000/𝜇L)
Pre 4th 7th
Day aer inhalation
F : Eects of inhalation on (a) CRP and (b) WBC in the eucalyptus oil (𝑛=25) and control (almond oil; 𝑛=27) groups. Values are
expressed as mean ±SEM. Abbreviations: CRP, C-reactive protein; WBC, white blood cell.
cause inammation in guinea pigs [], and to signicantly
reduce edema and CRP at sites of inammation throughout
the entire body []. ese studies prompted us to hypoth-
by lessening inammatory reactions. However, markers of
inammatory responses, such as CRP concentration and
WBC count, did not dier signicantly between the our
eucalyptus oil and control groups although comparisons
before and aer inhalation showed that the WBC count
tended to be lower in the eucalyptus than in the control
group, which may have been due to the time of inspection, the
concentration of eucalyptus oil inhaled, and/or its frequency
of application.
In summary, this study, which investigated the eects
of eucalyptus oil inhalation on patients who underwent
TKR, showed that eucalyptus oil inhalation was eective
aer surgery. ese ndings suggest that the inhalation of
eucalyptus oil might be a valuable nursing intervention for
pain relief aer TKR.
Conflict of Interests
e authors declare they have no conict of interests.
e rst two authors (Yang Suk Jun and Purum Kang)
contributed equally to this work. is work was supported
by the National Research Foundation of Korea (NRF) Grants
funded by the Korea government (MEST) (nos. 
and ).
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... Eucalyptus globulus which belongs to the Myrtaceae family is one of the medicinal plant products (Hayat et al., 2015). It has been widely benefited to treat upper respiratory conditions (Her et al., 2022) and other diseases such as diabetes, gastritis, and knee pain (Jun et al., 2013). The existing studies also reported that E. globulus has analgesic and anti-inflammatory properties (Nakamura et al., 2020). ...
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Stress during the COVID-19 pandemic affects the physiological and immunological response to women's reproductive health. Eucalyptus globulus and Apium graveolens are immunomodulators related to women's reproductive health. This study aimed to investigate E. globulus and A. graveolens towards the expression of Heat Shock Protein-70 (HSP70) and tumor necrosis factor-alpha (TNF-α) as stress markers, luteinizing hormone (LH), and Growth Differentiation Factor 9 (GDF-9) as folliculogenesis markers. This study was an experimental randomized controlled trial using a pre-posttest control group design. Sixty women of reproductive health age who had stress based on the DASS-21 questionnaire were divided into two groups at area of Nusukan Health Center, Indonesia. The intervention group was given 300 mg A. graveolens capsules orally and E. globulus essential oil for 14 days. The control group was given a placebo. Blood samples and stress levels were evaluated before and after the intervention to determine the effect of the intervention. There was no difference in stress levels in the control and treatment groups at pre-test. The intervention group decreased HSP70, TNF-α, and stress levels (p<0.001). A significantly decreased TNF-α increased LH level (p<0.001). Moreover, LH and GDF-9 levels increased in the intervention group compared to the control group (p<0.001). In summary, A. graveolens supplementation and E. globulus essential oil decreased stress and protected folliculogenesis markers on women's reproductive health due to stressful conditions during pandemic COVID-19.
... An optimized nanoemulsion from micellar nanoparticles of eucalyptus oil demonstrated high central and peripheral analgesic activity in rats [76]. In addition, patients who inhaled eucalyptus oil after a total knee replacement surgery described less pain after the surgery and had lower blood pressure [77]. Taken together, eucalyptus essential oil and its main active component, 1,8-cineol, have proved to be promising candidates in pain management. ...
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The active compounds from essential oils have been an important asset in treating different diseases for many centuries. Nowadays, there are various available formulations used as food supplements to stimulate the immune system. In light of the current pandemic and the large amount of fake news circulating the internet, it is important to analyze which of the active compounds from essential oils can be successfully used in the treatment of COVID-19 infections. We analyzed the current literature on the effects of essential oils against the new SARS-CoV-2 virus to gain a better understanding of the underlying mechanisms of these compounds and establish their possible antiviral efficacy. The available studies have highlighted the antiviral potential of active compounds from essential oils, indicating that they could be used as adjuvants in treating various viral infections, including COVID-19, leading to a milder course of the disease, and improving patients’ outcomes. At the same time, these compounds relieve pain and lift the mood in comorbid patients suffering from opioid addiction. Essential oils might be useful as adjuvant tools, not only against SARS-CoV-2 but also for a subset of especially vulnerable patients affected with both COVID-19 and opioid addiction. However, randomized clinical trials are needed to determine their efficacy and develop standardized high-quality preparations that can be safely administered to the general population.
