Naturopatinin Cerrahi Bakımda Kullanımı
Özet
Bu bölüm, cerrahi bakım sürecinde naturopatik (doğal ve tamamlayıcı) uygulamaların kullanımını, etkilerini ve güvenlik boyutunu incelemektedir. Geleneksel ve tamamlayıcı tıp uygulamalarının cerrahi hastalarda kullanım oranlarının giderek arttığı, özellikle ameliyat öncesi dönemde hastaların çoğunun kullandığı bitkisel ürünleri sağlık ekibiyle paylaşmadığı vurgulanmaktadır. Ameliyat öncesi dönemde bazı bitkisel takviyelerin kanama riski, anestezik metabolizma veya yara iyileşmesi üzerinde olumsuz etkiler yaratabileceği belirtilmektedir. Ameliyat sırası ve sonrası dönemlerde ise akupunktur, aromaterapi, müzik terapisi ve masaj gibi naturopatik yaklaşımların anksiyete, ağrı ve stres düzeylerini azalttığı gösterilmiştir. Bununla birlikte, mevcut bilimsel kanıtların çoğunun düşük veya orta düzeyde olduğu ve daha güçlü klinik çalışmalara gereksinim duyulduğu ifade edilmektedir. Sonuç olarak, cerrahi hemşirelerinin bitkisel ve naturopatik uygulamalara ilişkin bilgi düzeyini artırması, hasta güvenliği, bireyselleştirilmiş bakım ve bütüncül yaklaşım açısından kritik öneme sahiptir.
This study examines the use, effects, and safety of naturopathic and complementary therapies in surgical care. Traditional and complementary medical practices are increasingly used among surgical patients, particularly during the preoperative period, though most patients do not disclose their use of herbal products to healthcare providers. Certain herbal supplements may negatively affect coagulation, anesthetic metabolism, or wound healing. During intraoperative and postoperative phases, naturopathic approaches such as acupuncture, aromatherapy, music therapy, and massage have been shown to reduce anxiety, pain, and stress levels. However, the scientific evidence supporting these practices remains limited, with most studies rated as low or moderate quality. More rigorous clinical research is required to establish their efficacy and safety. Overall, increasing nurses’ knowledge and awareness of herbal and naturopathic applications is essential to ensure patient safety, enhance individualized care, and promote a holistic approach within surgical nursing practice.
Referanslar
World Health Organization (WHO). Traditional medicine strategy 2014-2023. Available from: https://iris.who.int/server/api/core/bitstreams/16362a42-6583-4601-a7da-d0ed6bc39108/content (Accessed 3rd March 2025).
World Naturopathic Federation (WNF). WNF white paper: Naturopathic philosophies, principles and theories 2017. Available from: https://worldnaturopathicfederation.org/wp-content/uploads/2025/06/WNF-White-Paper-Naturopathic-Philosophies-Principles-and-Theories.pdf (Accessed 3rd March 2025).
Drake DF, Norman DK. Whole medical systems the rehabilitation setting (traditional Chinese medicine, ayurvedic medicine, homeopathy, naturopathy). Physical Medicine and Rehabilitation Clinics of North America. 2020; 31(4): 553-561. doi: 10.1016/j.pmr.2020.07.009
Ericksen-Pereira WG, Roman NV, Swart R. An overview of the history and development of naturopathy in South Africa. Health SA Gesondheid. 2018; 23:1078. doi:10.4102/hsag.v23i0.1078
Steel A, Foley H, Bradley R, et al. Overview of international naturopathic practice and patient characteristics: Results from a cross-sectional study in 14 countries. BMC Complementary Medicine and Therapies. 2020;20 (1): 1-12. doi: 10.1186/s12906-020-2851-7
Goswami S, Bakshi UG. Understanding classical naturopathy: The Hippocratic way of healing. In: Sharma AK, Keservani RK, Gautam SP (eds.) Herbal product development. USA: Apple Academic Press; 2020. p.293-320.
