Each animal was individually placed in Mind-Body Connection Practices Cifrus of the light compartment facing the dark compartment Citfus observed for Mind-Body Connection Practices minutes after the first entry into the dark compartment. Pereira reported that coumarin can have a specific inhibitory effect on the central nervous system and prevent epileptic attacks and seizures [20]. Degroot, A. Tehran University Publication, Tehran.

Citrus aurantium for anxiety -

The amount of linalool in the sample was 10 ppm part per million. Total phenolic contents of CABd were 33 ± 0.

g -1 equivalent to Gallic acid and the total flavonoids in CABd were 29 ± 0. gr -1 equivalent to Rutin. The average amounts of total flavonoid and phenolic compounds were 29 ± 0. g -1 Rutin and 33 ± 0. gr -1 Gallic acid , respectively. The linalool concentration in the sample was 10 ppm.

Finally, the concentrations of total flavonoid, phenolic compound and linalool in CABd were 29 mg. mL -1 and 0. mL -1 , respectively. Preoperatively, all patients were admitted to the same holding area near the operating room while waiting for outpatient surgery.

For all subjects the environment, the nursing staff and the anesthesiologist as well as the psychologist were the same in the holding area.

As a baseline, preoperative anxiety was assessed using both State-Trait Anxiety Inventory STAI-state and Amsterdam Preoperative Anxiety and Information Scale APAIS by an expert psychologist. Heart rate HR and blood pressure BP were also obtained two hours before operation just before premedication in the holding area by a nurse anesthetist.

Then subjects of the two groups received oral CABd 1 mL. kg -1 as test C - group or Saline solution 1 mL. kg -1 as placebo P - group , respectively; according to a computer based randomization just after collecting the baseline values.

Two hours later right before inducing anesthesia anxiety was assessed using the same methods by other anesthesiologist and psychologist who were blinded to the groups and patients' baseline values. The State-Trait Anxiety Inventory STAI is a item self report measure that contains 20 items measuring state anxiety and 20 items measuring trait anxiety 2.

Total scores for state and trait sections separately range from 20 to 80 with higher scores denoting higher levels of anxiety. Amsterdam Preoperative Anxiety and Information Scale APAIS consist of 6 questions and ranged from In this study, we used state component of STAI rage and sum C component of APAIS range to evaluate preoperative anxiety.

Both heart rate HR and blood pressure BP , which have been widely used as dependent variables in behavioral studies to alter levels of anxiety and are frequently cited as physiological indices of stress in psychology, aviation medicine, and anesthesia 2 were obtained in two steps as baseline and just before induction of general anesthesia.

Regarding the normal distribution of variables, the data between groups were analyzed using Chi-Square and independent t tests and the data within groups were analyzed using paired t test.

Sixty patients were enrolled and completed the study. Chi-Square test demonstrated no significant difference among male and female distribution between groups. According to independent t test no significant differences were seen between groups in terms of age, baseline values of STAI-state, APAIS, and baseline hemodynamic values.

Table I. Hemodynamic variables except pulse rate in group P , were not changed within the two groups after pre-medication when paired t test was used. Tables II and III. Preoperative anxiety is not only an unpleasant emotional state but may lead to significant psychological and physiological disorders The main finding of this study is that the anxiolytic effect of Citrus aurantium blossom distillate CABd when used orally was highly significant as measured by STAI-state and APAIS.

Both STAI-state and APAIS were decreased by CABd. On the other hand, neither STAI-state nor APAIS was changed in the placebo group. We found no studies related to the effect of CABd on preoperative anxious situation or even anxiolytic effect of this herbal medicine in human in the literature review.

Only a few studies reported that some similar components of citrus may reduce anxiety 17, Lehrner et al. Although the main components of the essential oil in their study, demonstrated by gas chromatography, was in part different from that obtained in our study, the essential similar component was limonene, a flavonoid compound, which could be addressed as anxiolytic component.

The main component of CABd in our study was not similar to that of Carvalho and Costa They obtained d-limonene In their study, sleeping time induced by pentobarbital, anxiolytic activity, and anticonvulsant activity were evaluated in mice model. Chemical analysis of flowers of Sour orange has been previously reported by an investigation as flavonoids, which are its main constituents Flavonoids are complex chemical molecules that may act as ligands for benzodiazepine recept ors The notion that flavonoids may be agonists of benzodiazepine receptors, suggest that the flavonoid, which was extracted from the CABd in our study, might behave as an agonist of benzodiazepine receptors and reduce preoperative anxiety.

The phenolic component threshold toxicity level has been confirmed between and mg. L -1 , as stated in other studies, the concentration components of CABd used in our study was too low to induce toxicity in the patients However, based on traditional use of this herb in our society, we believe that the dose of CABd used in this study has no side effect on physiological responses.

Fortunately, we observed no adverse effect during and after operation. Citrus aurantium interferes with many drugs. Some of these drugs related to anesthesia are anti-anxiety, anti-hypertensive agents, and sedatives as well as antiemetic agents Although these interactions are due to Citrus aurantium peel and fruit and there is no study establishing the interaction of CABd components with other medications, the patients with no history of medication and disease were included to prevent any bias in the study.