... Eucalyptus oil contains cineole and limonene which may act as pain relievers. It has been reported that three days clinical trial on approximately 52 people who have recently gone for knee replacement treatment indicated that inhalation of Eucalyptus oil mixed with almond oil for 30 to 45 minutes significantly decreased pain and level of blood pressure down rather than use of single almond oil [10] . Whereas it has no beneficiary effect reported among cancer patients [11] . ...
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Analgesics are pain relievers. Analgesics are of two classes: opioids and non-opioids. NSAIDs and paracetamol come under non opioids class and are taken to relieve pain during inflammation by decreasing body's internal temperature. Certain lifelong pain conditions like rheumatoid arthritis, wisdom teeth pain, accidental pain, after surgery pain, back pain, frequent body pain needs dose of analgesics in a required time period. In such conditions person already know about duration of analgesics. Long term usage of allopathic analgesics has several adverse effects. Thus during such long term pain time consumption of medicinal plants and traditional ayurveda based product is more preferable. Present review focuses on few medicinally important plants having anti-inflammatory and analgesic properties such as: Moringa oleifera and Senna auriculata as a chief medicinal source. Other than these Eucalyptus globules, Ricinus communis, Syzygium aromaticum L. Trachyspermum ammi, Zingiber officinale and Vitex negundo, Cinnamomum camphora and Plumbago zeylanica are also reported to have these properties. This review is less based on botanical identity of mentioned medicinal plants and more based on their therapeutic and medicinal analgesic and anti-inflammatory properties to relieve pain.
... The research tools were: 1 Demographic and clinical questionnaires include age, gender, job, education, marital status [21], duration of decease, location, smoking, time of diagnosis of rheumatoid arthritis, having Family history of rheumatoid arthritis, criterion DSA28, movement limitation, and BMI. 2 The numerical pain rating scale (NRS), the numerical pain scale with the values of 0 (no pain) to 10 (severe pain) was also used to record the pain severity. The patients recorded the pain before and after the intervention [15,22]. 3 The Quality of Life (SF-12), the SF-12 questionnaire consisting of 8 subscales, the general perception of personal health, physical performance, physical health, emotional disorders, physical pain, social performance, joy, having energy for life, and mental health was used to measure. ...
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Problem considered Pain is one of the most significant symptoms of rheumatoid arthritis that reduce the quality of life. The purpose of the study was to determine the effect of eucalyptus on pain and the quality of life in patients with rheumatoid arthritis. Methods In this randomized clinical trial, 70 patients with rheumatoid arthritis were selected by random sampling. In the eucalyptus group, 1 mL of eucalyptus oil was inhaled for 5 minutes, 3 times a day, for one month. The control group received placebo inhalation. Both groups used routine treatments. Data were collected using a questionnaire of demographics, the numerical pain rating scale (NRS), and Quality of Life (SF-12). Statistical analysis was done using 19th edition SPSS software and applied on paired t-test, chi-square, Fisher's exact test, and analysis of covariance. Results The mean score of pain severity in the eucalyptus group significantly decreased in comparison with the control group (P < 0.001). The severity of pain there was no statistical difference in both groups before, the first, and the second weeks after the intervention, (p > 0.05); however, in the third and fourth weeks after the intervention, the mean severity of pain in the eucalyptus group was lower than in the control group, and these differences were statistically significant between the two groups (p < 0.05). Also, the patients' quality of life in the eucalyptus group was increased significantly (P < 0.001). Conclusion The eucalyptus leads to pain reduction, and consequently, improves the quality of life of patients with rheumatoid arthritis. Trial registration IRCT20160110025929N15 Registration date: 2018-10-07;
Patients with total knee arthroplasty (TKA) experience pain, decreased muscle strength, and decreased knee function, resulting in increases in depression and decreased subjective well-being. A multidimensional home program may prevent these adverse events. The aim of this study was to test the effect of a home rehabilitation program that included education, exercise, aroma massage, and phone counseling for post-TKA patients. We used a randomized control group pretest/posttest design. Fifty-nine patients participated, with 29 in the experimental group and 30 in the control group. Pain, knee joint range of motion (ROM), quadriceps strength, depression, and subjective well-being were measured as outcome variables. Data were analyzed using repeated-measures analysis of variance and generalized estimating equations. The experimental group showed significant improvement in knee pain, active ROM, muscle strength, depression, and subjective well-being with no significant between-groups difference in passive ROM. The multidimensional home rehabilitation program can be an effective nursing intervention for physical and emotional recovery of patients with TKA.
