@2024 Afarand., IRAN
ISSN: 2252-0805 The Horizon of Medical Sciences 2018;24(1):23-28
ISSN: 2252-0805 The Horizon of Medical Sciences 2018;24(1):23-28
Comparing Effect of Safranal and Diazepam in Reducing Preoperative Anxiety and Improving Vital Symptoms
ARTICLE INFO
Article Type
Original ResearchAuthors
Godarzi N. (1)Hamzei A. (2)
Basiri-Moghadam M. (3 )
Ghenaati J. (4 )
Torkamani-Noghbai M. (4 )
Zarif Najafi P. (5 )
Pasban-Noghabi S. (* )
(* ) Student Research Committee, Nursing Department, Nursing & Midwifery Faculty, Gonabad University of Medical Sciences, Gonabad , Iran
(1) Basic Sciences Department, Medicine Faculty, AJA University of Medical Sciences, Tehran, Iran
(2) Operating & Anesthesia Department, Paramedicine Faculty, Gonabad University of Medical Sciences, Gonabad , Iran
(3 ) “Social Development & Health Promotion Research Center” and “Pediatric Nursing Department, Nursing & Midwifery Faculty”, Gonabad University of Medical Sciences, Gonabad , Iran
(4 ) Basic Sciences Department, Medicine Faculty, Gonabad University of Medical Sciences, Gonabad, Iran
(5 ) Obstetric & Gynecology Department, Medicine Faculty, Medical Sciences Branch, Islamic Azad University Mashhad, Mashhad, Iran
Correspondence
Article History
Received: February 12, 2017Accepted: August 30, 2017
ePublished: January 11, 2018
ABSTRACT
Aims
Preoperative anxiety is an unpleasant manner created by fear of surgery. The aim of the present study was to compare the effects of diazepam pill with Safranal in reducing preoperative anxiety and improving vital symptoms.
Materials & Methods In this double blind randomized clinical trial, 54 patients who were candidates of urology surgery (varicocele) in 15th Khordad Hospital, Gonabad, Iran, were selected by purposive sampling method, using a randomized numbers table; they were divided into intervention (n=29) and control group (n=25). The patients in intervention group received 15mg Safranal and the patients in control group received 5mg oral diazepam 3 hours before surgery. The State-Trait Anxiety Inventory (STAI) questionnaire was completed by the patients prior to the intervention and just at the entrance to the surgery room, and the vital symptoms of the patient were evaluated. The data were analyzed by SPSS 11.5 software, using of Chi-square and independent sample t-test.
Findings After intervention, the trait anxiety in the Safranal group was significantly lower than diazepam group (p=0.007) and before the intervention (p=0.002). Also, diastolic blood pressure decreased significantly in the Safranal group compared with the diazepam group (p=0.049).
Conclusion Saffranal consumption before surgery is more effective than diazepam consumption in reducing the trait anxiety, but it does not affect state anxiety. Also, compared to diazepam, Saffranal consumption leads to a more reduction in diastolic blood pressure, while it does not affect systolic blood pressure and heart rate.
Materials & Methods In this double blind randomized clinical trial, 54 patients who were candidates of urology surgery (varicocele) in 15th Khordad Hospital, Gonabad, Iran, were selected by purposive sampling method, using a randomized numbers table; they were divided into intervention (n=29) and control group (n=25). The patients in intervention group received 15mg Safranal and the patients in control group received 5mg oral diazepam 3 hours before surgery. The State-Trait Anxiety Inventory (STAI) questionnaire was completed by the patients prior to the intervention and just at the entrance to the surgery room, and the vital symptoms of the patient were evaluated. The data were analyzed by SPSS 11.5 software, using of Chi-square and independent sample t-test.
Findings After intervention, the trait anxiety in the Safranal group was significantly lower than diazepam group (p=0.007) and before the intervention (p=0.002). Also, diastolic blood pressure decreased significantly in the Safranal group compared with the diazepam group (p=0.049).
Conclusion Saffranal consumption before surgery is more effective than diazepam consumption in reducing the trait anxiety, but it does not affect state anxiety. Also, compared to diazepam, Saffranal consumption leads to a more reduction in diastolic blood pressure, while it does not affect systolic blood pressure and heart rate.
CITATION LINKS
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[16]Berbel P, Moix J, Quintana S. Music versus Diazepam to reduce preoperative anxiety: A randomized controlled clinical trial. Rev Esp Anestesiol Reanim. 2007;54(6):355-8.
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[19]Verma SK, Bordia A. Antioxidant property of saffron in man. Indian J Med Sci. 1998;52(5):205-7.