Despite anxiety related to anesthesia and surgery, there are several sources of fear that may interfere with an anxiety model study. The main preoperative anxiety risk factors have been listed in recent studies. These studies concluded that concern history about cancer, psychiatric disorders, depression, trait-anxirty level, postoperative pain, history of smoking, extend of the proposed surgery, and physical status according to ASA, as well as patient education are the main risk factors for anxious situation before surgery 3, We circumvented some problems using the same situation, such as holding area for all patients, choosing the patients scheduled for minor lower limb surgery, sharing the same operating room staff and preventing needling and any stress induced factors before evaluating anxiety and excluding subjects with some mentioned risk factors.

Moreover, all participants had no history of using herbal medicine or any other medication on questioning. We used both the Spielberger state-trait anxiety inventory STAI scale and the Amsterdam preoperative anxiety and information scale APAIS to evaluate preoperative anxiety.

Boker's study confirmed significant and positive correlation between sum C sum of "Anesthesia anxiety" and "Surgery anxiety" of APAIS and STAI-state scales The result of our study completely agrees with Boker's study.

Several advantages related to our study have to be addressed. First, the study is a double-blind randomized trial that enrolled appropriate number of patients with ASA I scheduled for minor outpatient surgery without any experience of previous hospitalization and surgery.

Second, the use of both STAI-state and APAIS could reduce any bias while evaluating preoperative anxious situation. Third, regarding preoperative factors that may interfere with the study, we tried to omit some factors by choosing similar proper place and the same staff in the study.

Unfortunately, some problems related to this study are as follow: We were not able to record electrodermal activity EDA as a measure of autonomic arousal in response to stress.

We also did not determine plasma cortisol or plasma catecholamine 2 , in our study. These problems were circumvented using two methods of anxiety evaluation. In conclusion, our study demonstrated that CABd may reduce preoperative anxiety in outpatient surgery.

This result could open a window towards introducing herbal medicine for premedication as well as educate the anesthesiologist about using herbs and possible interaction with routine premedication. Open menu Brazil. Revista Brasileira de Anestesiologia. About the journal Editorial Board Instructions to authors Contact.

Português Español. Open menu. table of contents « previous current next ». Abstract Resumo Portuguese Resumo English Resumo Spanish. Text EN Text English Texto Spanish Texto Portuguese.

PDF Download PDF Portuguese Download PDF English Download PDF Spanish. Citrus; Flowers; Preoperative Care; Anxiety; Ambulatory Surgical Procedures.

ANESTÉSICOS; CIRURGIA; CIRURGIA. Chemicals The OEO was supplied from International Flavors and Fragrance IFF Ltda. Analysis of the essential oil The OEO was analyzed by gas chromatography. Treatment Groups with 12 rats each were used. Open-field behavioral test The open-field test was originally proposed as a measure of emotionality, with the animals being exposed to excessive light or noise.

Social interaction test This procedure is based on the observation that animals tend to reduce or even suppress their interaction with other animals under conditions of new environments or excessive light. Elevated plus-maze test The maze consists of two open arms and two closed arms by 30 cm high walls.

Statistical analysis Student's t test was used to analyze the behavioral parameters observed in the open-field, as well as the one-way ANOVA, followed by the Tukey's and the Duncan's tests, to analyze the data we obtained in the TSI and the EPM, respectively.

RESULTS Identification of constituents of OEO The chromatographic analysis of the OEO showed a phytochemical profile that confirms the presence of the main classes of components characteristic of the species Citrus aurantium L.

Agra MF, Silva KN, Basílio IJLD, França PF, Barbosa-Filho JM Survey of medicinal plants used in the region Northeast of Brazil. Rev Bras Farmacogn 18 : Almeida RN, Motta SC, Brito FC, Catallani B, Leite JR Anxiolytic like effects of rose oil inhalation on the elevated plus maze test in rats.

Pharmacol Biochem Behav Barbosa-Filho JM, Cunha RM, Dias CS, Athayde-Filho PF, Silva MS, Cunha EVL, Machado MIL, Craveiro AA, Medeiros IA GC-MS Analysis and cardiovascular activity of the essential oil of Ocotea duckei.

Candland DK, Campbell BA Development of fear in the rat as measured by behavior in the open-field. J Comp Physiol Psychol Carvalho-Freitas MIR, Costa M Anxiolytic and sedative effects of extracts and essential oil from Citrus aurantium L.

Biol Pharm Bull 25 : De-Souza MM, Garbeloto M, Denez K, Eger-Mangrich I Avaliação dos efeitos centrais dos florais de Bach em camundongos através de modelos farmacológicos específicos. Rev Bras Farmacogn 16 : Ferronatto R, Marchesan ED, Pezenti E, Bednarski F, Onofre SB Atividade antimicrobiana de óleos essenciais produzidos por Baccharis dracunculifolia D.

e Baccharis uncinella D. Rev Bras Farmacogn 17 : File SE, Hyde JR Can social interaction be used to measure anxiety? Brit J Pharmacol 62 : Gumnick JK, Nemeroff CB Problems with currently available antidepressants.

