Skip to main content
Top
Published in: Journal of Anesthesia 1/2012

01-02-2012 | Original Article

Passiflora incarnata Linneaus as an anxiolytic before spinal anesthesia

Authors: Pınar Aslanargun, Ozgun Cuvas, Bayazit Dikmen, Eymen Aslan, Mustafa Ugur Yuksel

Published in: Journal of Anesthesia | Issue 1/2012

Login to get access

Abstract

Purpose

Patients who undergo regional anesthesia experience anxiety in the preoperative period. Passiflora incarnata Linneaus is a plant that has traditionally been used as an anxiolytic and sedative. We aimed to investigate the effect of preoperative oral administration of Passiflora incarnata Linneaus on anxiety, psychomotor functions, sedation, and hemodynamics in patients undergoing spinal anesthesia.

Methods

Under local ethics committee approval, 60 patients who were aged 25–55 years and ASAI–II and who were scheduled for spinal anesthesia were enrolled in this prospective, randomized, double-blind and placebo-controlled study. Thirty minutes before spinal anesthesia, baseline hemodynamic parameters, State-Trait Anxiety Inventory (STAI) score, sedation score, and psychomotor function test results were measured, then patients were randomly assigned to two groups: oral Passiflora incarnata Linneaus extract or placebo was given to the patients. Tests were repeated just before spinal anesthesia. Hemodynamics, sedation score, sensory-motor block and side effects were assessed during the operation. Psychomotor function tests were repeated at the end of the operation and 60 min after the operation.

Results

There was a statistically significant difference between the two groups for the increase in State Anxiety Inventory (STAI-S) score obtained just before spinal anesthesia when compared to the baseline. There was no statistically significant difference in psychomotor function from the baseline for either group. A significant difference was not found between the two groups in demographics, psychomotor function, sedation score, hemodynamics, and side effects.

