Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1590/S0034-70942011000600002
Brazilian Journal of Anesthesiology
Scientific Article

Flor de Citrus aurantium e ansiedade pré-operatória

Citrus aurantium Blossom and Preoperative Anxiety

Mahmood Akhlaghi; Gholamreza Shabanian; Mahmoud Rafieian-Kopaei; Neda Parvin; Mitra Saadat; Mohsen Akhlaghi

Downloads: 0
Views: 1091

Resumo

JUSTIFICATIVA E OBJETIVOS: Reduzir a ansiedade é muito importante antes da operação. A visita no pré-operatório e a utilização de pré-medicação são os métodos mais populares para se atingir esse objetivo, mas o papel da pré-medicação ansiolítica permanece incerto e os efeitos colaterais no pós-operatório podem partir de uma pré-medicação de rotina. Citrus aurantium é usado como medicina alternativa em alguns países para tratar a ansiedade. Recentemente, o papel ansiolítico dessa planta medicinal foi estabelecido em um estudo realizado em modelo animal. O objetivo deste estudo foi avaliar o efeito ansiolítico da flor de Citrus aurantium sobre a ansiedade pré-operatória. MÉTODOS: Foram estudados 60 pacientes ASA I submetidos a uma pequena cirurgia. Em um desenho randomizado e duplo-cego, dois grupos de 30 pacientes receberam uma das seguintes MPA oral duas horas antes da indução da anestesia: 1) Citrus aurantium destilado 1 mL.kg-1 (Grupo C); 2) solução salina 1 mL.kg-1 como placebo (Grupo P). A ansiedade foi medida antes e após pré-medicação com o Inventário de Ansiedade Traço-Estado (IDATE) e a Escala de Ansiedade e Informação Pré-Operatória de Amsterdam (APAIS) antes da operação. RESULTADOS: Após pré-medicação, tanto o IDATE quanto as escalas APAIS estavam diminuídos no Grupo C (p < 0,05), embora não tenham apresentado alterações significativas no Grupo P. CONCLUSÕES:Citrus aurantium pode mostrar-se eficaz na redução da ansiedade pré-operatória em cirurgias de pequeno porte.

Palavras-chave

ANESTÉSICOS, CIRURGIA, CIRURGIA

Abstract

ACKGROUND AND OBJECTIVES: Reducing anxiety is very important before operation. Preoperative visit and use of premedication are popular methods to achieve this goal, but the role of anxiolytic premedication remains unclear and postoperative side-effects may result from routine premedication. Citrus aurantium is used as an alternative medicine in some countries to treat anxiety, and recently the anxiolytic role of this medicinal plant was established in an animal model study. The aim of this study was to assess the anxiolytic effect of Citrus aurantium blossom on preoperative anxiety. METHODS: We studied 60 ASA I patients undergoing minor operation. In a randomized double-blind design, two groups of 30 patients received one of the following oral premedication two hours before induction of anesthesia: 1) Citrus aurantium blossom distillate 1 mL.kg-1 (C-group); 2) Saline solution 1 mL.kg-1 as placebo (P-group). Anxiety was measured before and after premedication using the Spielberger state-trait anxiety inventory (STAI-state) and the Amsterdam preoperative anxiety and information scale (APAIS) before operation. RESULTS: After premedication, both the STAI-state and the APAIS scales were decreased in C-group (p < 0.05); while exhibiting no significant changes in P-group. CONCLUSIONS: Citrus aurantium blossom may be effective in terms of reduction in preoperative anxiety before minor operation.

Keywords

Citrus, Flowers, Preoperative Care, Anxiety, Ambulatory Surgical Procedures

References

Cooke M, Chaboyer W, Schluter P. The effect of music on preoperative anxiety in day surgery. J Adv Nurs. 2005;52:47-55.

Wang SM, Kulkarni L, Dolev J. Music and preoperative anxiety: a randomized, controlled study. Anesth Analg. 2002;94:1489-1494.

Caumo W, Schmidt AP, Schneider CN. Risk factors for preoperative anxiety in adults. Acta Anaesthesiol Scand. 2001;45:298-307.

Osborn TM, Sandler NA. The effects of preoperative anxiety on intravenous sedation. Anesth Prog. 2004;51:46-51.

Maranets I, Kain ZN. Preoperative anxiety and intraoperative anesthetic requirements. Anesth Analg. 1999;89:1346-1351.