Objective The aim of this study was to determine the effect of aromatherapy and Su Jok interventions as nonpharmacological methods of relieving pain after cesarean section. Materials and methods This randomized controlled trial was conducted with 120 women who had cesarean delivery in the gynecology and obstetrics department of a training and research hospital between February 9 and October 2, 2019. The participants were allocated to the aromatherapy group, Su Jok group, Su Jok and aromatherapy group, or control group using block randomization based on parity. Su Jok was performed using buckwheat seed; aromatherapy was applied using lavender, eucalyptus, or rose oil. Data were collected using a participant information form and pain was assessed using the Visual Analog Scale. Results There was no significant difference between the groups in mean pain levels before or after the intervention, although the control group had less initial pain compared to the intervention groups. However, all three intervention groups showed significant decreases in pain levels immediately and 30 min after the intervention compared to pre-intervention levels (p < 0.05). The intervention in all three groups reduced the level of pain. In particular, the pain level of the Su Jok group reached from moderate to mild. There was no significant change in the control group. Conclusions Aromatherapy and Su Jok interventions performed separately and simultaneously in addition to routine hospital care were more effective in reducing post-cesarean pain than routine care alone.
Objective: Gather scientific evidence on the application of inhalation aromatherapy for pain relief and estimate the effect measure of this practice on pain reduction. Methods: Searches were performed in 2021 in the Pubmed, Scopus, Web of Science, Cochrane, Science direct, Lilacs, Scielo databases. We selected 44 articles demonstrating the effect of aromatherapy on different painful conditions, of which 17 were inserted in the meta-analysis. The risk of bias was assessed according to Cochrane methodology. Results: In 35 (79.55%) studies was observed a significant reduction in pain, especially pain labor and postoperative pain. Through the meta-analysis, it was found that inhalation aromatherapy reduces by up to -1.73 points of the visual analog scale (VAS), indicating that this practice contributes to the reduction of pain perception in different painful conditions. In addition, the meta-analysis indicated that the time after inhalation, the type of oil used and the type of pain treated are important variables that interfere with the magnitude of the effect. These effects are attributed to the ability of essential oils to modulate nerve control centers and neurotransmission systems involved in pain control. Conclusion: From the gathering of articles on aromatherapy, it can be noted that aromatherapy appears to be helpful in alleviating acute pain, however there is an imminent need to improve aromatherapy studies to reduce the risk of bias and increase the power of its clinical evidence. Prospero: CRD42019121665.
Purpose This study aimed to assess the effect of aromatherapy administered before coronary angiography on anxiety levels and physiological parameters. Material and method The study used a randomized controlled trial design. The study group consisted of a total of 96 individuals. The research data were collected using the descriptive information form, the State-Trait Anxiety Inventory (STAI), and the Physiological Parameters Assessment Form. Results The results of this study indicated a significant difference between the groups in terms of pain levels and mean STAI-I scores prior to coronary angiography. Conclusion The results revealed that aromatherapy administered before angiography reduced the anxiety and pain levels of patients.
