Search JIM Advanced Search

Journal of Integrative Medicine ›› 2017, Vol. 15 ›› Issue (5): 373-378.doi: 10.1016/S2095-4964(17)60358-3

Special Issue: Natural Drug

• Research Article • Previous Articles     Next Articles

Efficacy of topical chamomile on the incidence of phlebitis due to an amiodarone infusion in coronary care patients: A double-blind, randomized controlled trial

Maryam Sharifi-Ardania, Leili Yekefallaha, Saeed Asefzadehb, Marjan Nassiri-Aslc   

  1. a School of Nursing and Midwifery, Qazvin University of Medical Sciences, Qazvin 341197-5981, Iran 
    b Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin 341197-5981, Iran
    c Cellular and Molecular Research Center, Department of Pharmacology, Qazvin University of Medical Sciences, Qazvin 341197-5981, Iran
  • Received:2017-04-01 Accepted:2017-05-26 Online:2017-09-15 Published:2017-09-15
  • Contact: Prof. Marjan Nassiri-Asl; E-mail: mnassiriasl@qums.ac.ir

Background

Amiodarone is a useful antiarrhythmic drug. Phlebitis, caused by intravenous amiodarone, is common in patients in coronary care units (CCUs).

Objective

The aim of this study was to evaluate the effect of topical chamomile on the incidence of phlebitis due to the administration of an amiodarone infusion into the peripheral vein.

Design, Setting, Participants and Interventions

This was a randomized, double-blind clinical trial, conducted on 40 patients (n = 20 per group) in two groups—an intervention group (chamomile ointment) and a control group (lanoline, as a placebo), hospitalized in the CCUs and undergoing an amiodarone infusion into the peripheral vein over 24 h. Following the cannulation and commencement of the infusion, placebo or chamomile ointment was rubbed in, up to 10 cm superior to the catheter and repeated every eight hours for three days. The cannula site was then assessed based on the phlebitis checklist.

Main Outcome Measures

The incidence and time of occurrence of phlebitis, relative risk, severity of phlebitis were the main outcome measures.

Results

Nineteen patients (19/20) in the control group had phlebitis on the first day of the study and one patient (20/20) on the second day. In the intervention group, phlebitis occurred in 13 cases (13/20) on the first day and another two (2/7) was found on the second day. The incidence of phlebitis was significantly different between two groups (P = 0.023). The cumulative incidence of phlebitis in the intervention group (15/20) is significantly later and lower than that in the control group (20/20) during two days (P = 0.008). Two patients in the intervention group did not develop phlebitis at all during the 3-day study. Also, the relative risk of phlebitis in the two groups was 0.68 (P = 0.008 5). A significant difference was not observed with regard to phlebitis severity in both groups.

Conclusion

It seems that phlebitis occurred to a lesser extent and at a later time frame in the intervention group compared to control group. Topical chamomile may be effective in decreasing the incidence of phlebitis due to an amiodarone infusion.

Trial Registration

This protocol was registered in the Iranian Registry of Clinical Trials (IRCT2014042017361N1).

Key words: Phlebitis, Amiodarone, Prevention, chamomile, Clinical trial, Plants, medicinal

