Medicinal Plants for Postoperative Pain Management: Evidence from Animal, Preclinical Models and Clinical Studies
Resumo
Postoperative pain is a common and challenging complication that adversely affects patients' quality of life. Medicinal plants, due to their analgesic and anti-inflammatory properties, have gained attention as complementary approaches for pain management. This systematic review aimed to identify medicinal plants effective in alleviating postoperative pain, summarize preclinical evidence of their effects, explore underlying analgesic mechanisms, and compare traditional and modern medicine contributions. A comprehensive search was conducted in MagIran, Google Scholar, PubMed, SID, and Scopus using keywords such as “medicinal plants,” “pain,” and “surgery.” The review identified several plants, including Mentha piperita, Oenothera biennis, Borago officinalis, Foeniculum vulgare, Brassica nigra, Cuminum cyminum, Nigella sativa, Trigonella foenum-graecum, Lavandula angustifolia, Curcuma longa, Hypericum perforatum, Ananas comosus, Melissa officinalis, Matricaria chamomilla, Glycyrrhiza glabra, Colchicum autumnale, Juniperus communis, Ocimum basilicum, and Syzygium aromaticum, with notable efficacy reported for S. aromaticum in traditional Iranian medicine. Both traditional knowledge and clinical evidence suggest that these plants may serve as complementary strategies to manage postoperative pain. However, clinical findings remain limited and heterogeneous. Integrating historical medicinal practices with rigorous clinical research is essential to establish safe, effective, and evidence-based therapies that enhance postoperative recovery and improve patient outcomes.
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NASIRI AA, AFSARGHAREHBAGH R, SANE S, NEISARI R, SHARGH A. Treatment of intractable hiccups using phrenic nerve block. Journal of Clinical Anesthesia. 2019 Mar 2; 57:7-8.
BABAEI G, ALIARAB A, ASGHARI VOSTAKOLAEI M, HOTELCHI M, NEISARI R, GHOLIZADEH-GHALEH AZIZ S, BAZL MR. Crosslink between p53 and metastasis: focus on epithelial–mesenchymal transition, cancer stem cell, angiogenesis, autophagy, and anoikis. Molecular biology reports. 2021 Nov;48(11):7545-57.
KOLETTAS A, LAZARIDIS G, BAKA S, MPOUKOVINAS I, KARAVASILIS V, KIOUMIS I, et al. Postoperative pain management. J Thorac Dis. 2015 Feb;7(Suppl 1): 62–72. doi: 10.3978/j.issn.2072-1439.2015.01.15.
RAWAL N. Current issues in postoperative pain management. Eur J Anaesthesiol. 2016 Mar;33(3):160–71.
BONNET F, MARRET E. Postoperative pain management and outcome after surgery. Best Pract Res Clin Anaesthesiol. 2007 Mar;21(1):99–107. doi: 10.1016/j.bpa.2006.12.007.
VADIVELU N, MITRA S, NARAYAN D. Recent advances in postoperative pain management. Yale J Biol Med. 2010 Mar;83(1):11–25.
SINATRA RS, TORRES J, BUSTOS AM. Pain management after major orthopaedic surgery: current strategies and new concepts. J Am Acad Orthop Surg. 2002 Mar;10(2):117–29. doi: 10.5435/00124635-200203000-00007.
SAIDI R, HEIDARI H, SEDEHI M, SAFDARIAN B. Evaluating the effect of Matricaria chamomilla and Melissa officinalis on pain intensity and satisfaction with pain management in patients after orthopedic surgery. J Herbmed Pharmacol. 2020 Jul;9(4):339–45. doi: 10.34172/jhp.2020.43.
ANG-LEE MK, MOSS J, YUAN CS. Herbal medicines and perioperative care. JAMA. 2001 Jul 11;286(2):208–16. doi: 10.1001/jama.286.2.208.
PANCHE AN, DIWAN AD, CHANDRA SR. Flavonoids: an overview. J Nutr Sci. 2016 Jan;5: 47. doi: 10.1017/jns.2016.41.
MAROON JC, BOST JW, MAROON A. Natural anti-inflammatory agents for pain relief. Surg Neurol Int. 2010 Dec 13;1:80. doi: 10.4103/2152-7806.73804.
SILVA-CORREA CR, CAMPOS-REYNA JL, VILLARREAL-LA TORRE VE, CALDERÓN-PEÑA AA, BLAS MV, ASPAJO-VILLALAZ CL, et al. Potential activity of medicinal plants as pain modulators: a review. Pharmacogn J. 2021;13(1):1–12. doi:10.5530/pj.2021.13.35.
AROME D, SUNDAY AI, ONALIKE EI, AMARACHI A. Pain and inflammation: management by conventional and herbal therapy. Indian J Pain. 2014 Jan 1;28(1):5–12. doi:10.4103/0970-5333.128879.
YATOO MI, GOPALAKRISHNAN A, SAXENA A, PARRAY OR, TUFANI NA, CHAKRABORTY S, et al. Anti-inflammatory drugs and herbs with special emphasis on herbal medicines for countering inflammatory diseases and disorders: a review. Recent Pat Inflamm Allergy Drug Discov. 2018 May 1;12(1):39–58. doi: 10.2174/1872213X12666180115153635.
MALAIRAJAN P, GOPALAKRISHNAN G, NARASIMHAN S, VENI KJ. Analgesic activity of some Indian medicinal plants. J Ethnopharmacol. 2006 Jul 19;106(3):425–8. doi: 10.1016/j.jep.2006.03.015.
SINGH A, MALHOTRA S, SUBBAN R. Anti-inflammatory and analgesic agents from Indian medicinal plants. International Journal of Integrative Biology.. 2008;3(1):57–72.]