Cayleff SE. Nature's path: A history of naturopathic healing in America. USA: JHU Press; 2016.
Pizzorno JE, Snider P, Katzinger J. Naturopathic medicine. In: Micozzi MD. Marc S. (eds.) Fundamentals of complementary and integrative medicine. 3rd ed. USA: Saunders; 2006. p. 292–321.
Kohli M, Kohli G. Understanding of naturopathy. International Journal of Nursing Education and Research. 2014;2(2):135–139.
Fleming SA, Gutknecht NC. Naturopathy and the primary care practice. Primary Care: Clinics in Office Practice. 2010;37(1):119–136. doi: 10.1016/j.pop.2009.09.002
Singh S. The importance of naturopathy in modern times. International Journal of Research & Technology. 2025;13(3):305–321.
Hakami N. Integrating complementary and alternative medicine in surgical care: A narrative review. Medicine. 2024;103(41) :e40117. doi:10.1097/MD.0000000000040117
Lederer AK, Schmucker C, Kousoulas L, et al. Naturopathic treatment and complementary medicine in surgical practice. Deutsches Ärzteblatt International. 2018;7;115(49):815-821. doi:10.3238/arztebl.2018.0815
Soós SÁ, Jeszenoi N, Darvas K, et al. Nem konvencionális gyógymódok használata sebészeti betegek között. Orv Hetil. 2016;157:1483–1488. doi: 10.1556/650.2016.30543
Diller ML, Master V. Integrative surgery: Embedding complementary and nonpharmacologic therapies into surgical pain management strategies. The American Surgeon. 2023;89(2):192–196. doi: 10.1177/00031348221110244
Barqawi A, Egbaria A, Omari A, et al. The use of complementary and alternative medicine among surgical patients: A cross-sectional study. Perioper Med. 2024;13(1):110. doi:10.1186/s13741-024-00468-7
Elvir Lazo OL, White PF, Lee C, et al. Use of herbal medication in the perioperative period: Potential adverse drug interactions. J Clin Anesth. 2024;95:111473. doi: 10.1016/j.jclinane.2024.111473.
Ivascu R, Torsin LI, Hostiuc L, et al. The surgical stress response and anesthesia: A narrative review. J Clin Med. 2024;13(10):3017. doi:10.3390/jcm13103017
Wei L, Zhang L, Zhang T, et al. Effect of intraoperative electroacupuncture on peripheral blood lymphocyte subsets in patients undergoing laparoscopic cholecystectomy: A randomized controlled trial. Acupuncture & Electro-Therapeutics Research: International Journal of Integrated Medicine. 2025;49(3):162-173. doi:10.1177/03601293251340752
Lee A, Fan LT. Stimulation of the wrist acupuncture point P6 for preventing postoperative nausea and vomiting. Cochrane Database Syst Rev. 2015;(11):CD003281. doi.org/10.1002/14651858.CD003281.pub4
Zhang W, Zhang M, Han Y, et al. Combined acupuncture–medicine anesthesia used in thyroid surgery: A systematic review and meta-analysis. Medicine. 2023;102(1):e32582. doi: 10.1097/MD.0000000000032582.
Tong QY, Liu R, Zhang K, et al. Can acupuncture therapy reduce preoperative anxiety? A systematic review and meta-analysis. Journal of Integrative Medicine. 2021;19(1):20–28. doi: 10.1016/j.joim.2020.10.007.
Tajbakhsh A, Salimi S, Daftarian N, et al. Effect of music during general anesthesia on anesthetic consumption during vitrectomy surgery. Adv Biomed Res. 2023;12(59):1-6. doi:10.4103/abr.abr_444_22
Koelsch S, Fuermetz J, Sack U, et al. Effects of music listening on cortisol levels and propofol consumption during spinal anesthesia. Front Psychol. 2011;2(58):1-9. doi: 10.3389/fpsyg.2011.00058.
