Herbal medications for anxiety, depression, pain, nausea and vomiting related to preoperative surgical patients: a systematic review and meta-analysis of randomised controlled trials

Abstract

ObjectiveTo summarise the effects of herbal medications for the prevention of anxiety, depression, pain, and postoperative nausea and vomiting (PONV) in patients undergoing laparoscopic, obstetrical/gynaecological or cardiovascular surgical procedures.MethodsSearches of MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials and LILACS up until January 2018 were performed to identify randomised controlled trials (RCTs). We included RCTs or quasi-RCTs evaluating any herbal medication among adults undergoing laparoscopic, obstetrical/gynaecological or cardiovascular surgeries. The primary outcomes were anxiety, depression, pain and PONV. We used the Grading of Recommendations Assessment, Development and Evaluation approach to rate overall certainty of the evidence for each outcome.ResultsEleven trials including 693 patients were eligible. Results from three RCTs suggested a statistically significant reduction in vomiting (relative risk/risk ratio (RR) 0.57; 95% CI 0.38 to 0.86) and nausea (RR 0.69; 95% CI 0.50 to 0.96) with the use of Zingiber officinale (ginger) compared with placebo in both laparoscopic and obstetrical/gynaecological surgeries. Results suggested a non-statistically significantly reduction in the need for rescue medication for pain (RR 0.52; 95% CI 0.13 to 2.13) with Rosa damascena (damask rose) and ginger compared with placebo in laparoscopic and obstetrical/gynaecological surgery. None of the included studies reported on adverse events (AEs).ConclusionsThere is very low-certainty evidence regarding the efficacy of both Zingiber officinale and Rosa damascena in reducing vomiting (200 fewer cases per 1000; 288 fewer to 205 fewer), nausea (207 fewer cases per 1000; 333 fewer to 27 fewer) and the need for rescue medication for pain (666 fewer cases per 1000; 580 fewer to 752 more) in patients undergoing either laparoscopic or obstetrical/gynaecological surgeries. Among our eligible studies, there was no reported evidence on AEs.PROSPERO registration numberCRD42016042838

The effectiveness of ginger extract addition in calorified drinks during perioperative period to nausea severity, vomitus, post-operative anxiety, and metabolic disorder: A randomized control trial

“…The significance test to compare the descriptive categorical characteristics of the data from the two treatment groups used the Chi-square test. This study has been reported in line with the CONSORT criteria [ 11 ].…”

Effects of Topical Application and Oral Intake of Rosa damascena on Acute Pain in Adults: A Systematic Review and Meta-analysis

“…In a recent meta-analysis by Koohpayeh et al, 47 the pooled analysis of five RCTs on the effects of oral intake and aromatherapy of R damascena reduced the menstruation-related pain non-significantly (weighted mean difference (WMD) = –1.39; 95% CI: -3.21–0.43; p = 0.133). Also, in a systematic review of herbal medications for postoperative pain, Arruda et al, 50 found no significant reduction in the need for analgesics after oral intake of R damascena in combination with gingeRosa. However, Nayebi et al, 2 reported the analgesic effects and safety of R damascena in the forms of inhalation aromatherapy, topical treatment, or massage application on pain induced by surgery, PD, pregnancy, and aphthous ulcer.…”

The Effect of Preoperative Anxiety on Postoperative Symptoms in Patients Without a History of Anxiety Scheduled for Coronary Artery Bypass Grafting

“…Postoperative nausea and vomiting (PONV) are one of the most common postoperative complications usually occurring the immediate 24 postoperative hours and continuing to 72 hours [50][51][52]. In various studies, the prevalence of PONV ranges from 25% to 30%; however, there are studies reporting its rate as high as 80% [53,54]. Although it is not a life-threatening complication, it can cause dehydration, electrolyte imbalance, wound dehiscence, pulmonary aspiration, and delayed discharge [55].…”