CALIXTO JB, SCHEIDT C, OTUKI M, SANTOS AR. Biological activity of plant extracts: novel analgesic drugs. Expert Opin Emerg Drugs. 2001 Oct 1;6(2):261–79. doi: 10.1517/14728214.6.2.261.
ROBERTS M, BRODRIBB W, MITCHELL G. Reducing the pain: a systematic review of postdischarge analgesia following elective orthopedic surgery. Pain Med. 2012 May 1;13(5):711–27.
NIAZI A, MORADI M, ASKARI VR, SHARIFI N. Effect of complementary medicine on pain relief and wound healing after cesarean section: a systematic review. J Pharmacopuncture. 2021 Jun 30;24(2):41–8.
SHEN CY, JIANG JG, YANG L, WANG DW, ZHU W. Anti-ageing active ingredients from herbs and nutraceuticals used in traditional Chinese medicine: pharmacological mechanisms and implications for drug discovery. Br J Pharmacol. 2017 Jun;174(11):1395–425.
LIU Y, WENG W, GAO R, LIU Y. New insights for cellular and molecular mechanisms of aging and aging-related diseases: herbal medicine as potential therapeutic approach. Oxid Med Cell Longev. 2019; 2019:4598167.
AVICENNA. The Canon of Medicine (Al-Qanun fi al-Tibb). Beirut: Alamy Le-Al-Matbooat; 2005.
AGHILI KHORASANI MH. Makhzan al-Adwiah (Treasure of Medicaments). Tehran: Tehran University Press; 2008.
RAZI AB. AL-HAWI FI AL-TIBB (Comprehensive Book on Medicine). Beirut: Dar Al-Kutub Al-Ilmiyah; 2004.
GHAFOURI ZADEH R. Iranian Traditional Medicine and Medicinal Plants. Tehran: Iranian Traditional Medicine Publishing; 2012.
MOZAFFARIAN V. A Dictionary of Iranian Plant Names: Latin, English, Persian. Tehran: Farhang Moaser; 1996.
SAPUTRO RA, SUANDIKA M, SUKMANINGTYAS W. The effect of peppermint aromatherapy (Mentha piperita leaf) on reducing post-dural puncture headache pain in post-spinal anesthesia patients. Java Nurs J. 2025 Feb 28;3(1):99–106.
SHARIFI M, NOURANI N, SANAIE S, HAMEDEYAZDAN S. The effect of Oenothera biennis (Evening primrose) oil on inflammatory diseases: a systematic review of clinical trials. BMC Complement Med Ther. 2024 Feb 15;24(1):89. doi: 10.1186/s12906-024-04378-5.
NALIATO E. Clinical assessment of treatment outcomes following Borago officinalis extract therapy in patients presenting with cyclical mastalgia. Int J Clin Med. 2015 Jan 1. doi:10.4236/ijcm.2015.66047.
IMRAN A, XIAO L, AHMAD W, ANWAR H, RASUL A, IMRAN M, et al. Foeniculum vulgare (Fennel) promotes functional recovery and ameliorates oxidative stress following a lesion to the sciatic nerve in mouse model. J Food Biochem. 2019 Sep;43(9): 12983. doi: 10.1111/jfbc.12983.
AMIN EA, ISMAIL E, MAHBOOBEH R, TABANDEH S. The effect of Cuminum cyminum on the return of bowel motility after abdominal surgery: a triple-blind randomized clinical trial. BMC Complement Med Ther. 2024 Jul 4;24(1):254.
Sahbaz A, Ersan F, Aydin S. Effect of Nigella sativa oil on postoperative peritoneal adhesion formation. J Obstet Gynaecol Res. 2014 Feb;40(2):532–7. doi: 10.1111/jog.12172
Nazari SE, Khalili-Tanha N, Mehrabadi S, Mobasheri L, Naimi H, Khojasteh-Leylakoohi F, et al. The effects of Trigonella foenum-graecum L. on post-surgical adhesion band formation. Lett Drug Des Discov. 2024 Jun 1;21(8):1400–5. doi:10.2174/1570180820666230417100810.
DALE A, CORNWELL S. The role of lavender oil in relieving perineal discomfort following childbirth: a blind randomized trial. J Adv Nurs. 2006;19(1):89–96. doi: 10.1111/j.1365-2648. 1994. tb01056.x.
VAKILIAN K, ATARHA M, BEKHRADI R. Effect of lavender essential oil on relieving of episiotomy after delivery. J Babol Univ Med Sci. 2008;11(4):25–30. doi: 10.1016/j.ctcp.2010.05.006.
PULOK K, SURESH B. The evaluation of wound healing potential of Hypericum hookerianum leaf and stem extracts. J Complement Med. 2000;6(1):61–9. doi: 10.1089/acm.2000.6.61.
EVANS WC. Trease and Evans Pharmacognosy. 15th ed. New York: W.B. Saunders; 2002. p.418.
GOLEZAR S, ABASPOOR Z. Effect of oral bromelain on pain severity after episiotomy in primiparous women [master’s thesis]. Ahvaz: Ahvaz Medical University; 2009.
SAIDI R, HEIDARI H, SEDEHI M, SAFDARIAN B. Evaluating the effect of Matricaria chamomilla and Melissa officinalis on pain intensity and satisfaction with pain management in patients after orthopedic surgery. J Herbmed Pharmacol. 2020 Jul;9(4):339–45. doi: 10.34172/jhp.2020.43
BAKKER CJ, WISE KL, WILLIAMS BR, Swiontkowski MF. Complementary and alternative medicine for postoperative pain: a systematic review. JBJS. 2020 May 20;102 (Suppl 1):36–46. doi: 10.2106/JBJS.19.01439.
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