Conclusion

Oral preoperative administration of Passiflora incarnata Linneaus suppresses the increase in anxiety before spinal anesthesia without changing psychomotor function test results, sedation level, or hemodynamics.
Literature
1.
go back to reference Höhener D, Blumenthal S, Borgeat A. Sedation and regional anaesthesia in the adult patient. Br J Anaesth. 2008;100:8–16.CrossRefPubMed Höhener D, Blumenthal S, Borgeat A. Sedation and regional anaesthesia in the adult patient. Br J Anaesth. 2008;100:8–16.CrossRefPubMed
2.
go back to reference Dhawan K, Kumar S, Sharma A. Anti-anxiety studies on extracts of Passiflora incarnata Linneaus. J Ethnopharm. 2001;78:165–70.CrossRef Dhawan K, Kumar S, Sharma A. Anti-anxiety studies on extracts of Passiflora incarnata Linneaus. J Ethnopharm. 2001;78:165–70.CrossRef
3.
go back to reference Mills S, Bone K (eds). Principles and practice of phytotherapy. Edinburgh: Churchill Livingstone; 2000. p. 232–3. Mills S, Bone K (eds). Principles and practice of phytotherapy. Edinburgh: Churchill Livingstone; 2000. p. 232–3.
4.
go back to reference Sopranzi N, DeFeo G, Mazzanti G, Tolu L. Biological and electroencephalographic parameters in rats in relation to Passiflora incarnata. Clin Ter. 1990;132:329–33.PubMed Sopranzi N, DeFeo G, Mazzanti G, Tolu L. Biological and electroencephalographic parameters in rats in relation to Passiflora incarnata. Clin Ter. 1990;132:329–33.PubMed
5.
go back to reference Akhondzadeh S, Naghavi HR, Vazirian M, Shayeganpour A, Rashidi H, Khani M. Passionflower in the treatment of generalized anxiety: a pilot double-blind randomized controlled trials with oxazepam. J Clin Pharm Ther. 2001;26:363–7.CrossRefPubMed Akhondzadeh S, Naghavi HR, Vazirian M, Shayeganpour A, Rashidi H, Khani M. Passionflower in the treatment of generalized anxiety: a pilot double-blind randomized controlled trials with oxazepam. J Clin Pharm Ther. 2001;26:363–7.CrossRefPubMed
6.
go back to reference Soulimani R, Younus C, Jarmouni S, Bousta D, Misslin R, Mortier F. Behavioral effects of Passiflora incarnata L. and its indole alkaloid and flavonoid derivatives and maltol in the mouse. J Ethnopharmacol. 1997;57:11–20.CrossRefPubMed Soulimani R, Younus C, Jarmouni S, Bousta D, Misslin R, Mortier F. Behavioral effects of Passiflora incarnata L. and its indole alkaloid and flavonoid derivatives and maltol in the mouse. J Ethnopharmacol. 1997;57:11–20.CrossRefPubMed
7.
go back to reference Grundmann O, Wahling C, Staiger C, Butterweck V. Anxiolytic effects of a passion flower (Passiflora incarnata L.) extract in the elevated plus maze in mice. Pharmazie. 2009;64:63–4.PubMed Grundmann O, Wahling C, Staiger C, Butterweck V. Anxiolytic effects of a passion flower (Passiflora incarnata L.) extract in the elevated plus maze in mice. Pharmazie. 2009;64:63–4.PubMed
8.
go back to reference Movafegh A, Alizadeh R, Hajimohamadi F, Esfahani F, Nejatfar M. Preoperative oral Passiflora incarnata reduces anxiety in ambulatory surgery patients: a double-blind, placebo-controlled study. Anesth Analg. 2008;106:1728–32.CrossRefPubMed Movafegh A, Alizadeh R, Hajimohamadi F, Esfahani F, Nejatfar M. Preoperative oral Passiflora incarnata reduces anxiety in ambulatory surgery patients: a double-blind, placebo-controlled study. Anesth Analg. 2008;106:1728–32.CrossRefPubMed
9.
go back to reference Grundmann O, Wang J, McGregor GP, Butterweck V. Anxiolytic activity of a phytochemically characterized Passiflora incarnata extract is mediated via the GABAergic system. Planta Med. 2008;74:1769–73.CrossRefPubMed Grundmann O, Wang J, McGregor GP, Butterweck V. Anxiolytic activity of a phytochemically characterized Passiflora incarnata extract is mediated via the GABAergic system. Planta Med. 2008;74:1769–73.CrossRefPubMed
10.
go back to reference Miyasaka LS, Atallah AN, Soares BG. Passiflora for anxiety disorder. Cochrane Database Syst Rev. 2007;24:CD004518. Miyasaka LS, Atallah AN, Soares BG. Passiflora for anxiety disorder. Cochrane Database Syst Rev. 2007;24:CD004518.
11.
go back to reference Ersnst E. Herbal remedies for anxiety—a systematic review of controlled clinical trials. Phytomedicine. 2006;13:205–8. Ersnst E. Herbal remedies for anxiety—a systematic review of controlled clinical trials. Phytomedicine. 2006;13:205–8.
12.
go back to reference Spielberger CD. Manuel for the State-Trait Anxiety Inventory (Form Y). Palo Alto: Consulting Psychologists Press Inc.; 1983. Spielberger CD. Manuel for the State-Trait Anxiety Inventory (Form Y). Palo Alto: Consulting Psychologists Press Inc.; 1983.