1 Trappe HJ.Concept of the five ‘A’s for treating emergency arrhythmias.J Emerg Trauma Shock. 2010; 3(2): 129-136.
2 Iqbal FM, Chawla B, Koneru J, Bikkina M.Amiodaroneinduced thrombosis: a case series and brief review of the literature.Am J Ther. 2012; 19(5): 389-391.
3 Eppert HD, Goddard KB.Administration of amiodarone during resuscitation of ventricular arrhythmias.J Emerg Nurs. 2010; 36(1): 26-28.
4 Norton L, Ottoboni LK, Varady A, Yang-Lu CY, Becker N, Cotter T, Pummer E, Haynes A, Forsey L, Matsuda K, Wang P.Phlebitis in amiodarone administration: incidence, contributing factors, and clinical implications.Am J Crit Care. 2013; 22(6): 498-505.
5 Saini R, Agnihotri M, Gupta A, Walia I.Epidemiology of infiltration and phlebitis.Nurs Mid Res J. 2011; 7(1): 22-33.
6 Boyce BA, Yee BH.Incidence and severity of phlebitis in patients receiving peripherally infused amiodarone.Crit Care Nurse. 2012; 32(4): 27-34.
7 Mowry JL, Hartman LS.Intravascular thrombophlebitis related to the peripheral infusion of amiodarone and vancomycin.West J Nurs Res. 2011; 33(3): 457-471.
8 Singh O, Khanam Z, Misra N, Srivastava MK.Chamomile (Matricaria chamomilla L.): an overview. Pharmacogn Rev. 2011; 5(9): 82-95.
9 Amin GH, Shirzad M.Babonneh.J Islamic Iran Tradit Med. 2011; 1(4): 391-396.
10 Jabri MA, Sakly M, Marzouki L, Sebai H.Chamomile (Matricaria recutita L.) decoction extract inhibits in vitro intestinal glucose absorption and attenuates high fat diet-induced lipotoxicity and oxidative stress. Biomed Pharmacother. 2017; 87: 153-159.
11 Jabri MA, Aissani N, Tounsi H, Sakly M, Marzouki L, Sebai H.Protective effect of chamomile (Matricaria recutita L.) decoction extract against alcohol-induced injury in rat gastric mucosa. Pathophysiology. 2017; 24(1): 1-8.
12 Sebai H, Jabri MA, Souli A, Hosni K, Rtibi K, Tebourbi O, El-Benna J, Sakly M.Chemical composition, antioxidant properties and hepatoprotective effects of chamomile (Matricaria recutita L.) decoction extract against alcoholinduced oxidative stress in rat. Gen Physiol Biophys. 2015; 34(3): 263-275.
13 Kazemian H, Ghafourian S, Sadeghifard N, Badakhsh B, Heidari H, Taji A, Shavalipour A, Mohebi R, Ebrahim- Saraie HS, Houri H, Houshmandfar R. In vivo antibacterial and wound healing activities of Roman chamomile (Chamaemelum nobile). Infect Disord Drug Targets. 2016; Epub ahead of print.
14 Srivastava JK, Shankar E, Gupta S.Chamomile: a herbal medicine of the past with bright future.Mol Med Rep. 2010; 3(6): 895-901.
15 Reis PE, Carvalho EC, Bueno PC, Bastos JK.Clinical application ofChamomilla recutita in phlebitis: dose response curve study. Rev Lat Am Enfermagem. 2011; 19(1): 3-10.
16 Aradmehr M, Azhari S, Ahmadi S, Azmoude E.The effect of chamomile cream on episiotomy pain in primiparous women: a randomized clinical trial.J Caring Sci. 2017; 6(1): 19-28.
17 Alexander M.Infusion nursing standards of practice.J Infus Nurs. 2011; 34(Suppl 1): S65.
18 Gallant P, Schultz AA.Evaluation of a visual infusion phlebitis scale for determining appropriate discontinuation of peripheral intravenous catheters.J Infus Nurs. 2006; 29(6): 338-345.
19 Hashempur MH, Lari ZN, Ghoreishi PS, Daneshfard B, Ghasemi MS, Homayouni K, Zargaran A.A pilot randomized double-blind placebo-controlled trial on topical chamomile (Matricaria chamomilla L.) oil for severe carpal tunnel syndrome. Complement Ther Clin Pract. 2015; 21(4): 223-228.
