Neurosci Behav Rev. Substances Oils, Aurantiuk Placebos Plant Citrus aurantium for anxiety. The animals previously exposed to the inhalation of OEO 2. The results of the GABAergic and serotonergic interference study are presented in Figure 2.

Video

Bitter Orange as Traditional Chinese Medicine. Herbal Spotlight with Dr. Jenelle Kim

Citrus aurantium for anxiety -

Kurowska EM, Manthey JA: Hypolipidemic effects and absorption of Citrus polymethoxylated flavones in hamsters with diet-induced hypercholesterolemia. J Agric Food Chem. Santiago JVA, Jayachitra J, Shenbagam M, Nalini N: d -limonene attenuates blood pressure and improves the lipid and antioxidant status in high fat diet and L-NAME treated rats.

J Pharm Science Res. Download references. We are grateful to Dr. Márcia Ortiz M Marques and Dr. Roselaine Facanali Laboratory of Natural Products — Instituto Agronômico IAC , Campinas, Brazil for the GC-MS analysis of the EO and to Vinícius Bertotti Ribeiro for technical assistance.

This work was supported by grants from FAPESP Celso ARA Costa — Proc. Department of Pharmacology, Institute of Biosciences, Unesp - Univ Estadual Paulista, P.

Box , , Botucatu, São Paulo, Brazil. Department of Pathology, School of Veterinary Medicine and Animal Science, Unesp - Univ Estadual Paulista, Laboratório Clínico Veterinário, , Botucatu, SP, Brazil. Department of Pathology, School of Veterinary Medicine, USP - University of São Paulo, Av.

Orlando Marques de Paiva, 87, São Paulo, SP, Brazil. You can also search for this author in PubMed Google Scholar. Correspondence to Mirtes Costa.

CARAC participated in the design of the study, carried out all the experimental procedures and drafted the manuscript. TCC and BOC participated in experimental protocols and analyzed the behavioral data. RKT made and supervised all biochemical analyzes. JCF participated in the design of the study and made the neurochemical analyses.

MC supervised the entire project, participated in its design and statistical analysis and helped to the final form of the manuscript. The work was part of the Ph. dissertation of CARAC and the graduation work of TCC and BOC. All of the authors significantly contributed to and have approved the final manuscript.

This article is published under license to BioMed Central Ltd. Reprints and permissions. Costa, C. et al. Citrus aurantium L. essential oil exhibits anxiolytic-like activity mediated by 5-HT 1A -receptors and reduces cholesterol after repeated oral treatment.

BMC Complement Altern Med 13 , 42 Download citation. Received : 11 September Accepted : 11 February Published : 23 February Anyone you share the following link with will be able to read this content:. Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative. Skip to main content. Search all BMC articles Search. Download PDF. Research article Open access Published: 23 February Citrus aurantium L.

Abstract Background The current treatments for anxiety disorders and depression have multiple adverse effects in addition to a delayed onset of action, which has prompted efforts to find new substances with potential activity in these disorders.

Conclusion This work contributes to a better understanding of the biological activity of C. Background Since the s, the benzodiazepines, which improve GABAergic neurotransmission, have been used extensively to treat anxiety disorders.

Methods Plant materials C. EO extraction and phytochemical analysis Immediately after harvesting the fruits were peeled and the fresh peels were processed with a Clevenger apparatus, and the EO was obtained through hydrodistillation while protected from light and heat.

Animals All of the experiments were conducted in accordance with the Ethical Principles in Animal Research adopted by the Brazilian College of Animal Experimentation COBEA and were approved by the Biosciences Institute — Ethics Committee for Animal Research CEEA.

Drugs Diazepam DZP, Germed - EMS, Brazil was used as the standard anxiolytic drug, and imipramine hydrochloride IM, Sigma-Aldrich, USA was used as the standard antidepressant drug. Rotarod Test RRT At the end of the LDB procedure, the mice acutely or repeatedly treated with EO or used to study the EO mechanism of action were immediately placed onto the Rotarod apparatus to verify the integrity of their motor systems.

