Aromatherapy

The use of essential oils to stimulate, soothe, refresh and heal (Hodgson 1994)

The use of essential oils for general health and wellbeing (Stevenson 1994)

The therapeutic use of essential oils (Buckle 1998)

Aromatherapy is a science and an art in which essential oils derived from plants are used for their therapeutic properties (Tiran 1996)

Essential oils

Highly concentrated volatile substances extracted from different parts of numerous plants

They are volatile at room temperature

The oils have different chemical constituents which give them their therapeutic qualities

They interact with the body pharmacologically, physiologically and psychologically (Lis-Balchin 2006)

Methods of application of aromatherapy treatment1. A diffuser, usually powered by electricity, giving out a fine

mist

2. A burner, with water added to the fragrance to prevent burning of the essential oil (1-2 drops of essential oil to 10 mils of water). The burner can be warmed by candles or electricity.

3. Ceramic or metal rings, placed on an electric light.

4. A warm bath with drops of essential oil added, results in a slow vapourization of the essential oil.

5. A bowl of hot water with drops of essential oil used for soaking the feet or used as a bidet.

6.Compresses using essential oils on a wet cloth, either hot or cold.

7 Massage, the essential oil is diluted in a carrier oil and massaged into the skin

8. Oral intake, not recommended and only to be prescribed by an aromatologist.

Issues in the use of essential oils:

Training/approved staff

Information from the woman: suitability and contraindications, treating the person and not the symptoms

Selection of oils and dosage

Selection of carrier oil

Blending of oils

No single oil should be used for more than 3 weeks at any one time

Administration

Storage

Aftercare advice

Documentation

Adverse reactions associated with Aromatherapy (Lis-Belchin 2006)

Some oils act a respiratory irritants and can trigger asthma

Migraine and headaches

Allergic reaction e.g.lavender, tea tree, sandlewood.

Phototoxicity e.g citrus ols , petigraain, neroli, ylang ylang

Dermal toxicity e.g. tea tree, camomile, lemon

Oral toxicity: thuja, nutmeg, wormwood

Neurotoxicity, rosemary

Teratogenicity/mutagenicity

Abortifacient/emmanogogue, e.g.pennyroyal, nutmeg, lavender

Carcinogenic

Other issues: sensitisation

Hazardous essential oils contraindicated in Aromatherapy

Armoise HorseradishArnica Jaborandi leafBasil (exotic) MelilotusBirch (sweet) MustardBitter almond OriganumBoldo leaf PennyroyalBroom Pine (dwarf)Bachu RueCalamus SassafrasCamphor SavinCassia SavoryChervil TansyCinnamon bark ThujaClove (bud, leaf or stem) TonkaCostus VanillaDeertongue WintergreenElecampane WormwoodFennel (bitter)Essential oils that may cause skin reactionsBasil (French) JasmineBenzoin LavenderBergamot LemonCederwood LemongrassCamomile MelissaCinnamon OrrangeCitronella PeppermintGeranium Tea-TreeGinger ThymeEssential oils thought to be emmenagogic (use with caution in pregnancy)Angelica Galbanum FrankinsenseAniseed Hyssop ThymeBasil JasmineBay JuniperCarrot seed LavenderCamomile MarjoramCelery seed MyrrhClary sage PeppermintFennel Rose (Adapted from Tiran D 2000 Clinical Aromatherapy for Pregnancy and Childbirth Churchill Livingston)

Some Research Findings

Treating Depression and Anxiety with Aromatherapy32 patients with depression/anxiety allocated to aromatherapy or control group.

Aromatherapy group received: 6 fortnightly massages lasting for 40 mins. Oils were selected according to physical and psychological symptoms

Control group received the same massage routine without the essential oils.

Outcomes: Depression rating scale, anxiety rating scale, hospital anxiety rating scale monthly until 12 weeks.

Significant differences in all measures were recorded in the aromatherapy group.

Essential oils most frequently used:Bergamot, lemon, clary-sage, lavender, chamomile, geranium, rose, sandalwood and jasmine (Lemon K 2004 An assessment of trerating depression and anxiety with aromatherapy In J of Aromatherapy 14(2) 63-69).)

The effects of Lavender baths on psychological wellbeingA single blind randomised controlled trial to assess lavender baths on positive mood state and positive outlook with respect to the future measured in 80 participants randomly allocated to lavender or grapeseed oil baths for 14 days

OutcomesMeasure of anger –frustration was reduced with lavender baths but no difference for energetic arousal ( feeling vigorous and alert), tense arousal (nervousness and perceived stress) and hedonic tone( feeling cheerful and happy) showed no difference/

There was also a marked reduction in the number of negative responses from the lavender group.(Morris N 2002 The effects of lavender baths on psychological wellbeing Complementary therapies in Nursing and Midwifery 10 223-228.)Oil of peppermint reduced fatique and improved mood in 21 healthy sleepers in a sleep laboratory (adaptation, control and

stimulus nights). In addition was rated more pleasant, intense and stimulating and elating than water (Goel and Lao 2005)

Odours of lavender and orange reduce anxiety and improve mood in a dental office when compared to music or a control group

Spanish oregano, thymus vulgaria and cinnamon were found to be effective against candida and Streptococcus B (Arnal et al 2004)

Essential oils used in Burns and Blamey study 2002

Essential oil Reason for useClary sage Augment labourEucalyptus Nasal congestion, pain reliefFrankincense High anxiety, hysteria, hyperventilationJasmine Depression, anxiety, to enhance

labour, to expel placentaLavender Anxiety, tension, stress, relaxation,

headacheLemon Upper respiratory tract infections, to

mood enhance/uplift/energiseMandarin Relaxation, mood

enhance/uplift/energisePeppermint Nausea, vomiting, headaches, pyrexiaRoman Chamomile Mothers with multiple allergies,

anxiety, skin irritation, eczemaRose absolute Depression, low spirits, bereavement,

anxiety, to augment labour.

