Aromatherapy and intravenous administration of a dextrose solution may offer effective new approaches to relieving nausea and vomiting after surgery, according to a pair of studies in the September issue of the journal Anesthesia & Analgesia.
Postoperative nausea and vomiting occurs in up to a third of untreated surgical patients. It not only is unpleasant for patients and associated with increased costs for antiemetic medications, but is linked to prolonged hospitalization and an increased risk of readmission, according to a journal news release. Effective, non-drug approaches to preventing and managing PONV are needed.
In the aromatherapy study, 301 patients reporting nausea after surgery were randomly assigned to receive one of four types of aromatherapy. Two groups received true aromatherapy, with essential oil of ginger or a blend of aromatherapy oils (ginger, spearmint, peppermint and cardamom) placed on a gauze pad.
The two other groups received gauze pads with non-aromatherapy solutions: either rubbing alcohol or, as an odorless placebo, saline solution. Rates of subsequent nausea and vomiting and need for antiemetic medications were compared between groups.
Patients receiving the two aromatherapy treatments had lower nausea scores than those receiving the placebo saline solution, reported Ronald Hunt, MD, of Carolinas Medical Center University in Charlotte, N.C., and colleagues. In contrast, rubbing alcohol had no significant effect on nausea, compared with saline solution. Patients receiving aromatherapy were also less likely to require antiemetic drugs.
The aromatherapy blend was somewhat more effective than ginger only. About 80% of patients receiving the blend had improvement in nausea, compared with about 70% with ginger only (versus 40% to 50% with saline solution or rubbing alcohol).
“Aromatherapy is promising as an inexpensive, noninvasive treatment for postoperative nausea that can be administered and controlled by patients as needed,” the authors wrote, saying the concept merits additional research.
IV dextrose solution
In the second study, Susan Dabu-Bondoc, MD, and colleagues at the Yale School of Medicine evaluated IV administration of a 5% solution of dextrose — a simple sugar — for prevention or treatment of postoperative nausea and vomiting. Immediately after surgery, 62 patients were randomly assigned to receive the dextrose solution or standard IV fluid.
Postoperative nausea scores were not significantly different between groups. However, patients receiving intravenous dextrose needed less antiemetic medication than those receiving standard IV fluids. Patients in the IV dextrose group also were ready for discharge from the recovery room slightly earlier. “This form of PONV therapy has a low side effect profile, is easily accessible and is inexpensive,” the authors wrote.