Forced Swim Test FST FST is consistently recognized as a model for assessing antidepressant activity [ 34 — 36 ] and our experimental conditions were previously detailed [ 28 ]. Statistical analysis The quantitative data from the behavioral procedures were subjected to Kruskal-Wallis non-parametric variance analysis followed by the Mann-Whitney test when appropriate.

Results EO composition Table 1 shows the results from the gas chromatography coupled with mass spectrometry analysis of the C.

Table 1 Chemical composition of the C. aurantium L. EO obtained by gas chromatography coupled with mass spectrometry Full size table.

Figure 1. Full size image. Figure 2. Table 2 Effects of distinct treatments on motor coordination as evaluated by the rotarod test Full size table. Table 3 Effects of oral or inhaled C. aurantium EO on immobility time s in the forced swim test Full size table. Table 4 Changes in body weight and biochemical parameters after 14 days of treatment with C.

aurantium EO Full size table. Discussion Traditional populations usually consider the leaves and flowers of Citrus species as a useful decoction [ 12 , 14 ] or infusion [ 13 , 15 ] to treat nervous system disturbances.

Conclusion C. References López-Muñoz F, Alamo C, García-García P: The Discovery of chlordiazepoxide and the clinical introduction of benzodiazepines: half a century of anxiolytic drugs.

Google Scholar Ravindran LN, Stein MB: The pharmacologic treatment of anxiety disorders: a review of progress. Article CAS Google Scholar Uzun S, Kozumplik O, Jakovljević M, Sedić B: Side effects of treatment with benzodiazepines. Google Scholar Barret JE, Vanover KE: 5-HT receptors as targets for the development of novel anxiolytic drugs: models, mechanisms and future directions.

Article Google Scholar Lowry CA, Johnson PL, Hay-Schmidt A, Mikkelsen J, Shekhar A: Modulation of anxiety circuits by serotonergic systems. Article CAS PubMed Google Scholar Mitchell AJ: Two-week delay in onset of action of antidepressants: new evidence.

Article Google Scholar Halfin A: Depression: the benefits of early and appropriate treatment. PubMed Google Scholar Hamon M, Bourgoin S: Pharmacological profile of antidepressants: a likely basis for their efficacy and side effects?. Article CAS Google Scholar Cryan JF, Holmes A: The ascent of mouse: advances in modeling human depression and anxiety.

Article CAS PubMed Google Scholar Pilc A, Nowak G: GABA-ergic hypotheses of anxiety and depression: Focus on GABA-B receptor. Article CAS Google Scholar Hernandez L, Munoz RA, Miro G, Martinez M, Silva-Parra J, Chaves PI: Use of medicinal plants by ambulatory patients in Puerto Rico.

CAS PubMed Google Scholar Girón LM, Freire V, Alonzo A, Cáceres A: Ethnobotanical survey of the medicinal flora used by the Caribs of Guatemala. Article PubMed Google Scholar Tortoriello J, Romero O: Plants used by Mexican tradicional medicine with presumable sedative properties: an ethnobotanical approach.

CAS PubMed Google Scholar Longuefosse JL, Nossin E: Medical ethnobotany survey in Martinique. Article CAS PubMed Google Scholar Vásquez FM, Suarez MA, Pérez A: Medicinal plants used in the Barros Área, Badajoz province Spain.

Article Google Scholar Leite MP, Fassin-Jr J, Baziloni EMF, Almeida RN, Mattei R, Leite JR: Behavioral effects of essential oil of Citrus aurantium L.

Article CAS Google Scholar Saiyudthong S, Marsden CA: Acute effects of bergamot oil on anxiety-related behaviour and corticosterone level in rats. Article CAS Google Scholar Lehner J, Eckersberger C, Walla P, Pötsch G, Deecke L: Ambient odor of orange in a dental office reduces anxiety and improves mood in female pacients.

Article Google Scholar Akhlaghi M, Shabanian G, Rafieian-Kopaei M, Parvin N, Saadat M, Akhlaghi M: Citrus aurantium Blossom and Preoperative Anxiety. Article PubMed Google Scholar Potdar VH, Kibile SJ: Evaluation of Antidepressant-like Effect of Citrus Maxima Leaves in Animal Models of Depression.

