Apryanti YP, et al.
Belitung Nursing Journal.
2017 October.
:487-495
Received: 11 March 2017 | Accepted: 30 October 2017 http://belitungraya.
org/BRP/index.
php/bnj/ A 2017 The Author.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.
International License which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
ORIGINAL RESEARCH
ISSN: 2477-4073
THE IMPACT OF LAVENDER AROMATHERAPY ON PAIN
INTENSITY AND BETA-ENDORPHIN LEVELS IN
POST-CAESAREAN MOTHERS
Yohana Putri Apryanti1*.
Suhartono2.
Ngadiyono1 Magister Applied Midwifery.
Politeknik Kesehatan Kementrian Kesehatan Semarang.
Indonesia Medical Faculty of Diponegoro University.
Semarang.
Indonesia Corresponding author:
Yohana Putri Apryanti.
MTr.
Keb Magister Applied Midwifery.
Politeknik Kesehatan Kementrian Kesehatan Semarang Jl.
Tirto Agung.
Pedalangan.
Banyumanik Kota Semarang.
Jawa Tengah.
Indonesia .
E-mail: putrisembiring1990@gmail.
ABSTRACT
Background: Caesarean section is one of the most common interventions to overcome labor complications.
However, pain cannot be avoided after the surgery.
Lavender aromatherapy is considered as one of nonpharmacological therapy to reduce pain and increase beta-endorphin levels.
Objective: To examine the effect of lavender aromatherapy on the intensity of pain and beta-endorphin levels in post-caesarean mothers.
Methods: This was a quasi-experimental study with pretest and posttest with control group at Sembiring Delitua General Hospital in Indonesia on December 2016 to February 2017.
There were 40 samples selected using purposive sampling, with 20 samples assigned in the experiment and control group.
Numerical Rating Scale (NRS) was used to measure pain and ELIZA methods to measure beta-endorphin levels.
Independent ttest and paired t-test were used for data analysis Results: Results of this study showed that there was a significant difference in the mean value of pain intensity levels .
= 0.
and beta-endorphin levels .
= 0.
between experiment and control group.
Conclusion: There was a significant effect of lavender aromatherapy on the decrease of pain intensity and the increase of beta-endorphin hormone in post-caesarean mothers.
It is expected that lavender aromatherapy can be used as an alternative treatment to reduce pain and increase beta-endorphin levels in post-caesarean mothers.
Keywords: caesarean section, pain intensity, beta-endorphin, lavender aromatherapy Belitung Nursing Journal .
Volume 3.
Issue 5.
September-October 2017 EditorAos Note: This article has been updated on 7 July 2020 in terms of minor changes in the reference format.
The update is according to BNJ Policy on article correction.
INTRODUCTION
Caesarean section is one of the most common interventions to treat dystocia, especially in mothers with complications or risk factors of gestational distance, maternal age > 35 years, obesity, height <150 cm, and over-month pregnancy.
Cesarean delivery also will be at a greater risk of 46% if there was a case of dystocia in previous pregnancies.
Research conducted at Liun Kendage Hospital in Makasar in 2014 indicated that cesarean section increased 31.
14% by various indications, namely: prolonged labor .
55%), preeclampsia .
55%),
and narrow pelvis .
76%).
2 Similar with Pirngadi Hospital in Medan found that the incidence of c-section increased in 2014 4% with referral case .
%), eclampsia/preeclampsia .
8%), complications of pulmonary edema .
1%) and require treatment duration of 4-5 days .
4%).
Due to the use of narcotic drugs and painkillers after cesarean section, mothers often complain of dizziness, nausea or vomiting and excessive sleep, especially for 48 hours after surgery.
4 In addition, postoperative pain, especially in the area of injury incision in two months after the operation that can take place constantly every day in the form of mild pain felt on the move and rest.
5 Pain that occurs after c-section is a result of a tissue incision resulting in loss of tissue continuity that causes a pain response.
The pain is also the result of the stimulation of nerve endings by chemicals released at the time of surgery or due to tissue ischemia because of impaired blood flow to one part of tissue that is disconnected due to wound of c-section.
The pain perceived by clients after c-section varies from mild to very severe pain, depending on factors that affect pain, as the nature of the pain is highly subjective.
According to literature, it was found that 75% of surgical patients had moderate to severe pain after surgery.
6 This is consistent with the results of the study found that 93% of patients with c-section suffered from moderate to severe pain using the Visual Analogue Scale (VAS).
Similarly, in India almost 66.
3% of postcaesarean women complained moderate to severe pain, and 15.
4% of headache and 4% of back pain, which resulted in inability to breastfeed immediately after surgery due to inadequate breast milk.
Another study also said that 76.
5% of respondents did not breastfeed their babies for the first time because of pain postcaesarean section.
Pain can last for 24 to 48 hours, but may last longer depending on how patient can tolerate and respond to the pain.
In other studies it was found that women experienced pain level with pain intensity during the first 24 hours post caesarean 10 Effort to reduce the pain in the post-caesarean mothers is to use pharmacological and non-pharmacological treatment.
Implementation of pain with pharmacological treatment is by using analgesic drug either intravenously or intramuscular, such as the combination of 75 mg bupivacaine 0.
5% and 30 mg clonidine, and 75 mg bupivacaine 0.
and 25 mg fentanyl.
However, these kinds of drugs have side effects, such as hypotension and shivering.
Thus, nonpharmacological treatment could be an alternative, which is also affordable and no side effects.
Belitung Nursing Journal .
Volume 3.
Issue 5.
September-October 2017 Aromatherapy is one of the nonpharmacological methods that can cause relaxation and comfort to encourage the release of neurotransmitters, such as enkephalins and endorphins.