Çalışır F, Urfalıoğlu A, Bilal B, et al. The effect of lavender aromatherapy on intraoperative anxiety in caesarean cases under spinal anesthesia: A randomized controlled trial. Explore (NY). 2023;19(3):356–361. doi:10.1016/j.explore.2022.11.008
Wu MS, Chen KH, Chen IF, et al. The efficacy of acupuncture in post-operative pain management: A systematic review and meta-analysis. PLoS One. 2016;11(3):1-12. doi: 10.1371/journal.pone.0150367.
Nouira M, Souayeh N, Kanzari SA, et al. Aromatherapy using lavender oil effectiveness on pain and anxiety after C-section: A randomized controlled trial. J Epidemiol Glob Health. 2024;14(4):1536–1544. doi:10.1007/s44197-024-00305-6
Ren Y, Xiang Y, Li Z, et al. Inhalation aromatherapy with lavender for postoperative pain management: A systematic review of randomized controlled trials. Pain Manag Nurs. 2025;26(5):e441-e447. doi: 10.1016/j.pmn.2025.03.005.
Fu VX, Oomens P, Sneiders D, et al. The effect of perioperative music on the stress response to surgery: A meta-analysis. J Surg Res. 2019;244:444–455. doi: 10.1016/j.jss.2019.06.052.
Göktuna G, Dağcan N, Gürol Arslan G. Kalp cerrahisi sonrası el refleksoloji masajının ağrı ve anksiyete üzerine etkisi: Çift kör, randomize, plasebo kontrollü bir çalışma. 6. Ulusal 2. Uluslararası Temel Hemşirelik Bakımı Kongresi. Türkiye. 15-17 Eylül 2022. p.112.
Rahbardar MG, Hosseinzadeh H. Therapeutic effects of rosemary (Rosmarinus officinalis L.) and its active constituents on nervous system disorders. Iran J Basic Med Sci. 2020;23(9):1100-1112. doi: 10.22038/ijbms.2020.45269.10541.
Lu C, Chen X, Yan X, et al. The preventive and relieving effects of ginger on postoperative nausea and vomiting: A systematic review and meta-analysis of randomized controlled trials. Int J Nurs Stud. 2022;125:104094. doi: 10.1016/j.ijnurstu.2021.104094.
Ha NY, Park MJ, Ko SJ, et al. Effect of herbal medicine on postoperative nausea and vomiting after laparoscopic surgery: A systematic review and meta-analysis. Medicine (Baltimore). 2024;7:103(23):1-18. doi: 10.1097/MD.0000000000038334.
Imani B, Alizade S, Khazaei S, et al. Effects of ginger and ondansetron on intra- and postoperative nausea and vomiting in cesarean section under spinal anesthesia: A double-blinded randomized clinical trial. J Herbmed Pharmacol. 2023;12(4):585–591. doi: 10.34172/jhp.2023.46050
Luo C, Zou L, Sun H, et al. A review of the anti-inflammatory effects of rosmarinic acid on inflammatory diseases. Front Pharmacol. 2020;11(153):1-10. doi:10.3389/fphar.2020.00153.
Daliu P. Managing preoperative use of herbal medications. Journal of Orthopedics;2024;16(2):87-94. doi: 10.69149/orthopedics/2024v16iss2_6.
Posadzki P, Watson L, Ernst E. Herb-drug interactions: An overview of systematic reviews. Br J Clin Pharmacol; 2013;75(3):603-618. doi: 10.1111/j.1365-2125.2012.04350.x.
American Society of Anesthesiologists (ASA). Herbal and dietary supplements and anesthesia: What you should know before surgery. Available from: https://madeforthismoment.asahq.org/wp-content/uploads/2020/10/ASA_Supplements-Anesthesia_Updated-1.pdf (Accessed 30 August 2025).