[20]Akhondzadeh S, Tahmacebi-Pour N, Noorbala AA, Amini H, Fallah-Pour H, Jamshidi AH, et al. Crocus sativus L. In the treatment of mild to moderate depression: A double-blind, randomized and placebo controlled trial. Phytother Res. 2005;19(2):148-51.
[21]Akhondzadeh S, Fallah Pour H, Afkham K, Jamshidi AH, Khalighi Cigaroudi F, Miller LG. A comparative trial of crocus sativus L (saffron) and imipramine in mild to moderate 1PCO (Posterior capsule opacification) depression. Focus Altern Complement Ther. 2005;10(1):22-3.
[22]Noorbala AA, Akhondzadeh S, Tahmacebipour N, Jamshidi AH. Hydro-alcoholic extract of crocus sativus L. versus fluoxetine in the treatment of mild to moderate depression: A double-blind, randomized pilot trial. J Ethnopharmacol. 2005;97(2):281-4.
[23]Kianbakht S, Ghazavi A. Evaluation of immunological and hematological effects of saffron in men. Ethno Pharmacol. 2005;36(1):78-83.
[24]Agha Hosseini M, Kashani L, Aleyaseen A, Ghoreishi A, Rahmanpour H, Zarrinara AR, et al. Crocus sativus L. (saffron) in the treatment of premenstrual syndrome: A double blind, randomized and placebo-controlled trial. Int J Obst Gyn. 2008;115(4):515-9.
[25]Abdullaev FI. Cancer chemopreventive and tumoricidal properties of Saffron (Crocus sativus L). Exp Biol Med (Maywood). 2002;227(1):20-5.
[26]Tarantilis PA, Polissiou MG. Isolation and identification of the aroma constituents of saffron. J Agric Food Chem. 1997;45(2):459-62.
[27]Akhondzadeh S, Fallah Pour H, Afkham K, Jamshidi AH, Khalighi Cigaroudi F. Comparison of crocus sativus L. and imiperamine in the treatment of mild to moderate depression: A pilot double-blind randomized trial. BMC Complement Altern Med. 2004;4:12.
[28]Kianbakht S. A Systematic Review on Pharmacology of Saffron and its Active Constituents. J Med Plants. 2008;4(28):1-27. [Persian]
[29]Basiri Moghadam M, Hamzei A, Moslem A, Pasban Noghabi S, Ghorbani N, Ghenaati J. Comparison of the anxiolytic effects of saffron (Crocus sativus. L) and diazepam before herniorrhaphy surgery: A double blind randomized clinical trial. Zahedan J Res Med Sci. 2016;18(3):e6248. [Persian]
[30]Salehi Surmaghi MH. Medicinal plants and phytotherapy. Tehran: The World of Nutrition Publications; 2006. pp. 207-10. [Persian]
[31]Bazrafshan MR, Mahmoudi Rad AR. The effect of pregnant women's anxiety on apgar score and birth weight of newborns in 2009. Sci J Hamadan Nurs Midwifery Fac. 2009;17(12):58-68. [Persian]
[32]Banaiyan Gh, Rasti Boroujeni A, Shirmardi M. Comparison of the effect of citrus aurantium and diazepam on preoperative anxiety. J Shahrekord Univ Med Sci. 2009;10(4):13-8. [Persian]
[33]Axelson DA, Birmaher B. Relation between anxiety and depressive disorders in childhood and adolescence. Depress Anxiety. 2001;14(2):67-78.
[34]Shores MM, Glubin T, Cowley DS, Dager SR, Roy Byrne PP, Dunner DL. The relationship between anxiety and depression: A clinical comparison of generalizanxiety disorers, dysthymic disorder, panic disorder, and major depressive disorder. Compr Psychiatry. 1992;33(4):237-44.
[35]Shahmansouri N, Farokhnia M, Abbasi SH, Kassaian SE, Noorbala Tafti AA, Gougol A, et al. A randomized, double-blind, clinical trial comparing the efficacy and safety of crocus sativus L. With fluoxetine for improving mild to moderate depression in post percutaneous coronary intervention patients. J Aff Disord. 2014;155:216-22.
[36]Hosseinzadeh H, Noraei NB. Anxiolytic and hypnotic effect of crocus sativus aqueous extract and its constituents, crocin and safranal, in mice. Phytothar Res. 2009;23(6):768-74.
[37]Nutt DJ, Malizia AL. New insights into the role of the GABA (A)-benzodiazepine receptor in psychiatric disorder. Br J Psychiatry. 2001;179:390-6.