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AbstrakMinyak kayu putih adalah salah satu obat tradisional yang digunakan untuk penyakit saluran nafasseperti asma, sinusitis, dan paru-paru. Eucalyptol atau 1,8-sineol merupakan bahan aktif dari minyakkayuputih biasa digunakan untuk mengobati peradangan saluran nafas. Penelitian secara in vitromaupun in vivo menunjukkan bahwa 1,8-sineol memperlihatkan banyak khasiat. Tulisan ini bertujuanuntuk mengulas secara sistimatik dan komprehensif dari pustaka tentang kegunaan dari 1,8-sineolsebagai bahan obat untuk berbagai penyakit. Pustaka dikumpulkan melalui Pub Med dan GoogleScholar sampai dengan tanggal 27 Mei 2020, dengan kata kunci : 1,8-cineole, eucalyptol, respiratory,medicinal properties. Dari penelusuran literatur didapatkan 116 jurnal dari PubMed dan 51 jurnal dariGoogle Scholar, dan setelah duplikasi dihilangkan didapat 49 artikel untuk diulas. 1,8-Sineolbermanfaat untuk: a) anti inflamasi saluran nafas, b) anti inflamasi, c) anti mikroba, d) anti virus, e) antikanker, f) anti spasmodik, g) analgesik, h) obat penenang, i) hipertensi, j) farmakokinetik. Uji in vitromaupun in vivo menunjukkan bahwa 1,8-sineol memiliki banyak manfaat terhadap kesehatan. Untukmemperkuatnya diperlukan uji klinik pada manusia agar dapat dimanfaatkan oleh masyarakat.Kata kunci : Eucaliptol, saluran nafas, 1,8-Sineol, khasia (PDF) Artikel Penelitian Minyak Kayu Putih, Obat Alami dengan Banyak Khasiat: Tinjauan Sistematik Eucalyptus Oil, A Natural Remedy with Many Benefits: A Systematic Review. Available from: [accessed Mar 22 2022].
Essential oil from Eucalyptus plant is used as traditional and complementary medicine worldwide. It is used as therapeutic agent in food and pharmaceutical companies due to various biological activities. The objective of present study was aromatic profile of essential oil and molecular docking of Eucalyptus essential oil component eucalyptol (1-8 cineole) against Glucosamine-6-phosphate synthase chitin synthase and UDP-glycosyltransferase, fungal enzymes as an appropriate sites to design drug against “Aspergillosis” and in vitro validation. GC-FID analysis was used to find out aromatic profile. For docking, Patch-dock analysis was used. Ligand Protein 2D and 3D Interactions were also studied. Drug likeliness, toxicity profile and cancer cell line toxicity were also studied. GC-FID profiling revealed the presence of eucalyptol as major bioactive compound, hence selected for further docking studies. Docking analysis indicated effective binding of eucalyptol to Glucosamine-6-phosphate synthase, chitin synthase and UDP-glycosyltransferase. Wet lab validation was performed by two fungal strains Aspergillus niger and Aspergillus oryzae. Molecular docking results indicated that eucalyptol forms tight complexes with Glucosamine-6-phosphate synthase, chitin synthase and UDP-glycosyltransferase enzymes by hydrophobic and hydrogen interactions. Eucalyptol also depicted drug likeliness by LIPINSKY rule, sufficient level of bioactivity, drug likeliness and cancer cell line toxicity. In vitro results revealed that Eucalyptus oil was able to inhibit growth of fungal strains toxicity thus signifying its role as potent anti-fungal drug
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The objective of this study was to determine the patterns of C-reactive protein (CRP) changes during the postoperative period after total knee replacement (TKR), and to determine the CRP changes associated with infection after TKR.
