BACKGROUND: Most postoperative patients have unrelieved pain despite the use of patient-controlled analgesia. Nurses need additional effective modalities. Relaxation and music (RM), in addition to analgesics, have been shown to reduce pain more than do analgesics alone. OBJECTIVES: The objectives of the study were to test an intervention of patient teaching for pain management (PT) and compare it with RM for immediate and general effects on postoperative pain. METHODS: Patients having abdominal surgery and receiving patient-controlled analgesia aged 18-75 years (n = 517) were randomized to four groups: PT, RM, a combination (PTRM), and a control. A 2 x 2 factorial design was used to assess PT-Effects and RM-Effects. Immediate effects on pain were measured on visual analogue sensation and distress scales before and after five 20-min tests in the first 2 days. Because participants also listened independently, general nonimmediate effects were examined at eight other times. RESULTS: Using multivariate analysis of covariance with contrasts and pretest control, immediate RM-Effects on pain were found at Day 1 a.m. (p < .001), Day 1 p.m. (p = .04), and Day 2 a.m. (p = .04). No PT-Effects or nonimmediate RM-Effects were found. DISCUSSION: Patient teaching did not result in less pain and did not support the theoretical proposition that PT reduces pain. However, the immediate RM-Effects supported the proposition that nonpharmacological adjuvants to analgesics can ease pain without adding side effects.

Nurs Res. 2010 Jul-Aug;59(4):259-69. Good M, Albert JM, Anderson GC, Wotman S, Cong X, Lane D, Ahn S. Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio 44106-4904, USA. mpg@case.edu

Full Title: Effects of aromatherapy on changes in the autonomic nervous system, aortic pulse wave velocity and aortic augmentation index in patients with essential hypertension.

PURPOSE: To investigate the effectiveness of aromatherapy on blood pressure, heart rate variability, aortic pulse wave velocity and the aortic augmentation index of essential hypertensive patients. METHODS: Using a coin toss, 22 participants were assigned to the experimental group and 20 to the control. The experimental group was given a blend of oils of lemon (Citrus limonum), lavender (Lavandula angustifolia), and ylang ylang (Cananga odorata) which were prepared in the ratio of 2:2:1, respectively. The control group was given an artificial lemon fragrance of Limonene (35 cc) and Citral (15 cc) mixture. The experiment, inhalation, was conducted for 3 weeks (2 min per inhalation, 2 times per day) to both groups. RESULTS: There was a noticeable difference in systolic blood pressure between the groups (p=.001), however the difference in diastolic blood pressure between the two groups was not significant. There was a notable difference in sympathetic nerve system activity of heart rate variability (p=.047). However, the differences in aortic pulse wave velocity or the aortic augmentation index were not significant. CONCLUSION: Aromatherapy is effective in lowering systolic blood pressure and sympathetic nerve system activity.

J Korean Acad Nurs. 2010 Oct;40(5):705-13. [Article in Korean] Cha JH, Lee SH, Yoo YS. Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.