Preoperative Oral Passiflora Incarnata Reduces Anxiety in Ambulatory Surgery Patients: A Double-Blind, Placebo-Controlled Study

Department of Anesthesiology and Critical Care, Dr Ali Shariati Hospital, North Karegar St., Tehran, Iran.
Anesthesia and analgesia (Impact Factor: 3.47). 06/2008; 106(6):1728-32. DOI: 10.1213/ane.0b013e318172c3f9
Source: PubMed


Many patients have preoperative anxiety; therefore, the development of a strong anxiolytic with minimal psychomotor impairment for premedication may be desirable.
In this study, 60 patients were randomized into two groups to receive either oral Passiflora incarnata (500 mg, Passipy IranDarouk) (n = 30) or placebo (n = 30) as premedication, 90 min before surgery. A numerical rating scale (NRS) was used for each patient to assess anxiety and sedation before, and 10, 30, 60, and 90 min after premedication. Psychomotor function was assessed with the Trieger Dot Test and the Digit-Symbol Substitution Test at arrival in the operating room, 30 and 90 min after tracheal extubation. The time interval between arrival in the postanesthesia care unit and discharge to home (discharge time) was recorded for each patient.
The demographic characteristics of patients, ASA physical status, duration of surgery, basal NRS score, sedation at the preset time intervals, and discharge time were similar in the two groups. The NRS anxiety scores were significantly lower in the passiflora group than in the control group (P < 0.001). There were no significant differences in psychological variables in the postanesthesia care unit and recovery of psychomotor function was comparable in both groups.
In outpatient surgery, administration of oral Passiflora incarnata as a premedication reduces anxiety without inducing sedation.

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    • "In the Passiflora genus, it could be presented in capsules of 500 mg. Passiflora incarnata reduces anxiety in patients when is administered previously to an ambulatory surgery [14]. Passiflora caerulea has been isolated and identified unequivocally; chrysin, a monoflavoide present in this plant, administered intracerebroventricularly to mice prevents the expression of tonic-clonic seizures induced by pentylenetetrazol, supporting the hypothesis that chrysin acts via central benzodiazepine receptors, but to the date it has not been possible to isolate or identify these natural molecules [11] [15]. "
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    ABSTRACT: The objective of this study was to determine the effect of a Melissa officinalis and Passiflora caerulea infusion on the severity of physiological chronic stress induced by movement restriction in CF-1 mice. 40 CF-1 male mice, six weeks of age, were divided into 4 groups (n = 10 for each group): (1) Group RS/MP received two treatments, induced stress through movement restriction and a infusion of Melissa officinalis and Passiflora caerulea in a dose of 200 mg/kg, (2) RS group with induced stress using movement restriction, (3) MP group, which received only a infusion, and (4) a CONTROL group that received no treatment. The severity of the stress was obtained by analysis of the physical parameters of body weight, thymus and spleen, and associated biomarkers with stress, corticosterone, and glucose. Animals that consumed Melissa officinalis and Passiflora caerulea infusion had lower plasma corticosterone levels (Student's t test, Welch, p = 0.05), which is the most important biomarker associated with physiological stress, demonstrating a phytotherapy effect.
    Full-text · Article · Jul 2013 · International Journal of Clinical and Experimental Medicine
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    • "Anxiety levels were measured using Numeric Rating Scale (NRS) prior to the administration of medication and 10, 30, 60 and 90 minutes following drug administration. Results indicated that anxiety levels were significantly lower in the group receiving Passion flower compared to the placebo group (p< 0.001) [11]. "
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    ABSTRACT: Statement of Problem: Oral premedication used to reduce the anxiety in patients undergoing dental treatment. Passion flower has been used as a sedative that can control the dental anxiety. Purpose: This study determines the efficacy of Passion flower, in reducing anxiety during the dental procedures. Material and Methods: In this randomized- one sided blind clinical trial, 63 patients, with moderate, high and severe anxiety(according to VAS score) in need of periodontal treatment were randomly divided into 3 groups of 21.The first group was given the drop Passion flower drop and the second group were given the drop of placebo and the third group; neither drug nor placebo were given (negative control group). Results were analyzed by Chi Square, Variance Analysis, Tucky and Paired-T using SPSS software. Results: Mean anxiety level prior to the drug administration was 12.09±2.42 for the Passion flower group, 12.00±2.66 for the placebo group and 11.66±2.39 for the negative control group. After premedication, these values were: 8.47±2.58 for the Passion flower group, 10.52±2.11 for the placebo group and 11.23±2.34 for the negative control group. These results demonstrated a significant difference (p< 0.0001) in the anxiety levels before and after the Passion flower administration in the Passion flower group and also between the Passion flower group and the other two groups. Conclusion: Results indicated that administration of Passion flower, as a premedication, is significantly effective in reducing the anxiety. Since this study is a pioneer on the subject, further trials with greater number of subjects are required to confirm our results.
    Full-text · Article · Jun 2013
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    • "Several studies in rodents have shown the anxiolytic and/or hypnoticsedative properties of these species (De Castro et al., 2007; Deng et al., 2010; Dhawan et al., 2001; Lolli et al., 2007; Provensi et al., 2008; Reginatto et al., 2006). Passiflora incarnata is the most studied species and has been submitted to clinical trials, which have confirmed its anxiolytic properties (Akhondzadeh et al., 2001a, 2001b; Movafegh et al., 2008). Besides Passiflora incarnata also has been used in Europe to reduce the feelings of anxiety and stress that may accompany dietary regimens (Moro and Basile, 2000). "
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    ABSTRACT: ETHNOPHARMACOLOGICAL RELEVANCE: Passiflora alata is a Southern American species that constitutes many traditional remedies as well as phytomedicines used for sedative and anxiolytic purposes in Brazil. However studies on repeated treatment effects are scarce. AIM OF THE STUDY: To evaluate behavioral, physiological and biochemical effects of the repeated treatment with an aqueous spray-dried extract of P. alata leaves containing 2.5% (w/v) of flavonoids (PA) in mice. MATERIAL AND METHODS: Male adult CF1 mice were treated (p.o.) for 14 days with PA (2.5; 25 or 250mg/kg). The feeding behavior was evaluated at the beginning (one hour after the first adminsitration) and at the end of the treatment (15(th) day). The body weight gain and food consumption were monitored along the days. On day 15 mice were evaluated on plus maze, spontaneous locomotor activity, catalepsy and barbiturate sleeping time tests. Serum glucose, lipids, ALT and AST enzymes were determined. Liver, kidney, perirenal fat, epididymal and peritoneal fat were analyzed. RESULTS: The repeated treatment with the highest dose tested (250mg/kg) did not alter the mice behavior on open field, elevated plus maze, catalepsy and barbiturate sleeping time tests. Repeated administration of PA 250 decreased mice feeding behavior and weight gain. PA 25 and PA 250 reduced mice relative liver weight and caused mild hepatic hydropic degeneration as well as a decrease in alanine aminotransferase (ALT) serum level. CONCLUSIONS: These results indicate that P.alata does not present central cumulative effects and point to the needs of further studies searching for its hepatotoxicity as well as potential anorexigenic.
    Full-text · Article · Oct 2012 · Journal of ethnopharmacology
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