Comparison of the effect of deep breathing with and without rosemary on pain, sleep quality and hemodynamic indicators during and after upper limb orthopedic surgery

Determining the effect of deep breathing with and without rosemary on pain, sleep quality and hemodynamic indicators during and after orthopedic surgery of the upper limb in reference to 17 Shahrivar Amol Hospital in 2023

It is a three-arm parallel randomized clinical trial with a sample size of 102 people in a continuous, accessible and random allocation manner.

In the hospital on 17th Shahrivar Amol, the breathing group with and without rosemary will perform deep breathing 12 times in the morning and 12 times in the evening for 7 days. The insert envelope and the type of intervention or control are specified inside the envelope.

Admission: over 18 years old, ability to read and write and communicate in Persian language; presence of any fractures and tears in the upper limbs (surgery time 30 minutes to 3 hours); full alertness; not suffering from respiratory diseases such as asthma, bronchitis and emphysema, not smoking; no pregnancy and breastfeeding; no allergy to rosemary; ASA1 and ASA2 anesthesia class one and two. Withdrawal: refusal to continue the study; creating an unwanted cardio-respiratory complication during anesthesia and surgery; suffering from compartment syndrome.

Breathing group with rosemary while the necklace containing rosemary essential oil is poured on cotton and placed at a distance of 20 cm from the person's nose, deep breathing is done lying down and sitting. The deep breathing group without rosemary is similar to deep breathing with rosemary and only from Normal saline will be used and routine procedures will be performed and recorded in the control group

Pain at the operation site; pain at the tourniquet site; sleep quality; hemodynamic indices; awareness and recall of events during anesthesia

For this research, before the start of the study, after obtaining informed consent before the operation, the patients are referred continuously and available, and with the block randomization method, they are divided into three groups: deep breathing without rosemary (B), deep breathing with rosemary (R). , control (C) or routine will be assigned. The blocks of this study are 6 (BB, RR, CC) and 27 states will be created, first determine the possible states of these 6 letters inside the blocks and then randomly and using the table of random numbers number 17 from the block. which will be the completion of the number of samples will be determined (1-27) and in this way the type of intervention will be determined based on the desired letters with the number of each patient and will be kept in a master sheet and the continuous entry number of the patients will be inserted on the envelope respectively And the type of intervention or control is specified inside the envelope. Gradually, according to the presence of eligible patients, the relevant envelope is returned, and the type of intervention that is inside the non-transparent envelope is determined and the desired technique is performed.

In order to blind the patients, the same cotton necklace is used for all patients, although the cotton impregnated with rosemary essential oil contains perfume, an effort is made to ensure that there is no communication between the patients during the study period. And to blind the researchers, the opening of the envelope was done by the secretary of the department, who has no role in the evaluation of the groups, and the person who measures the variables is not aware of the type of intervention. Considering the different forms of providing services to the study groups, the behaviors in dealing with the three groups are tried to be similar in terms of having a cotton necklace dipped in rosemary oil or normal saline and without these items. However, it is not possible to completely blind due to the smell of rosemary.