Prior to having a minor operation, I was keen to discover which essential oils could be used perioperatively i.e. during the three phases of surgery - pre-operative, intra-operative and post-operative.

This article explores how aromatherapy oils may be used, in the main, to support patients during the post-operative stage, not forgetting, of course, that good nutrition, adequate rest and following doctor’s orders are also important in aiding a successful recovery.

The mechanism of action of inhaled essential oils via the olfactory and respiratory system is well documented, together with the physiological and psychological effects. Studies, shown below in more detail, indicate the value of the beneficial effects of aromatherapy oils when included in a patient’s post-operative therapeutic plan, and how they can play a useful role in alleviating risks associated with operations such as pain, wound infection, depression and anxiety. For example, Lavendin and Sweet Orange essential oils have been proven to be effective in treating anxiety, whilst Peppermint and Ginger essential oils are useful in alleviating the symptoms of nausea and sickness. There is also promising, although inconclusive, results on the efficacy of Tea Tree essential oil in treating infection.

Scientific studies

Anxiety is commonly experienced by patients either before, during or after surgery. Studies show that essential oils such as Lavender can help alleviate anxiety. For example, Braden et al. (1) enrolled 150 adult patients undergoing different types of surgery and then randomly assigned them to either control (standard care), experimental (standard care plus Lavandin - Lavandula hybrida), or sham (standard care plus jojoba oil) groups. Oils were sniffed and applied on the skin before surgery. Visual analog scales were used to assess anxiety on admission to preoperative suite and operating room transfer. Results showed that the Lavandin group had significantly lower anxiety during operating room transfer.

Whilst there is little scientific evidence proving efficacy of essential oils in reducing pain, a randomized clinical trial on paediatric patients evaluated the effect of Lavender on pain related to tonsillectomy and found that periodic inhalation of the essence decreased the amount of analgesic required (2).

Another study by Yang Suk Jun et al in 2013 investigated the effects of Eucalyptus oil inhalation on pain and inflammatory responses after total knee replacement (TKR). Inhaling the oil for 30 minutes on 3 consecutive days was found to be effective in decreasing both the patient's pain and blood pressure following surgery (3).

Postoperative nausea and vomiting occur as a common side effect of general anesthesia, with approximately one-third of patients undergoing surgery suffering from these conditions at various degrees of intensity. Ginger, Spearmint, and Peppermint oils are generally indicated for nausea. In Europe, Peppermint has traditionally been used as a herbal remedy for treating nausea and sickness, due to its antiemetic and antispasmodic effects on the digestive tract; its active ingredients being menthol and menthone. Ferruggiari et al. (4) evaluated the efficacy of inhaled Peppermint essential oil in treating the post-op nausea in a small group of women. Only a small sample of patients were used in the study and, therefore, statistical significance was not reached, however, the aroma of the inhaled Peppermint oil did reduce nausea compared to standard pharmacological intervention. A more recent study by Maghami et al (5) also found that inhaling Peppermint oil could decrease the frequency, duration, and severity of nausea, and the frequency of vomiting in patients undergoing cardiac surgery. Hunt et al. (6) conducted an accurate randomized trial and ascertained that both Ginger essential oil and a blend of Ginger, Spearmint, Peppermint and Cardamom essential oils are effective in reducing nausea and the requirement for antiemetic medications when inhaled following surgery.

One risk of surgery is post-operative infection. Studies on Tea Tree essential oil have shown that it is effective in vitro on several strains of Staphylococcus aureus, isolated from wounds including surgical wounds, and on methicillin-resistant and -sensitive bacteria (MRSA and MSSA) (7). Some experts suggest that hand wash containing Tea Tree oil, reputed to possess antimicrobial properties, can reduce the spread of germs within the clinical environment.

Using essential oils for post-operative care

Essential oils are easily used at home during the recovery process. For example, patients experiencing nausea and sickness can put a couple of drops of Peppermint essential oil onto a tissue and inhale as required to ease the symptoms.

To reduce the risk of infection and aid wound healing place two drops of Tea Tree essential oil in a cup of cooled, boiled water. Stir well. Take a clean cotton cloth or swab and dip it into the solution. Use the cloth or swab to clean the wound using a gentle sweeping motion. Do not apply the essential oil until the dressing has been removed and do not apply to open wounds.

To alleviate post-operative blues, place a couple of drops of Lavendin and Sweet Orange essential oil into an aromatherapy diffuser or candle burner.

I do hope you remain fit and healthy, but, if you do need to have an operation, please remember to stock up on essential oils to aid in your recuperation and restoration of good health.

Christine Fisk
Consultant Aromatherapist

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References:

1. R. Braden, S. Reichow, and M. A. Halm, “The use of the essential oil lavandin to reduce preoperative anxiety in surgical patients,” Journal of Perianesthesia Nursing, vol. 24, no. 6, pp. 348–355, 2009 (as cited in Stea et al., 2014)
2. R. Soltani, S. Soheilipour, V. Hajhashemi, G. Asghari, M. Bagheri, and M. Molavi, “Evaluation of the effect of aromatherapy with lavender essential oil on post-tonsillectomy pain in pediatric patients: a randomized controlled trial,” International Journal of Pediatric Otorhinolaryngology, vol. 77, no. 9, pp. 1579–1581, 2013 (as cited in Stea et al., 2014)
3. Yang Suk Jun, Purum Kang, Sun Seek Min, Jeong-Min Lee, Hyo-Keun Kim, and Geun Hee Seol, “Effect of Eucalyptus Oil Inhalation on Pain and Inflammatory Responses after Total Knee Replacement: A Randomized Clinical Trial,” Evidence-Based Complementary and Alternative Medicine, Volume 2013, Article ID 502727
4. L. Ferruggiari, B. Ragione, E. R. Rich, and K. Lock, “The effect of aromatherapy on postoperative nausea in women undergoing surgical procedures,” Journal of PeriAnesthesia Nursing, vol. 27, no. 4, pp. 246–251, 2012 (as cited in Stea et al., 2014)
5. M. Maghami, M. Reza Afazel, I. Azizi-Fini, M. Maghami, "The effect of aromatherapy with peppermint essential oil on nausea and vomiting after cardiac surgery: A randomized clinical trial," Complementary Therapies in Clinical Practice, Volume 40, August 2020, 101199 https://doi.org/10.1016/j.ctcp.2020.101199
6. R. Hunt, J. Dienemann, H. James Norton et al., “Aromatherapy as treatment for postoperative nausea: a randomized trial,” Anesthesia & Analgesia, vol. 117, no. 3, pp. 597–604, 2012 (as cited in Stea et al., 2014)
7. L. Halcón and K. Milkus, “Staphylococcus aureus and wounds: a review of tea tree oil as a promising antimicrobial,” American Journal of Infection Control, vol. 32, no. 7, pp. 402–408, 2004 in (as cited in Stea et al., 2014)