13.
go back to reference Goyal N, Ramakrishna B, Bhandarkar S. A comparative evaluation of the characteristics of recovery from anaesthesia with isoflurane and halothane in day-care surgery. Indian J Anaesth. 2006;50:183–6. Goyal N, Ramakrishna B, Bhandarkar S. A comparative evaluation of the characteristics of recovery from anaesthesia with isoflurane and halothane in day-care surgery. Indian J Anaesth. 2006;50:183–6.
14.
go back to reference Caumo W, Schmidt AP, Schneider CN, Bergmann J, Iwamoto CW, Bandeira D, Ferreira MBC. Risk factors for preoperative anxiety in adults. Acta Anaesthesiol Scand. 2001;45:298–307.CrossRefPubMed Caumo W, Schmidt AP, Schneider CN, Bergmann J, Iwamoto CW, Bandeira D, Ferreira MBC. Risk factors for preoperative anxiety in adults. Acta Anaesthesiol Scand. 2001;45:298–307.CrossRefPubMed
15.
go back to reference Cravotta G, Boffa L, Genzini L, Garella D. Phytotherapeutics: an evaluation of the potential of 1000 plants. J Clin Pharm Ther. 2010;35:11–48.CrossRef Cravotta G, Boffa L, Genzini L, Garella D. Phytotherapeutics: an evaluation of the potential of 1000 plants. J Clin Pharm Ther. 2010;35:11–48.CrossRef
16.
go back to reference Wolfman C, Viola H, Paladini A, Dajas F, Medina JH. Possible anxiolytic effects of chrysin, a central benzodiazepine receptor ligand isolated from Passiflora caerulea. Pharmacol Biochem Behav. 1994;47:1–4.CrossRefPubMed Wolfman C, Viola H, Paladini A, Dajas F, Medina JH. Possible anxiolytic effects of chrysin, a central benzodiazepine receptor ligand isolated from Passiflora caerulea. Pharmacol Biochem Behav. 1994;47:1–4.CrossRefPubMed
17.
go back to reference Loli F, Sato CM, Romanini CV, Viaggi Billas-Boas LD, Moraes Santos CA, de Oliveira RMW. Possible involvement of GABAA-benzodiazepine receptor in the anxiolytic-like effect induced by Passiflora actinia extracts in mice. J Ethnopharmacol. 2007;111:308–14. Loli F, Sato CM, Romanini CV, Viaggi Billas-Boas LD, Moraes Santos CA, de Oliveira RMW. Possible involvement of GABAA-benzodiazepine receptor in the anxiolytic-like effect induced by Passiflora actinia extracts in mice. J Ethnopharmacol. 2007;111:308–14.
18.
go back to reference Wohlmuth H, Penman KG, Pearson T, Lehmann RP. Pharmacognosy and chemotypes of passionflower (Passiflora incarnata L.). Biol Pharm Bull. 2010;33:1015–8.CrossRefPubMed Wohlmuth H, Penman KG, Pearson T, Lehmann RP. Pharmacognosy and chemotypes of passionflower (Passiflora incarnata L.). Biol Pharm Bull. 2010;33:1015–8.CrossRefPubMed
19.
go back to reference Blumenthal M. The Complete German Commission E Monographs. Therapeutic guide to herbal medicines. Austin: American Botanical Council; 1998. Blumenthal M. The Complete German Commission E Monographs. Therapeutic guide to herbal medicines. Austin: American Botanical Council; 1998.
20.
go back to reference Gentili M, Chau Huu P, Enel D, Hollande J, Bonnet F. Sedation depends on the level of sensory block induced by spinal anaesthesia. Br J Anaesth. 1998;81:970–1.CrossRefPubMed Gentili M, Chau Huu P, Enel D, Hollande J, Bonnet F. Sedation depends on the level of sensory block induced by spinal anaesthesia. Br J Anaesth. 1998;81:970–1.CrossRefPubMed
21.
go back to reference Smith GW, Chalmers TM, Nuki G. Vasculitis associated with herbal preparation containing Passiflora extract. Br J Rheumatol. 1993;32:87–8.CrossRefPubMed Smith GW, Chalmers TM, Nuki G. Vasculitis associated with herbal preparation containing Passiflora extract. Br J Rheumatol. 1993;32:87–8.CrossRefPubMed
22.
go back to reference Fisher AA, Purcell P, Le Couteur DG. Toxicity of Passiflora incarnata L. J Toxicol Clin Toxicol. 2000;38:63–6. Fisher AA, Purcell P, Le Couteur DG. Toxicity of Passiflora incarnata L. J Toxicol Clin Toxicol. 2000;38:63–6.
23.
go back to reference Pierre S, Crosbie L, Duttaroy AK. Inhibitory effect of aqueous extracts of some herbs on human platelet aggregation in vitro. Platelets. 2005;16:469–73.CrossRefPubMed Pierre S, Crosbie L, Duttaroy AK. Inhibitory effect of aqueous extracts of some herbs on human platelet aggregation in vitro. Platelets. 2005;16:469–73.CrossRefPubMed
Metadata
Title
Passiflora incarnata Linneaus as an anxiolytic before spinal anesthesia
Authors
Pınar Aslanargun
Ozgun Cuvas
Bayazit Dikmen
Eymen Aslan
Mustafa Ugur Yuksel
Publication date
01-02-2012
Publisher
Springer Japan
Published in
Journal of Anesthesia / Issue 1/2012
Print ISSN: 0913-8668
Electronic ISSN: 1438-8359
DOI
https://doi.org/10.1007/s00540-011-1265-6

Other articles of this Issue 1/2012

Journal of Anesthesia 1/2012 Go to the issue