20 Shoara R, Hashempur MH, Ashraf A, Salehi A, Dehshahri S, Habibagahi Z.Efficacy and safety of topicalMatricaria chamomilla L.(chamomile) oil for knee osteoarthritis: a randomized controlled clinical trial. Complement Ther Clin Pract. 2015; 21(3): 181-187.
21 Srivastava JK, Pandey M, Gupta S.Chamomile, a novel and selective COX-2 inhibitor with anti-inflammatory activity.Life Sci. 2009; 85(19-20): 663-669.
22 Nekuzad N, Ashke Torab T, Mojab F, Alavi-Majd H, Azadeh P, Ehtejab G.Effect of external use of sesame oil in the prevention of chemotherapy-induced phlebitis.Iran J Pharm Res. 2012; 11(4): 1065-1071.
23 Bagheri-Nesami M, Shorofi SA, Hashemi-Karoie SZ, Khalilian A.The effects of sesame oil on the prevention of amiodarone-induced phlebitis.Iran J Nurs Midwifery Res. 2015; 20(3): 365-370.
24 Martinho RDFS, Rodrigues AB.Occurrence of phlebitis in patients on intravenous amiodarone.Einstein. 2008; 6(4): 459-462.
[1] Ning Guo, Fei Wu, Mei Wu, Yuan Wang, Qing Lang, Xiao Lin, Yi Feng. Progress in the design and quality control of placeboes for clinical trials of traditional Chinese medicine . Journal of Integrative Medicine, 2022, 20(3): 204-212.
[2] Rui-jin Qiu, Min Li, Jia-yuan Hu, Jing Chen, Hong-cai Shang. Methods for development of a core outcome set for clinical trials integrating traditional Chinese medicine and Western medicine. Journal of Integrative Medicine, 2021, 19(5): 389-394.
[3] Ning Zhang, Xiao-he Xiao. Integrative medicine in the era of cancer immunotherapy: Challenges and opportunities. Journal of Integrative Medicine, 2021, 19(4): 291-294.
[4] Pratya Phetkate, Tanawan Kummalue, Prasob-orn Rinthong, Somboon Kietinun, Kusuma Sriyakul. Study of the safety of oral Triphala aqueous extract on healthy volunteers. Journal of Integrative Medicine, 2020, 18(1): 35-40.
[5] Arthur Yin Fan, Hui Ouyang, Xinru Qian, Hui Wei, David Dehui Wang, Deguang He, Haihe Tian, Changzhen Gong, Amy Matecki, Sarah Faggert Alemi. Discussions on real-world acupuncture treatments for chronic low-back pain in older adults. Journal of Integrative Medicine, 2019, 17(2): 71-76.
[6] L. Elisabeth Burton, Fares Qeadan, Mark R. Burge. Efficacy of equine-assisted psychotherapy in veterans with posttraumatic stress disorder. Journal of Integrative Medicine, 2019, 17(1): 14-19.
[7] Ubiratan Cardinalli Adler, Ana Carolina Acorinte, Fernando Oliveira Calzavara, Adriano Andréda Silva, Amarilys de Toledo Cesar, Maristela Schiabel Adler, Edson Zangiacomi Martinez, José Carlos Fernandes Galduróz. Double-blind evaluation of homeopathy on cocaine craving: A randomized controlled pilot study. Journal of Integrative Medicine, 2018, 16(3): 178-184.
[8] Shahnaz Karkon Varnosfaderani, Fataneh Hashem-Dabaghian, Gholamreza Amin, Mahbubeh Bozorgi, Ghazaleh Heydarirad, Esmaeil Nazem, Mohsen Nasiri Toosi, Seyed Hamdollah Mosavat. Efficacy and safety of Amla (Phyllanthus emblica L.) in non-erosive reflux disease: A double-blind, randomized, placebo-controlled clinical trial. Journal of Integrative Medicine, 2018, 16(2): 126-131.
[9] Susana Seca, Sebastian Kirch, António S.Cabrita, Henry J.Greten. Evaluation of the effect of acupuncture on hand pain, functional deficits and health-related quality of life in patients with rheumatoid arthritis—A study protocol for a multicenter, double-blind, randomized clinical trial. Journal of Integrative Medicine, 2016, 14(3): 219-227.
[10] Arthur Yin Fan. The methodology flaws in Hinman’s acupuncture clinical trial, Part III: Sample size calculation. Journal of Integrative Medicine, 2015, 13(4): 209-211.