[38]Herron ME, Shofer FS, Reisner IR. Retrospective evaluation of the effects of diazepam in dogs with anxiety-related behavior problems. J Am Vet Med Assoc. 2008;233(9):1420-4.
[39]Pippongskold K, Lehtinen AM, Laatikainen T, Hanninen H, Korttila K. The effect of orally administered diazepam and midazolam on plasma beta-endorphin, ACTH and preoperative anxiety. Acta Anaesthesiol Scand. 1991;35(2):175-80.
[2]Aghamohammadi Kalkhoran M, Karimollahi M. Religiousness and preoperative anxiety: A correlational study. Ann Gen Psychiatry. 2007;6:17.
[3]Ruiz Lopez E, Munoz Cuevas JH, Olivero Vasquez YL, Islas Saucillo M. Ansiedad preoperatoria en el Hospital General de México / Preoperative anxiety in the Hospital General de México. Rev Med Hosp Gen Mex. 2000; 63(4):231-6.
[4]Ravanipour M. Effects of therapeutic touch before abdominal surgery on anxiety of female patients. Iran J Nurs Midwifery Res. 2005;10(1):1-6.
[5]Ling LY, Wang RH. Abdominal surgery, pain and anxiety: Preoperative nursing intervention. J Adv Nurs. 2005;51(3):252-60.
[6]Barnason S, Zimmerman L, Nieveen J. The effect of music intervention on anxiety in the patient after coronary artery bypass grafting. Heart Lung. 1995;24(2):124-32.
[7]Monahan F, Sands JK, Neighbors M, Marek JF, Green CJ. Medical surgical nursing: Concepts & clinical practice (Phipps), 8th edition. Philadelphia: Mosby; 2005. pp. 462-90.
[8]Miller R. Anesthesia. Philadelphia: Mosby; 2004. pp. 651-5.
[9]Ayral X, Gicguere C, Duhalde A, Boucheny D, Dougados M. Effects of video information on preoperative anxiety level and tolerability of joint lavage in knee osteoarthritis. Arthritis Rheum. 2002;47(4):380-2.
[10]Brumfield VC, Kee CC, Johnson JY. Preoperative patient teaching in ambulatory surgery settings. AORN J. 1996;64(6):941-52.
[11]Linden I, Engberg IB. Patients’ opinions of information given and postoperative problems experienced in surgery. Ambul Surg. 1996;4(2):85-91.
[12]Wang SM, Kulkorni L, Dolev J, Kain ZN. Music and preoperative anxiety: A randomized controlled study. Anesth Analy. 2002;94(6):1489-94.
[13]Mitchell M. Patients perception of pre-operative preparation for day surgery. J Adv Nurs. 1997;26(2):356-63.
[14]Abdul-latif MS, Putland AJ, McCluskey A, Meadows DP, Remington SA. Oral midazolam premedication for day case breast surgery, a randomized prospective double-blind placebo-controlled study. Anesthesia. 2001;56(1):990-4.
[15]Richardson MG, Wu CL, Hussain A. Midazolam premedication increases but, dose not prolong discharge times after brief outpatient general anesthesia for laparoscopic tubal sterilization. Anesth Analg. 1997;85(2):301-5.
[16]Berbel P, Moix J, Quintana S. Music versus Diazepam to reduce preoperative anxiety: A randomized controlled clinical trial. Rev Esp Anestesiol Reanim. 2007;54(6):355-8.
[17]Miller RD, Pardo M. Basics of Anesthesia. 6th edition. Philadelphia (PA): Churchill Livingstone Elsevier; 2011.
[18]Movafegh A, Alizadeh R, Hajimohamadi F, Esfehani F, Nejatfar M. Preoperative oral Passiflora incarnata reduces anxiety in ambulatory surgery patients: A double-blind, placebocontrolled study. Anesth Analg. 2008;106(6):1728-32.
[19]Verma SK, Bordia A. Antioxidant property of saffron in man. Indian J Med Sci. 1998;52(5):205-7.
[20]Akhondzadeh S, Tahmacebi-Pour N, Noorbala AA, Amini H, Fallah-Pour H, Jamshidi AH, et al. Crocus sativus L. In the treatment of mild to moderate depression: A double-blind, randomized and placebo controlled trial. Phytother Res. 2005;19(2):148-51.
[21]Akhondzadeh S, Fallah Pour H, Afkham K, Jamshidi AH, Khalighi Cigaroudi F, Miller LG. A comparative trial of crocus sativus L (saffron) and imipramine in mild to moderate 1PCO (Posterior capsule opacification) depression. Focus Altern Complement Ther. 2005;10(1):22-3.