National Health and Medical Research Council (NHMRC). Natural therapies review: Naturopathy evidence evaluation. Government of Australia. Available from: https://www.health.gov.au/resources/publications/natural-therapies-review-2024-naturopathy-evidence-evaluation?language=en 2024 (Accessed 30 August 2025).
World Health Organization (WHO). Global report on traditional and complementary medicine. 2023. Available from: https://iris.who.int/server/api/core/bitstreams/f67507c0-30a3-41c0-b497-2fa9034b197d/content (Accessed 30 August 2025).
Myers SP, Vigar V. The state of the evidence for whole-system, multi-modality naturopathic medicine: A systematic scoping review. J Altern Complement Med. 2019;25(2):141-168. doi: 10.1089/acm.2018.0340
Bradt J, Dileo C, Shim M. Music interventions for preoperative anxiety. Cochrane Database Syst Rev. 2013;(6):CD006908. doi: 10.1002/14651858.CD006908.pub2.
Xie YH, Xie HT, Wang TS, et al.Perioperative holistic care reduces anxiety and depression compared with conventional care. Medicine (Baltimore), 2019;98(7),1-5. doi:10.1097/MD.0000000000014411
Referanslar
World Health Organization (WHO). Traditional medicine strategy 2014-2023. Available from: https://iris.who.int/server/api/core/bitstreams/16362a42-6583-4601-a7da-d0ed6bc39108/content (Accessed 3rd March 2025).
World Naturopathic Federation (WNF). WNF white paper: Naturopathic philosophies, principles and theories 2017. Available from: https://worldnaturopathicfederation.org/wp-content/uploads/2025/06/WNF-White-Paper-Naturopathic-Philosophies-Principles-and-Theories.pdf (Accessed 3rd March 2025).
Drake DF, Norman DK. Whole medical systems the rehabilitation setting (traditional Chinese medicine, ayurvedic medicine, homeopathy, naturopathy). Physical Medicine and Rehabilitation Clinics of North America. 2020; 31(4): 553-561. doi: 10.1016/j.pmr.2020.07.009
Ericksen-Pereira WG, Roman NV, Swart R. An overview of the history and development of naturopathy in South Africa. Health SA Gesondheid. 2018; 23:1078. doi:10.4102/hsag.v23i0.1078
Steel A, Foley H, Bradley R, et al. Overview of international naturopathic practice and patient characteristics: Results from a cross-sectional study in 14 countries. BMC Complementary Medicine and Therapies. 2020;20 (1): 1-12. doi: 10.1186/s12906-020-2851-7
Goswami S, Bakshi UG. Understanding classical naturopathy: The Hippocratic way of healing. In: Sharma AK, Keservani RK, Gautam SP (eds.) Herbal product development. USA: Apple Academic Press; 2020. p.293-320.
Cayleff SE. Nature's path: A history of naturopathic healing in America. USA: JHU Press; 2016.
Pizzorno JE, Snider P, Katzinger J. Naturopathic medicine. In: Micozzi MD. Marc S. (eds.) Fundamentals of complementary and integrative medicine. 3rd ed. USA: Saunders; 2006. p. 292–321.
Kohli M, Kohli G. Understanding of naturopathy. International Journal of Nursing Education and Research. 2014;2(2):135–139.
Fleming SA, Gutknecht NC. Naturopathy and the primary care practice. Primary Care: Clinics in Office Practice. 2010;37(1):119–136. doi: 10.1016/j.pop.2009.09.002
Singh S. The importance of naturopathy in modern times. International Journal of Research & Technology. 2025;13(3):305–321.
