Summary of findings 4. Aromatherapy plus analgesia versus placebo plus analgesia for post‐caesarean pain.
| Aromatherapy plus analgesia versus placebo plus analgesia for post‐caesarean pain | ||||||
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Patient or population: post‐caesarean pain
Settings: maternity unit
Intervention: aromatherapy plus analgesia Comparison: placebo plus analgesia | ||||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | No of Participants (studies) | Certainty of the evidence (GRADE) | Comments | |
| Risk with placebo plus analgesia | Risk with Aromatherapy plus analgesia | |||||
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Pain assessed with: VAS Scale from 0 to 10 Follow‐up: 12 hours |
The mean pain score in the placebo plus analgesia group ranged from 4.58 to 5.77 | MD 2.63 lower (3.48 lower to 1.77 lower) | ‐ | 360 (3 RCTs) | ⊕⊕⊝⊝ low1 | |
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Pain assessed with: VAS Scale from: 0 to 10 Follow‐up: 24 hours |
The mean pain score in the placebo plus analgesia group was 4.05 | MD 3.38 lower (3.85 to 2.91 lower) | ‐ | 200 (1 RCT) | ⊕⊕⊝⊝ low2,3 | |
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Adverse effects (anxiety) Assessed with: State‐Trait Anxiety Inventory Scale from 20 to 80 (higher score = greater anxiety) Follow‐up: 12 hours |
The mean adverse effects (anxiety) score in the placebo group was 49.02 | MD 19.87 lower (22.11 to 17.63 lower) | ‐ | 80 (1 RCT) |
⊕⊝⊝⊝ verylow1,3 | |
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Vital signs: heart rate Assessed with beats per minute |
The mean heart rate in the placebo plus analgesia group was 82.85 beats per minute | MD MD 0.6 beats per minute higher | ‐ | 80 (1 RCT) | ⊕⊝⊝⊝ very low1,4 | |
| Rescue analgesic requirement | Study population | RR 0.69 (0.19 to 2.49) | 220 (3 RCTs) | ⊕⊝⊝⊝ very low1,4,5 | ||
| 900 per 1,000 | 621 per 1,000 (171 to 1,000) | |||||
| Pain at six weeks after discharge | Not reported | |||||
| *The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; MD: mean difference; RCT: randomised controlled trial; RR: risk ratio. | ||||||
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GRADE Working Group grades of evidence High certainty: we are very confident that the true effect lies close to that of the estimate of the effect. Moderate certainty: we are moderately confident in the effect estimate; the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low certainty: our confidence in the effect estimate is limited; the true effect may be substantially different from the estimate of the effect. Very low certainty: we have very little confidence in the effect estimate; the true effect is likely to be substantially different from the estimate of effect. | ||||||
1 Downgraded two levels due to high risk of selection, performance, detection, attrition and reporting bias
2 Downgraded one level due to unclear risk of selection and detection bias
3 Downgraded one level due to imprecision: few participants
4 Downgraded two levels due to imprecision: few participants and 95% CI spans possible benefit and possible harm
5 Downgraded one level due to inconsistency: heterogeneity in effect size