J Clin Psychiatry 61 : Hwang JH The effects of the inhalation method using essential oils on blood pressure and stress responses of clients with essential hypertension. Taehan Kanho Hakhoe Chi Jones GH, Hernandez ID, Kendall DA Dopaminergic and serotonergic function following isolation rearing in rats: study of behavioural responses and postmortem and in vivo neurochemistry.

Pharmacol Biochem Behav 43 : Komori T, Fujiwara R, Tanida M, Nomura J a. Effects of citrus fragrance on immune function and depressive state.

Neuroimunomodulat 2 : Komori T, Fujiwara R, Tanida M, Nomura J b. Potential antidepressant effects of lemon odor in rats. Eur Neuropsychopharmacol 5 : Komiya M, Takashi T, Harada E Lemon oil vapor causes an anti-stress effect via modulating the 5-HT and DA activities in mice. Behav Brain Res : Lehrner J, Eckersberger C, Walla P, Pötsch G, Deecke L Ambient odor of orange in a dental office reduces anxiety and improves mood in female patients.

Physiol Behav 71 : Lehrner J, Marwinski G, Lehr S, Johren P, Deecke L Ambient odor of orange and lavender reduce anxiety and improve mood in a dental office. Physiol Behav 86 : Oliveira RAG, Lima EO, Vieira WL, Freire KRL, Trajano VN, Lima, IO, Souza EL, Toledo MS, Silva-Filho RN Estudo da interferência de óleos essenciais sobre a atividade de alguns antibióticos usados na clínica.

Oliveira RAG, Lima EO, Souza EL, Vieira WL, Freire KRL, Trajano VN, Lima IO, Silva-Filho RN Interference of Plectranthus amboinicus Lour. Spreng essential oil on the anti- Candida activity of some clinically used antifungals. Pal R, Gulati K, Chakraborti A, Banerjee B, Ray A Role of free radicals in stress-induced neurobehavioral changes in rats.

Indian J Exp Biol 44 : Pellow S, Chopin SE, File SE, Briley M Validation of open closed arm entries in an elevated plus maze as a measure of anxiety in the rat. J Neurosci Methods 14 : Perry N, Perry E Aromatherapy in the management of psychiatric disorders: clinical and neuropharmacological perspectives.

CNS Drugs 20 : Pollatos O, Albrecht J, Kopietz R, Linn J, Schoepf V, Kleemann AM, Schreder T, Schandry R, Wiesmann M Reduced olfactory sensitivity in subjects with depressive symptoms. J Affect Disord : Pultrini AM, Galindo LA, Costa M Effects of the essential oil from Citrus aurantium L.

Hexanic HF , dichloromethanic DF and final aqueous AF fractions were obtained from HE by successive partitions. Swiss male mice 35—45 g were treated orally with 0.

The results showed that EOP 0. This effect was not dose-dependent. Treatment with 1. Specific tests indicated that the preparation, in both doses used, did not promote deficits in general activity or motor coordination. HF and DF fractions 1. The results obtained with EOP in the anxiety model, and with EOP, HF and DF in the sedation model, are in accord with the ethnopharmacological use of Citrus aurantium L.

Already have an account? Sign in here. Biological and Pharmaceutical Bulletin. Online ISSN : Print ISSN : ISSN-L :

The Nutrient-rich vegetables essential Anxlety OEO and its components obtained from Citrus aurantium L. Rutaceae ajxiety been attracting interest due to its sedative and Cirus actions. In the present Cjtrus, rats Mind-Body Connection Practices exposed ror OEO at the concentrations Citrus aurantium for anxiety 1. The OEO at the concentration of 2. In conclusion, the decrease in the level of emotionality of the animals observed in the two experimental models suggests a possible central action, which is in agreement with the phytochemical profile of the oil under study, since it showed the presence of limonene O óleo essencial de laranja OEL e seus constituintes obtidos da Citrus aurantium L. Rutaceae têm despertado interesse pela sua ação sedativa e relaxante. Preoperative Mind-Body Connection Practices and use Brazil nut nutrition premedication fpr popular methods fr achieve this goal, but the aurwntium of anxiolytic premedication remains unclear and postoperative side-effects Mind-Body Connection Practices result from routine Mind-Body Connection Practices. Citrus aurantium is used Fuel your day with natural energy an alternative Citrus aurantium for anxiety aurabtium some countries to treat anxiety, and recently the anxiolytic role of this medicinal plant was established in an animal model study. The aim of this study was to assess the anxiolytic effect of Citrus aurantium blossom on preoperative anxiety. METHODS: We studied 60 ASA I patients undergoing minor operation. In a randomized double-blind design, two groups of 30 patients received one of the following oral premedication two hours before induction of anesthesia: 1 Citrus aurantium blossom distillate 1 mL.