PubMed PubMed Central Google Scholar Campelo LML, Sa CG, de Almeida AAC, Costa JP, Marques THC, Feitosa CM, Saldanha GB, Freitas RM: Sedative, anxiolytic and antidepressant activities of Citrus limon Burn essential oil in mice.

CAS Google Scholar Komori T, Fujiwara R, Tanida M, Nomura J, Yokoyama MM: Effects of Citrus fragrance an immune function and depressive states. Article CAS PubMed Google Scholar Carvalho-Freitas MIR, Costa M: Anxiolytic and sedative effects of extracts and essential oil from Citrus aurantium L.

Article CAS PubMed Google Scholar Pultrini AM, Galindo LA, Costa M: Effects of the essential oil from Citrus aurantium L. Article Google Scholar Gargano AC, Costa CARA, Costa M: Essential oils from Citrus latifolia and Citrus reticulate reduces anxiety and prolong ether sleeping time in mice.

Google Scholar Graeff FG, Zangrossi H: Animal models of anxiety disorders. Google Scholar Ichimaru Y, Egawa T, Sawa A: 5-HT1A Receptor subtype mediates the effect of fluvoxamine, a selective serotonin reuptake inhibitor, on marble-burying behavior in mice.

Article CAS PubMed Google Scholar Costa CARA, Köhn DO, Lima VM, Gargano AC, Flório JC, Costa M: The GABAergic system contributes to the anxiolytic-like effect of essential oil from Cymbopogon citratus lemongrass.

Article CAS PubMed Google Scholar Crawley J, Goodwin FK: Preliminary report of a simple animal behavior model for the anxiolytic effects of benzodiazepines.

Article CAS PubMed Google Scholar Davidson J, Feltner D, Dugar A: Management of Generalized Anxiety Disorder in Primary Care: Identifying the Challenges and Unmet Needs. CAS Google Scholar Petit-Demouliere B, Chenu F, Bourin M: Forced swimming test in mice: a review of antidepressant activity.

Article CAS PubMed Google Scholar Porsolt RD, Bertin A, Jalfre M: Behavioural despair in mice: a primary screening test for antidepressants. CAS PubMed Google Scholar Cryan JF, Markou A, Lucki I: Assessing antidepressant activity in rodents: recent developments and future needs. Article CAS PubMed Google Scholar Ottoni EB: EthoLog2.

Article CAS Google Scholar Almeida RN, Motta SC, Brito FC, Catallani B, Leite JR: Anxiolytic like effects of rose oil inhalation on the elevated plus maze test in rats.

Article PubMed Google Scholar Felício LF, Flório JC, Sider LH, Cruz-Casallas PE, Bridges RS: Reproductive experience increases striatal and hypothalamic dopamine levels in pregnant rats.

Article CAS PubMed Google Scholar Kendler KS, Heath AC, Martin NG, Eaves LJ: Symptoms of anxiety and symptoms of depression: same genes, different environments?. Google Scholar Vale TG, Furtado EC, Santor JG, Viana GSB: Central effects of citral, myrcene and limonene, constituents of essential oil chemotypes from Lippia alba Mill.

Article PubMed Google Scholar Galindo LA, Pultrini AM, Costa M: Biological effects of Ocimum gratissimum L. Article CAS PubMed Google Scholar Toth M: Use of Mice with Targeted Genetic Inactivation in the Serotonergic System for the Study of Anxiety.

Article CAS PubMed PubMed Central Google Scholar Calabrese EJ: An assessment of anxiolytic drug screening tests: hormetic dose responses predominate. Article CAS PubMed Google Scholar Conolly RB, Lutz WK: Nonmonotonic Dose-response Relationships: Mechanistic Basis, Kinetic Modeling, and Implications for Risk Assessment.

Article CAS PubMed Google Scholar Komiya M, Takeuchi T, Harada E: Lemon oil vapor causes an anti-stress effect via modulating the 5-HT and DA activities in mice. Article CAS PubMed Google Scholar Lucki I, Singh A, Kreiss DS: Antidepressant-Like Behavioral Effects of Serotonin Receptor Agonists.