Kain ZN, Sevarino F, Alexander GM. Preoperative anxiety and postoperative pain in women undergoing hysterectomy: A repeated-measures design. J Psychosom Res. 2000;49:417-422.

Hobson JA, Slade P, Wrench IJ. Preoperative anxiety and postoperative satisfaction in women undergoing elective caesarean section. Int J Obstet Anesth. 2006;15:18-23.

Klopfenstein CE, Forster A, Van GE. Anesthetic assessment in an outpatient consultation clinic reduces preoperative anxiety. Can J Anaesth. 2000;47:511-515.

Iizawa A, Oshima T, Kasuya Y. Oral tandospirone and clonidine provide similar relief of preoperative anxiety. Can J Anaesth. 2004;51:668-671.

Ng EH, Miao B, Ho PC. Anxiolytic premedication reduces preoperative anxiety and pain during oocyte retrieval: A randomized double-blinded placebo-controlled trial. Hum Reprod. 2002;17:1233-1238.

Carvalho-Freitas MI, Costa M. Anxiolytic and sedative effects of extracts and essential oil from Citrus aurantium L. Biol Pharm Bull. 2002;25:1629-1633.

Pultrini AM, Galindo LA, Costa M. Effects of the essential oil from Citrus aurantium L. in experimental anxiety models in mice. Life Sci. 2006;78:1720-1725.

Vaddi HK, Ho PC, Chan YW. Terpenes in ethanol: haloperidol permeation and partition through human skin and stratum corneum changes. J Control Release. 2002;81:121-133.

DO Kim. Antioxidant capacity of phenolic phytochemicals from various cultivars of plums. J Food Chem. 2003;81:321-326.

Chang C. Estimation of total flavonoid content in propolis by two complementary colorimetric methods. J Food Drug Analaysis. 2002;10:178-182.

Boker A, Brownell L, Donen N. The Amsterdam preoperative anxiety and information scale provides a simple and reliable measure of preoperative anxiety. Can J Anaesth. 2002;49:792-798.

Lehrner J, Eckersberger C, Walla P. Ambient odor of orange in a dental office reduces anxiety and improves mood in female patients. Physiol Behav. 2000;71:83-86.

Lehrner J, Marwinski G, Lehr S. Ambient odors of orange and lavender reduce anxiety and improve mood in a dental office. Physiol Behav. 2005;86:92-95.

Carnat A, Carnat AP, Fraisse D. Standardization of the sour orange flower and leaf. Ann Pharm Fr. 1999;57:410-414.

Medina JH, Paladini AC, Wolfman C. Chrysin (5,7-di-OH-flavone), a naturally-occurring ligand for benzodiazepine receptors, with anticonvulsant properties. Biochem Pharmacol. 1990;40:2227-2231.

Fugh-Berman A, M A. Citrus aurantium, an ingredient of dietary supplements marketed for weight loss: current status of clinical and basic research. Exp Biol Med. 2004;229:695-697.

Silva Brum LF, Emanuelli T, Souza DO. Effects of Linalool on Glutamate Release and Uptake in Mouse Cortical Synaptosomes. Neurochemical Research. 2010;26:191-194.

Hink WF. Toxicity of linalool to life stages of the cat flea. J Med Entomol. 1998;25:1-4.

Fang HHP, Chan O-C. Toxicity of phenol towards anaerobic biogranules. Water Res. 1997;31:2229-2242.

Firenzuoli F, G L, G C. Adverse reaction to an adrenergic herbal extract (Citrus aurantium). Phytomedicine. 2005;12:53-57.

Bui LT, N D, A PJ. Blood pressure and heart rate effects following a single dose of bitter orange. Ann Pharmacother. 2006;40:53-57.

Bent S. Seville orange juice-felodipine interaction: comparison with dilute grapefruit juice and involvement of furocoumarins. Am J Cardiol. 2004;94:1359-1361.

Bondy LR, Sims N, Schroeder DR. The effect of anesthetic patient education on preoperative patient anxiety. Reg Anesth Pain Med. 1999;24:158-164.

Kiyohara LY, Kayano LK, Oliveira LM. Surgery information reduces anxiety in the pre-operative period. Rev Hosp Clin Fac Med Sao Paulo. 2004;59:51-56.

Pekcan M, Celebioglu B, Demir B. The effect of premedication on preoperative anxiety. Middle East J Anesthesiol. 2005;18:421-433.

5dd682160e8825133bc8fca6 rba Articles
Links & Downloads

Braz J Anesthesiol

Share this page
Page Sections