Hakami N. Integrating complementary and alternative medicine in surgical care: A narrative review. Medicine. 2024;103(41) :e40117. doi:10.1097/MD.0000000000040117
Lederer AK, Schmucker C, Kousoulas L, et al. Naturopathic treatment and complementary medicine in surgical practice. Deutsches Ärzteblatt International. 2018;7;115(49):815-821. doi:10.3238/arztebl.2018.0815
Soós SÁ, Jeszenoi N, Darvas K, et al. Nem konvencionális gyógymódok használata sebészeti betegek között. Orv Hetil. 2016;157:1483–1488. doi: 10.1556/650.2016.30543
Diller ML, Master V. Integrative surgery: Embedding complementary and nonpharmacologic therapies into surgical pain management strategies. The American Surgeon. 2023;89(2):192–196. doi: 10.1177/00031348221110244
Barqawi A, Egbaria A, Omari A, et al. The use of complementary and alternative medicine among surgical patients: A cross-sectional study. Perioper Med. 2024;13(1):110. doi:10.1186/s13741-024-00468-7
Elvir Lazo OL, White PF, Lee C, et al. Use of herbal medication in the perioperative period: Potential adverse drug interactions. J Clin Anesth. 2024;95:111473. doi: 10.1016/j.jclinane.2024.111473.
Ivascu R, Torsin LI, Hostiuc L, et al. The surgical stress response and anesthesia: A narrative review. J Clin Med. 2024;13(10):3017. doi:10.3390/jcm13103017
Wei L, Zhang L, Zhang T, et al. Effect of intraoperative electroacupuncture on peripheral blood lymphocyte subsets in patients undergoing laparoscopic cholecystectomy: A randomized controlled trial. Acupuncture & Electro-Therapeutics Research: International Journal of Integrated Medicine. 2025;49(3):162-173. doi:10.1177/03601293251340752
Lee A, Fan LT. Stimulation of the wrist acupuncture point P6 for preventing postoperative nausea and vomiting. Cochrane Database Syst Rev. 2015;(11):CD003281. doi.org/10.1002/14651858.CD003281.pub4
Zhang W, Zhang M, Han Y, et al. Combined acupuncture–medicine anesthesia used in thyroid surgery: A systematic review and meta-analysis. Medicine. 2023;102(1):e32582. doi: 10.1097/MD.0000000000032582.
Tong QY, Liu R, Zhang K, et al. Can acupuncture therapy reduce preoperative anxiety? A systematic review and meta-analysis. Journal of Integrative Medicine. 2021;19(1):20–28. doi: 10.1016/j.joim.2020.10.007.
Tajbakhsh A, Salimi S, Daftarian N, et al. Effect of music during general anesthesia on anesthetic consumption during vitrectomy surgery. Adv Biomed Res. 2023;12(59):1-6. doi:10.4103/abr.abr_444_22
Koelsch S, Fuermetz J, Sack U, et al. Effects of music listening on cortisol levels and propofol consumption during spinal anesthesia. Front Psychol. 2011;2(58):1-9. doi: 10.3389/fpsyg.2011.00058.
Çalışır F, Urfalıoğlu A, Bilal B, et al. The effect of lavender aromatherapy on intraoperative anxiety in caesarean cases under spinal anesthesia: A randomized controlled trial. Explore (NY). 2023;19(3):356–361. doi:10.1016/j.explore.2022.11.008
Wu MS, Chen KH, Chen IF, et al. The efficacy of acupuncture in post-operative pain management: A systematic review and meta-analysis. PLoS One. 2016;11(3):1-12. doi: 10.1371/journal.pone.0150367.
Nouira M, Souayeh N, Kanzari SA, et al. Aromatherapy using lavender oil effectiveness on pain and anxiety after C-section: A randomized controlled trial. J Epidemiol Glob Health. 2024;14(4):1536–1544. doi:10.1007/s44197-024-00305-6
Ren Y, Xiang Y, Li Z, et al. Inhalation aromatherapy with lavender for postoperative pain management: A systematic review of randomized controlled trials. Pain Manag Nurs. 2025;26(5):e441-e447. doi: 10.1016/j.pmn.2025.03.005.