[11] Arthur Yin Fan. The methodology flaws in Hinman’s acupuncture clinical trial, Part II: Zelen design and effectiveness dilutions. Journal of Integrative Medicine, 2015, 13(3): 136-139.
[12] Arthur Yin Fan. The methodology flaws in Hinman’s acupuncture clinical trial, Part I: Design and results interpretation. Journal of Integrative Medicine, 2015, 13(2): 65-68.
[13] Samrat Ghosh, Sourav Sikdar, Avinaba Mukherjee, Anisur Rahman Khuda-Bukhsh. Evaluation of chemopreventive potentials of ethanolic extract of Ruta graveolens against A375 skin melanoma cells in vitro and induced skin cancer in mice in vivo. Journal of Integrative Medicine, 2015, 13(1): 34-44.
[14] Vamsi Reddy, Arvind Sridhar, Roberto F. Machado, Jiwang Chen. High sodium causes hypertension: Evidence from clinical trials and animal experiments. Journal of Integrative Medicine, 2015, 13(1): 1-8.
[15] Arndt Büssing, Ariane von Bergh, Xiao-feng Zhai, Chang-quan Ling. Interpretation of illness in patients with chronic diseases from Shanghai and their associations with life satisfaction, escape from illness, and ability to reflect the implications of illness. Journal of Integrative Medicine, 2014, 12(5): 409-416.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
[1] Wei-xiong Liang. Problems-solving strategies in clinical treatment guideline for traditional Chinese medicine and integrative medicine. Journal of Chinese Integrative Medicine, 2008, 6(1): 1-4
[2] Zhao-guo Li. Discussion on English translation of commonly used sentences in traditional Chinese medicine: part one. Journal of Chinese Integrative Medicine, 2008, 6(1): 107-110
[3] Jun Hu, Jian-ping Liu. Non-invasive physical treatments for chronic/recurrent headache. Journal of Chinese Integrative Medicine, 2008, 6(1): 31
[4] Xue-mei Liu, Qi-fu Huang, Yun-ling Zhang, Jin-li Lou, Hong-sheng Liu, Hong Zheng. Effects of Tribulus terrestris L. saponion on apoptosis of cortical neurons induced by hypoxia-reoxygenation in rats. Journal of Chinese Integrative Medicine, 2008, 6(1): 45-50
[5] . Uniform requirements for manuscripts submitted to biomedical journals: Writing and editing for biomedical publication (Chinese version, part two). Journal of Chinese Integrative Medicine, 2010, 8(11): 1001-1005
[6] Daniel Weber, Janelle M Wheat, Geoffrey M Currie. Inflammation and cancer: Tumor initiation, progression and metastasis,and Chinese botanical medicines. Journal of Chinese Integrative Medicine, 2010, 8(11): 1006-1013
[7] Hong Liu , Guo-liang Zhang, Li Shen , Zhen Zeng, Bao-luo Zhou, Cheng-hai Liu, Guang Nie . Application and evaluation of a pseudotyped virus assay for screening herbs for anti-H5Nl avian influenza virus. Journal of Chinese Integrative Medicine, 2010, 8(11): 1036-1040
[8] Zhao-guo Li . A discussion of English translation of 1995 and 1997 Chinese National Standards of Traditional Chinese Medical Terminologies for Clinical Diagnosis and Treatment. Journal of Chinese Integrative Medicine, 2010, 8(11): 1090-1096
[9] Rui Jin, Bing Zhang. A complexity analysis of Chinese herbal property theory: the multiple formations of herbal property (Part 1). Journal of Chinese Integrative Medicine, 2012, 10(11): 1198-1205
[10] Hui-min Liu, Xian-bo Wang, Yu-juan Chang, Li-li Gu. Systematic review and meta-analysis of randomized controlled trials of integrative medicine therapy for treatment of chronic severe hepatitis. Journal of Chinese Integrative Medicine, 2012, 10(11): 1211-1228