8 year study of 8058 women who used aromatherapy in labour

1997 1,592 mothers 60% primips, 40% multips majority of mothers used aromatherapy when in established

labour (60%)

29% used it in the latent stage

Most common reason cited for using aromatherapy was for anxiety and/or fear

Irrespective of parity and labour onset women rated aromatherapy as being helpful rather than unhelpful.

The uptake of epidural analgesia was significantly less for women who used aromatherapy regardless of parity and labour onset

Aromatherapy was associated with a reduction in the use of opiates (O.4% in 1997)

Only 1% of women reported any symptom following the use of aromatherapy.

0.29% of caregivers/partners reported symptoms

Symptoms were of a minor nature: developing a rash or itching (Burns E 2002 Aromatherapy in Childbirth MIDIRS Sept 12(3) 349-353)

Mothers in Mousely’s (2005) audit reported a greater sense of relaxation than analgesia whilst using aromatherapy in labour but greater effectiveness in easing the pain of perineal and caesarean wounds (Mousely’s S 2005 Audit of an aromatherapy service in a maternity unit Complementary therapies in clinical practice 11-205-210)

Women who received a 30 min aromatherapy massage on the 2nd postpartum day were found to have increased emotional wellbeing and infant attachment scores (Imura et al 2006The Psychological Effects of Aromatherapy Massage in health Postpartum Mothers Journal of Midwifery and Women’s Health 51(2) 21-27)

ReferencesArnal-Schebelen et al 2004 Essential oils in infections gynaecological disease: a statistical analysis of 658 cases International Journal of Aromatherapy 1494) 192-197

Baker J, 1998 Essential oils: a complementary therapy in wound management Journal of Wound Care 7,7. 355-357

Broughan C 2005 The psychological aspects of aromatherapy The International Journal of Aromatherapy 15 3-6

Buckle JT 1993 Aromatherapy Nursing_Times 89.20. 32-35 •'

Buckle J, 1997 Clinical Aromatherapy_Jn of Nursing Arnold London

Buckle J, 1998 Alternative/Complementary Therapies Critical Care Nursing 18,5. 54-61

Burns E, Blarney C. 1994 Using aromatherapy in childbirth Nursing Times 90,9. 54, 56, 58, 60

Burns E, Blarney C. 2000 Using aromatherapy in childbirth MIDIRS Sept12(3) 349-353

Dunning T 2005 Applying a quality use of medicines framework to using essential oils in nursing practice Complementary Therapies in Clinical Practice 11 172-181

Cawthom A, 1995 A review of the literature surrounding the research into aromatherapy Complementary Therapies in Nursing and Midwifery I. 118-120

Clarke S 2002 Essential chemistry for safe aromatherapy Endinburgh Churchill Livingstone

Dale A, Cornwell S, 1994 The role of lavender oil in relieving perineal discomfort following childbirth: a blind randomised clinical trial Journal of Advanced Nursing 19, 89-96

Downer C. 1999 Safety is of the essence Nursing Times 95.7. 14-15

Fowler P, Wall M, 1998 Aromatherapy, Control of Substances Hazardous to health (COSHH) and assessment of the chemical risk Complementary therapies in medicine 6, 85-93

Hodgson T 1994 Aromatherapy - a note of caution for midwives Modern Midwjfe Jan 31 -33

Lemon K 2004 An assessment of treating depression and anxiety with aromatherapy In J of Aromatherapy 14(2) 63-69.

Lis-Balchin M 2006 Aromatherapy Science: a guide for healthcare practitioners . London. Pharmaceutical press.

Maddocks-Jennings W, Wilkinson J 2004 Aromatherapy practice in nursing: literature review Journal of Advanced Nursing 48(1) 93-103

Morris N 2002 The effects of lavender baths on psychological wellbeing Complementary therapies in Nursing and Midwifery 10 223-228.

Mousely S 2005 Audit of an aromatherapy service in a maternity unit Complementary therapies in clinical practice 11-205-210

Price S, Price L, 1995 Aromatherapy for Health Professionals Churchill Livingstone London

Price S, 1998 Using essential oils in professional practice Complementary Therapies in Nnursing and Midwifery 4. 144-147

Rose S. 1994 Advantages of antenatal and postnatal aromatherapy British Journal of Midwifery 2.3. 133-134

Silver-man R-1995 Use of alternative therapies in childbirth British Journal of Midwifery 3.4. |96-200

Tale S, 1997 Peppermint oil: a treatment for postoperative nausea Journal of Advanced Nursing 26. 543-549

Tiran D, 1996 Aromatherapy in midwifery: benefits and risks Complementary Therapies in Nursing and Midwifery 2, 88-92

Tiran D, 1999 A holistic framework for maternity care Complementary Therapies in Nursing and Midwifery.5,127-135

Tiran D, 1996 Aromatherapy in Midwifery Practice Balliere Tindall London

Useful addressesAromatherapy Organisations Council (AOC)PO Box 19834, London SE25 6WP0181 251 7912 International Federation of Aromatherapists, Stamford House, 2-4 Chiswick High Road London W4 1TH

Research Council for Complementary therapies 60 Great Ormond Street London WCIN 3JP 0171 833 8897