Lavender (Lavandula officinali.
is one type of flowers that produces essential oil, so it can be used for aromatherapy with the main components of linalool oil .
%) and linalyl acetate .
%).
11 Lavender is considered having an effect of analgesic, antiseptic, antidepressant, antispasmodic, antiviral, diuretic, and hypotensive in which all the effects of lavender contribute to a relaxing effect.
Lavender is also the most popular and safest oil to use, which can stimulate the sensory and ultimately affect other organs so that it can have a strong effect on the Aromatherapy is captured by a receptor in the nose, then provides further information to areas of the brain that control emotions and memory, and provides information to the hypothalamus which is the regulator of the body's internal system, sexuality system, body temperature, and reaction to stress and hormonal system diseases.
Previous study suggested that lavender aromatherapy for 15 minutes may decrease the intensity of post-caesarean mother's pain.
12 Therefore, this study aimed to examine the effect of lavender aromatherapy to reduce pain in post-caesarean mothers.
METHODS
Design This was a quasi-experimental study with pretest and posttest with control group.
The research was conducted at Sembiring Delitua General Hospital in Indonesia for 2 months starting from December 2016 to February 2017.
Sample There were 40 samples selected using purposive sampling, with 20 samples assigned in the experiment and control The inclusion criteria were a mother in the 1st day of post caesarean section, full awareness, not allergic with verbally, and willing to be a respondent.
Instruments Numerical Rating Scale (NRS) was used to measure pain in this study, ranging from 0 to 10 .
= no pain, 1-3 = mild pain, 4-6 = moderate pain, and 7-10 = severe The coefficient of reliability ranged 66 to 0.
While beta-endorphin levels were measured using ELIZA (Enzyme-Linked immunosorbent assa.
method in laboratory.
Pain and betaendorphin were measured before and after given intervention.
Intervention The experiment group was given an intervention of aromatherapy in a diffuser that has been spilled with essential oil lavender as much as 5 drops and water mixture according to tool size and connect to electricity.
The diffuser was positioned 10-30 cm from patients.
Before intervention, the researchers prepared the patient by positioning the patient in a relaxed and comfortable state and could be accompanied by the family.
The intervention spent for 15 minutes to breathe and inhale lavender, and performed 3 times .
hours, 8 hours, and 12 hours after surger.
for 2 days.
While control group was given a diffuser but no essential oil.
Ethical consideration Ethical clearance of this research was obtained from the ethics commission of Poltekkes Kemenkes Semarang No.
Belitung Nursing Journal .
Volume 3.
Issue 5.
September-October 2017 KEPK / Poltekkes-Smg / EC / 2017.
Each participant signed informed consent prior to data collection.
Data analysis To determine the influence of lavender aromatherapy on pain intensity and Independent t-test and paired t-test were Normality test has been examined, and its results showed that pain intensity and beta-endorphin levels were in normal data distribution.
RESULTS
Majority of the characteristics of the respondents as shown in the table 1 aged 27-28 years, in the second parity, having senior high school background, working and having moderate level of anxiety.
Homogeneity test showed p-value >0.
in all variables, which indicated that there was no difference of the characteristics of the respondents in the experiment and control group.
Table 1 Characteristics of respondents based on age, parity, education, working status, experience and anxiety level in the experiment and control group Characteristics Age (Yea.
Mean Median Minimum Maximum Parity Mean Median Minimum Maximum Education (%) Junior high school Senior high school Working status (%) Working Not working Anxiety level (%) Mild Moderate Experience (%) Yes Experiment Control group P-value Table 2 Pain levels before and after given intervention in the experiment and control group using Independent t-test Pain intensity Pretest Posttest Mean difference Mean Experiment group Min Max Mean Control group Min Max Belitung Nursing Journal .
Volume 3.
Issue 5.
September-October 2017 p-value Table 2 shows that the mean of pain before intervention in the experiment group was 6.
90 and in the control group 55 with p-value 0.
314 (>0.
which indicated that there was no significant difference in the mean value of pain intensity before given intervention between experiment and control group.
However, the p-value after given intervention was 0.
000 (<0.
, indicated there was a statistically significant difference on pain level intensity in both groups with mean value of pain in the experiment group was 4.
10 and in the control group was 6.
The mean difference of pain levels between pretest and posttest in the experiment group was 80 higher than pain level in the control group was 0.
Table 3 Beta endorphin before and after given intervention in the experiment and control group using Independent t-test Beta Pretest Posttest Mean Mean Experiment group Min Max Table 3 shows that there was no difference in beta endorphin levels before given intervention .
=0.
, which indicated that the experiment and control group started in the same level.
However, after given intervention there was a Mean Control group Min Max Pvalue significant increase of beta endorphin levels in both groups with p-value 0.
(<0.
, however, the increase levels of beta endorphin in the experiment group .
was higher than beta endorphin in the control group .
Table 4 Mean difference of pain intensity and beta endorphin levels before and after given intervention in the experiment and control group using paired t-test Experiment group Control group Variables Mean p-value Mean p-value Pain intensity level Pretest-posttest Beta endorphin levels Pretest-posttest Paired t-test as shown in the table 4 shows that there was a significant decrease of pain levels in the experiment and control group with p-value 0.
046 (<0.
However, there was a higher decrease of pain levels in the experiment group compared to pain levels in the control Similar with beta endorphin levels, there was a significant increase of beta endorphin levels in both groups with pvalue 0.
033 (<0.
, but the level of beta endorphin in the experiment group .
was higher than the level in the control group .
DISCUSSION