[22]Noorbala AA, Akhondzadeh S, Tahmacebipour N, Jamshidi AH. Hydro-alcoholic extract of crocus sativus L. versus fluoxetine in the treatment of mild to moderate depression: A double-blind, randomized pilot trial. J Ethnopharmacol. 2005;97(2):281-4.
[23]Kianbakht S, Ghazavi A. Evaluation of immunological and hematological effects of saffron in men. Ethno Pharmacol. 2005;36(1):78-83.
[24]Agha Hosseini M, Kashani L, Aleyaseen A, Ghoreishi A, Rahmanpour H, Zarrinara AR, et al. Crocus sativus L. (saffron) in the treatment of premenstrual syndrome: A double blind, randomized and placebo-controlled trial. Int J Obst Gyn. 2008;115(4):515-9.
[25]Abdullaev FI. Cancer chemopreventive and tumoricidal properties of Saffron (Crocus sativus L). Exp Biol Med (Maywood). 2002;227(1):20-5.
[26]Tarantilis PA, Polissiou MG. Isolation and identification of the aroma constituents of saffron. J Agric Food Chem. 1997;45(2):459-62.
[27]Akhondzadeh S, Fallah Pour H, Afkham K, Jamshidi AH, Khalighi Cigaroudi F. Comparison of crocus sativus L. and imiperamine in the treatment of mild to moderate depression: A pilot double-blind randomized trial. BMC Complement Altern Med. 2004;4:12.
[28]Kianbakht S. A Systematic Review on Pharmacology of Saffron and its Active Constituents. J Med Plants. 2008;4(28):1-27. [Persian]
[29]Basiri Moghadam M, Hamzei A, Moslem A, Pasban Noghabi S, Ghorbani N, Ghenaati J. Comparison of the anxiolytic effects of saffron (Crocus sativus. L) and diazepam before herniorrhaphy surgery: A double blind randomized clinical trial. Zahedan J Res Med Sci. 2016;18(3):e6248. [Persian]
[30]Salehi Surmaghi MH. Medicinal plants and phytotherapy. Tehran: The World of Nutrition Publications; 2006. pp. 207-10. [Persian]
[31]Bazrafshan MR, Mahmoudi Rad AR. The effect of pregnant women's anxiety on apgar score and birth weight of newborns in 2009. Sci J Hamadan Nurs Midwifery Fac. 2009;17(12):58-68. [Persian]
[32]Banaiyan Gh, Rasti Boroujeni A, Shirmardi M. Comparison of the effect of citrus aurantium and diazepam on preoperative anxiety. J Shahrekord Univ Med Sci. 2009;10(4):13-8. [Persian]
[33]Axelson DA, Birmaher B. Relation between anxiety and depressive disorders in childhood and adolescence. Depress Anxiety. 2001;14(2):67-78.
[34]Shores MM, Glubin T, Cowley DS, Dager SR, Roy Byrne PP, Dunner DL. The relationship between anxiety and depression: A clinical comparison of generalizanxiety disorers, dysthymic disorder, panic disorder, and major depressive disorder. Compr Psychiatry. 1992;33(4):237-44.
[35]Shahmansouri N, Farokhnia M, Abbasi SH, Kassaian SE, Noorbala Tafti AA, Gougol A, et al. A randomized, double-blind, clinical trial comparing the efficacy and safety of crocus sativus L. With fluoxetine for improving mild to moderate depression in post percutaneous coronary intervention patients. J Aff Disord. 2014;155:216-22.
[36]Hosseinzadeh H, Noraei NB. Anxiolytic and hypnotic effect of crocus sativus aqueous extract and its constituents, crocin and safranal, in mice. Phytothar Res. 2009;23(6):768-74.
[37]Nutt DJ, Malizia AL. New insights into the role of the GABA (A)-benzodiazepine receptor in psychiatric disorder. Br J Psychiatry. 2001;179:390-6.
[38]Herron ME, Shofer FS, Reisner IR. Retrospective evaluation of the effects of diazepam in dogs with anxiety-related behavior problems. J Am Vet Med Assoc. 2008;233(9):1420-4.
[39]Pippongskold K, Lehtinen AM, Laatikainen T, Hanninen H, Korttila K. The effect of orally administered diazepam and midazolam on plasma beta-endorphin, ACTH and preoperative anxiety. Acta Anaesthesiol Scand. 1991;35(2):175-80.