Article CAS Google Scholar Arbo MD, Schmitt GC, Limberger MF, Charão MF, Moro AM, Ribeiro GL, Dallegrave E, Garcia SC, Leal MB, Limberger RP: Subchronic toxicity of Citrus aurantium L. Article CAS Google Scholar Kurowska EM, Manthey JA: Hypolipidemic effects and absorption of Citrus polymethoxylated flavones in hamsters with diet-induced hypercholesterolemia.

Article CAS PubMed Google Scholar Santiago JVA, Jayachitra J, Shenbagam M, Nalini N: d -limonene attenuates blood pressure and improves the lipid and antioxidant status in high fat diet and L-NAME treated rats.

Acknowledgements We are grateful to Dr. Author information Authors and Affiliations Department of Pharmacology, Institute of Biosciences, Unesp - Univ Estadual Paulista, P. Orlando Marques de Paiva, 87, São Paulo, SP, Brazil Jorge C Flório Authors Celso A R A Costa View author publications. View author publications.

Additional information Competing interests All authors declare that they have no competing interests. Rights and permissions This article is published under license to BioMed Central Ltd.

About this article Cite this article Costa, C. Copy to clipboard. BMC Complementary Medicine and Therapies ISSN: Brain Research Bulletin, 45, Biological Pharmaceutical Bulletin, 25, Raftari, Sh.

and Asadi Shekari, M. Kerman Medical Sciences Journal, 12, and Akhlaghi M. Shahrekord Medical Sciences University Magazine, 4, Pharmazie, 66, Pharmacological Research, 42, and Schmidt, D. Epilepsy Research, 53, and Barbosa Filho, J. Neuroscience Letters, , This work and the related PDF file are licensed under a Creative Commons Attribution 4.

Login 切换导航. Home Articles Journals Books News About Services Submit. Home Journals Article. Effect of Citrus aurantium L. Essential Oil and Its Interaction with Fluoxetine on Anxiety in Male Mice. Sorin Saketi , Maryam Bananej , Mahsa Hadipour Jahromy Biology Department, Faculty of Biological Sciences, Islamic Azad University, North Tehran Branch, Tehran, Iran.

Medical Sciences Research Centre, Tehran Medical Sciences Branch, Islamic Azad University, Tehran, Iran. DOI: Abstract Anxiety is a very common mental disorder among neurological diseases.

Keywords Anxiety , Essential Oil , Citrus aurantium L. Share and Cite:. Saketi, S. and Jahromy, M. Journal of Behavioral and Brain Science , 4 , doi: Introduction Anxiety is a very common mental disorder.

Methods and Materials 2. Animals Male albino mice weighed 22 to 28 g supplied from Pasteur Institute were used in this study. Essential Oil Preparation Collected Citrus aurantium L.

EPM Test The studies were carried out on mice according to the method of Lister [7]. Statistical Analysis All values were expressed as mean ± SEM from six animals. Results Figure 1 illustrates that in terms of the applied doses, the intraperitoneal injection of the essential oil of Citrus aurantium L.

Conflicts of Interest The authors declare no conflicts of interest. References [ 1 ] Brown, G. Journals Menu. Open Special Issues Published Special Issues Special Issues Guideline.

Follow SCIRP. Contact us. Copyright © by authors and Scientific Research Publishing Inc. Free SCIRP Newsletters Add your e-mail address to receive free newsletters from SCIRP.

Home Journals A-Z Subject Books Sitemap Contact Us. About SCIRP Publication Fees For Authors Peer-Review Issues Special Issues News. Policies Open Access Publication Ethics Preservation Retraction Privacy Policy.

Copyright © Scientific Research Publishing Inc. All Rights Reserved. Brown, G. Kulkarni, S. Aghajanian, G. Hagerman, R. Karimi, E. Costa, C. Lehrner, J. Turner, E. Artigas, F. Ninan, P. Higgins, G.

Lucchelli, A. Bagdy, E. Carvalho-Freitas, M. Mahmoudi, M. Shabanian, Gh. Lopes Campêlo, L. Re, L. Deckers, C. Pereira, E. Depression and Anxiety, 26, University of Iran Medical Sciences, Tehran.

and Treit, D. Brain Research, , Biological Psychiatry, 67, American Journal of Psychiatry, , and Condon, M. American Journal of Therapeutics, 7, Tehran University Publication, Tehran. and Wichtl, M. Medpharm GmbH Scientific Publishers, Stuttgart, CRC Press, Boca Raton, and Phelps, E.

