47 - Essential Oils and the Effect on PONV in the ASC Patient
Introduction: Post-Operative Nausea and Vomiting (PONV) is a significant side effect after general anesthesia. 30% of patients who have general anesthesia will experience PONV. The percentage climbs to approximately half for those with a history of PONV during subsequent exposures to general anesthesia.Problem:Increased cost for the patient and the facility, prolonged recovery time, and persistent nausea.
Purpose: Our purpose was to see if essential oils impacted the PONV of general surgery patients in the ASC setting both in the PACU phase as well as once the patient was at home.Goal:To decrease the number of patients experiencing PONV after ambulatory surgery by placing essential oils on the patient immediate post-operatively.
Methods: We educated the patient in our PreOp area regarding the use of essential oils and obtained verbal consent for a peppermint –orange essential oil patch to be applied.Once in the PACU after surgery, the nurse did an initial assessment of the level of nausea on arrival and applied the essential oils patch on the patient gown as close as possible to the neckline. The patch was opened to the minimal level of scent. Patients were not asked about nausea level unless they stated an issue during the course of their stay. Once discharge was eminent the nurse would ask “how do you feel” to see if they responded positively or negatively regarding nausea. If the response was positive for nausea the nurse then asked them to rank their nausea based on the Baxter animated retching faces scale (BARF) tool which they were educated on in our PreOp area.The post-op one day phone call also elicited a response as to their PONV once home based on the BARF scale. Pre-Data:We began collecting data in May of 2018 for all orthopedic and plastic general surgery patients. Our data was based on nausea level in PACU and nausea level on postoperative phone call. We collected data on 33 orthopedic patients and 21 plastic patients for 7 months. The results showed in the orthopedic population 39% complained of nausea in the PACU and 72% had complaints of nausea at home. Within the plastics population, 76% complained of nausea in the PACU and 36% complained of nausea once home.
Results: We began our study in February 2019 and completed it on June 30, 2019. We utilized the peppermint orange blend on 102 patients in the orthopedic service and 55 in the plastics service. Our data shows that within the Orthopedic population, with the use of the peppermint orange blend oil, only 11% complained of nausea in the PACU and on discharge the number decreased to 8% when following up on the post-operative phone call. The plastic population showed 42% of the patients complained of nausea in PACU and 18% at home.
Co-Authors: Kalina Hortman, Sheryce Gainer, Pam Wilson, Kathy Miller, Linda Puckett, Erica Morgan