Fu VX, Oomens P, Sneiders D, et al. The effect of perioperative music on the stress response to surgery: A meta-analysis. J Surg Res. 2019;244:444–455. doi: 10.1016/j.jss.2019.06.052.
Göktuna G, Dağcan N, Gürol Arslan G. Kalp cerrahisi sonrası el refleksoloji masajının ağrı ve anksiyete üzerine etkisi: Çift kör, randomize, plasebo kontrollü bir çalışma. 6. Ulusal 2. Uluslararası Temel Hemşirelik Bakımı Kongresi. Türkiye. 15-17 Eylül 2022. p.112.
Rahbardar MG, Hosseinzadeh H. Therapeutic effects of rosemary (Rosmarinus officinalis L.) and its active constituents on nervous system disorders. Iran J Basic Med Sci. 2020;23(9):1100-1112. doi: 10.22038/ijbms.2020.45269.10541.
Lu C, Chen X, Yan X, et al. The preventive and relieving effects of ginger on postoperative nausea and vomiting: A systematic review and meta-analysis of randomized controlled trials. Int J Nurs Stud. 2022;125:104094. doi: 10.1016/j.ijnurstu.2021.104094.
Ha NY, Park MJ, Ko SJ, et al. Effect of herbal medicine on postoperative nausea and vomiting after laparoscopic surgery: A systematic review and meta-analysis. Medicine (Baltimore). 2024;7:103(23):1-18. doi: 10.1097/MD.0000000000038334.
Imani B, Alizade S, Khazaei S, et al. Effects of ginger and ondansetron on intra- and postoperative nausea and vomiting in cesarean section under spinal anesthesia: A double-blinded randomized clinical trial. J Herbmed Pharmacol. 2023;12(4):585–591. doi: 10.34172/jhp.2023.46050
Luo C, Zou L, Sun H, et al. A review of the anti-inflammatory effects of rosmarinic acid on inflammatory diseases. Front Pharmacol. 2020;11(153):1-10. doi:10.3389/fphar.2020.00153.
Daliu P. Managing preoperative use of herbal medications. Journal of Orthopedics;2024;16(2):87-94. doi: 10.69149/orthopedics/2024v16iss2_6.
Posadzki P, Watson L, Ernst E. Herb-drug interactions: An overview of systematic reviews. Br J Clin Pharmacol; 2013;75(3):603-618. doi: 10.1111/j.1365-2125.2012.04350.x.
American Society of Anesthesiologists (ASA). Herbal and dietary supplements and anesthesia: What you should know before surgery. Available from: https://madeforthismoment.asahq.org/wp-content/uploads/2020/10/ASA_Supplements-Anesthesia_Updated-1.pdf (Accessed 30 August 2025).
National Health and Medical Research Council (NHMRC). Natural therapies review: Naturopathy evidence evaluation. Government of Australia. Available from: https://www.health.gov.au/resources/publications/natural-therapies-review-2024-naturopathy-evidence-evaluation?language=en 2024 (Accessed 30 August 2025).
World Health Organization (WHO). Global report on traditional and complementary medicine. 2023. Available from: https://iris.who.int/server/api/core/bitstreams/f67507c0-30a3-41c0-b497-2fa9034b197d/content (Accessed 30 August 2025).
Myers SP, Vigar V. The state of the evidence for whole-system, multi-modality naturopathic medicine: A systematic scoping review. J Altern Complement Med. 2019;25(2):141-168. doi: 10.1089/acm.2018.0340
Bradt J, Dileo C, Shim M. Music interventions for preoperative anxiety. Cochrane Database Syst Rev. 2013;(6):CD006908. doi: 10.1002/14651858.CD006908.pub2.
Xie YH, Xie HT, Wang TS, et al.Perioperative holistic care reduces anxiety and depression compared with conventional care. Medicine (Baltimore), 2019;98(7),1-5. doi:10.1097/MD.0000000000014411