The cardiovascular effects of i.v. treatment with 1,8-cineole, a monoterpenic oxide present in many plant essential oils, were investigated in normotensive rats. This study examined (i) whether the autonomic nervous system is involved in the mediation of 1,8-cineole-induced changes in mean aortic pressure (MAP) and heart rate (HR) and (ii) whether the hypotensive effects of 1,8-cineole could result from its vasodilatory effects directly upon vascular smooth muscle. In both pentobarbital-anesthetized and conscious, freely moving rats, bolus injections of 1,8-cineole (0.3–10 mg/kg, i.v.) elicited similar and dose-dependent decreases in MAP. Concomitantly, 1,8-cineole significantly decreased HR only at the highest dose (10 mg/kg). Pretreatment of anesthetized rats with bilateral vagotomy significantly reduced the bradycardic responses to 1,8-cineole (10 mg/kg) without affecting hypotension. In conscious rats, i.v. pretreatment with methylatropine (1 mg/kg), atenolol (1.5 mg/kg), or hexamethonium (30 mg/kg) had no significant effects on the 1,8-cineole-induced hypotension, while bradycardic responses to 1,8-cineole (10 mg/kg) were significantly reduced by methylatropine. In rat isolated thoracic aorta preparations, 1,8-cineole (0.006–2.6 mM) induced a concentration-dependent reduction of the contraction induced by potassium (60 mM). This is the first physiological evidence that i.v. treatment with 1,8-cineole in either anesthetized or conscious rats elicits hypotension; this effect seems related to an active vascular relaxation rather than withdrawal of sympathetic tone.Key words: 1,8-cineole, essential oil, cardiovascular effects, autonomic nervous system, isolated thoracic aorta.On a examiné les effets d'un traitement par administration i.v. de 1,8-cinéole, un oxyde monoterpénique entrant dans le composition de nombreuses huiles essentielles, chez des rats normotendus. On a examiné (i) si le système nerveux autonome joue un rôle dans les variations induites par le 1,8-cinéole de la pression aortique moyenne (PAM) et de la fréquence cardiaque (FC) et (ii) si les effets hypotenseurs du 1,8-cinéole pourraient découler de ses effets vasodilatateurs directement sur le muscle lisse vasculaire. Des injections de bolus de 1,8-cinéole (0,3–10 mg/kg, i.v.) ont provoqué des diminutions similaires et dose dépendantes de la PAM chez les rats anesthésiés au pentobarbital et chez les rats conscients libres de circuler. Le 1,8-cinéole a aussi diminué significativement la FC mais à la dose la plus élevée uniquement (10 mg/kg). Chez les rats anesthésiés, un prétraitement au moyen d'une vagotomie bilatérale a réduit de manière significative les réponses bradycardiques au 1,8-cinéole (10 mg/kg) sans influer sur l'hypotension. Chez les rats conscients, un prétraitement i.v. de méthylatropine (1 mg/kg), d'aténolol (1,5 mg/kg) ou d'hexaméthonium (30 mg/kg) n'a pas eu d'effet significatif sur l'hypotension induite par le 1,8-cinéole, alors que les réponses bradycardiques au 1,8-cinéole (10 mg/kg) ont été significativement réduites par la méthylatropine. Dans des préparations d'aortes thoraciques isolées de rats, le 1,8-cinéole (0,006–2,6 mM) a provoqué une réduction concentration dépendante de la contraction induite par le potassium (60 mM). Cette étude est la première à présenter des résultats physiologiques montrant qu'un traitement par administration i.v. de 1,8-cinéole suscite de l'hypotension tant chez les rats anesthésiés que chez les rats conscients; cet effet serait davantage lié à une relaxation vasculaire active qu'à une suppression du tonus sympathique.Mots clés : 1,8-cinéole, huile essentielle, effets cardiovasculaires, système nerveux autonome, aorte thoracique isolée.[Traduit par la Rédaction]
•Qualitative research exposes and explores important aspects of the pain experience that are inaccessible to other approaches.•Qualitative work adopts a different epistemological and ontological perspective to quantitative work.•Qualitative research is not well established in the field of pain, but is growing.•More interpretative engagement with qualitative data is required.
Effective pain management presents challenges to health care practitioners, particularly in the community setting. This is evident from the complexities associated with the phenomenon of pain and the circumstances for those patients suffering from pain. An overwhelming amount of literature and research surrounding pain exists in an effort to improve our understanding of pain, assessment and management strategies. But patients in pain are not managed well in the community or acute setting. Health care professionals continue to underestimate and under treat pain, failing to meet the patient's individual needs. Pain management it is not about cure, nor is it as simple as reporting zero on a pain score- it is about knowledge, expertise and understanding. Pain is a subjective and very personal experience, wherein health care professionals must listen to the patients' story. Myths and fears surrounding pain remains a barrier to effective management and care. This article aims to dispel the myths and improve clinical practice, particularly in effective pain assessment so patients in the community presenting with pain can be managed individually and effectively. Nurses need to be proactive in their approach, through effective communication and decision making, trusting in our patients' and their pain experience. This is key to a successful approach to managing patients' pain effectively.
To update the American College of Rheumatology (ACR) 2000 recommendations for hip and knee osteoarthritis (OA) and develop new recommendations for hand OA. A list of pharmacologic and nonpharmacologic modalities commonly used to manage knee, hip, and hand OA as well as clinical scenarios representing patients with symptomatic hand, hip, and knee OA were generated. Systematic evidence-based literature reviews were conducted by a working group at the Institute of Population Health, University of Ottawa, and updated by ACR staff to include additions to bibliographic databases through December 31, 2010. The Grading of Recommendations Assessment, Development and Evaluation approach, a formal process to rate scientific evidence and to develop recommendations that are as evidence based as possible, was used by a Technical Expert Panel comprised of various stakeholders to formulate the recommendations for the use of nonpharmacologic and pharmacologic modalities for OA of the hand, hip, and knee. Both “strong” and “conditional” recommendations were made for OA management. Modalities conditionally recommended for the management of hand OA include instruction in joint protection techniques, provision of assistive devices, use of thermal modalities and trapeziometacarpal joint splints, and use of oral and topical nonsteroidal antiinflammatory drugs (NSAIDs), tramadol, and topical capsaicin. Nonpharmacologic modalities strongly recommended for the management of knee OA were aerobic, aquatic, and/or resistance exercises as well as weight loss for overweight patients. Nonpharmacologic modalities conditionally recommended for knee OA included medial wedge insoles for valgus knee OA, subtalar strapped lateral insoles for varus knee OA, medially directed patellar taping, manual therapy, walking aids, thermal agents, tai chi, self management programs, and psychosocial interventions. Pharmacologic modalities conditionally recommended for the initial management of patients with knee OA included acetaminophen, oral and topical NSAIDs, tramadol, and intraarticular corticosteroid injections; intraarticular hyaluronate injections, duloxetine, and opioids were conditionally recommended in patients who had an inadequate response to initial therapy. Opioid analgesics were strongly recommended in patients who were either not willing to undergo or had contraindications for total joint arthroplasty after having failed medical therapy. Recommendations for hip OA were similar to those for the management of knee OA. These recommendations are based on the consensus judgment of clinical experts from a wide range of disciplines, informed by available evidence, balancing the benefits and harms of both nonpharmacologic and pharmacologic modalities, and incorporating their preferences and values. It is hoped that these recommendations will be utilized by health care providers involved in the management of patients with OA.
Knee-replacement surgery is frequently done and highly successful. It relieves pain and improves knee function in people with advanced arthritis of the joint. The most common indication for the procedure is osteoarthritis. We review the epidemiology of and risk factors for knee replacement. Because replacement is increasingly considered for patients younger than 55 years, improved decision making about whether a patient should undergo the procedure is needed. We discuss assessment of surgery outcomes based on data for revision surgery from national joint-replacement registries and on patient-reported outcome measures. Widespread surveillance of existing implants is urgently needed alongside the carefully monitored introduction of new implant designs. Developments for the future are improved delivery of care and training for surgeons and clinical teams. In an increasingly ageing society, the demand for knee-replacement surgery will probably rise further, and we predict future trends. We also emphasise the need for new strategies to treat early-stage osteoarthritis, which will ultimately reduce the demand for joint-replacement surgery.
Serotonin [5-hydroxytryptamine (5-HT)] in the central nervous system and in the periphery has long been considered to have an important role in the control of pain, for example, through descending inhibition. In recent years, considerable research efforts have focused on the role played by 5-HT on acute or chronic pain states as well as on the identification of the respective 5-HT receptors involved. However, preclinical studies have reported conflicting observations, and numerous important questions remain unanswered. The purpose of this study is to provide an analysis of the recent developments in understanding the role of 5-HT both within the periphery and at the level of the spinal dorsal horn. We discuss the inhibitory or facilitatory influences exerted by 5-HT, through the descending 5-HT pathway, on spinal processing of nociceptive information in pathological pain states. Evidence with regard to the possible implication of the 5-HT(1A), 5-HT(2A), 5-HT(3), and 5-HT(7) receptors in pain modulation is also reviewed. Recent studies (both behavioral and clinical, relevant to these targets) have indeed demonstrated that 5-HT(1A) and 5-HT(7) receptor agonists or 5-HT(2A) and 5-HT(3) receptor antagonists may be promising therapeutic agents for the treatment of pain states.