Biological Psychiatry, 60, and Sabzebari, S. Journal of Tehran University of Medical Sciences, 7, Pharmazie, 66, and Souza, D. Phytomedicine, 6, and Yokogoshi, H. Stress and Health, 24, and Harada, E. Behavioural Brain Research, , Brazilian Journal of Medical and Biological Research, 24, and Shekari, M.

Journal of Kerman University of Medical Sciences, 12, Pharmacological Research, 42, and Schmidt, D. Epilepsy Research, 53, and Akhlaghi, M. Journal of Shahrekord University of Medical Sciences, 4, and Costa, M. and Deecke, L.

and Roth, R. Neuroscience, 92, Neuroscience Research Communications, 27, and Barad, M. Learning and Memory, 12,

Ofr is Citrus aurantium for anxiety very common mental disorder among neurological Citrus aurantium for anxiety. Aurangium herbs dor soothing effects Citrux play an important role in African Mango seed diabetes support anxiety. The purpose of this study is to investigate the effect of Citrus aurantium L. essential oil on anxiety and its interference with serotonergic pathway. Sixty male mice were assigned into control, sham saline and olive oiland experimental groups. Intraperitoneal injection of Citrus aurantium L. essential oil was applied at doses of 0. Preoperative visit Citrus aurantium for anxiety use of premedication are Anti-cancer advocacy methods to achieve this goal, but the role of fir premedication fr unclear Citrus aurantium for anxiety postoperative side-effects may result from Natural skin remedies premedication. Citrus aurantium is anxieyt as auramtium alternative Citrus aurantium for anxiety in some countries to snxiety anxiety, and recently the anxiolytic role of this medicinal plant was established in an animal model study. The aim of this study was to assess the anxiolytic effect of Citrus aurantium blossom on preoperative anxiety. METHODS: We studied 60 ASA I patients undergoing minor operation. In a randomized double-blind design, two groups of 30 patients received one of the following oral premedication two hours before induction of anesthesia: 1 Citrus aurantium blossom distillate 1 mL. kg-1 C-group ; 2 Saline solution 1 mL.

Citrus aurantium for anxiety -

Open Special Issues Published Special Issues Special Issues Guideline. Follow SCIRP. Contact us. Copyright © by authors and Scientific Research Publishing Inc. Free SCIRP Newsletters Add your e-mail address to receive free newsletters from SCIRP.

Home Journals A-Z Subject Books Sitemap Contact Us. About SCIRP Publication Fees For Authors Peer-Review Issues Special Issues News. Policies Open Access Publication Ethics Preservation Retraction Privacy Policy. Copyright © Scientific Research Publishing Inc.

All Rights Reserved. Craske, M. Emami, A. Degroot, A. Martinez, D. Schneier, F. Giannini, A. Amin, G. Bisset, N. Rauch, S. Ghasemi Dehkordi, N. Lopes, C. Elisabetsky, E. Fukumoto, S. Komiya, M. da Silva, V. Mahmoodi, M. Re, L. Deckers, C. Shabanian, G. Carvalho-Freitas, M.

Lehrner, J. Morrow, B. Siemitkowski, H. Ponnusamy, R. Khoori, V. Karla, T. Stowe, R. The authors are grateful to Associação Fundo de Incentivo à Psicofarmacologia AFIP for the financial support.

Open menu Brazil. Revista Brasileira de Farmacognosia. About the journal Editorial Board Instructions to authors Contact. Português Español.

Open menu. table of contents « previous current next ». Abstract Resumo English Resumo Portuguese. Text EN Text English. PDF Download PDF English. Essential oil; Citrus aurantium; Rutaceae; orange oil; anxiety; inhalation; plus-maze.

ARTIGO Behavioral effects of essential oil of Citrus aurantium L. inhalation in rats Efeitos comportamentais em ratos após inalação do óleo essencial de Citrus aurantium L.

Leite I I Departamento de Psicobiologia, Universidade Federal de São Paulo, Rua Botucatu , Ed. Ciências Biomédicas, São Paulo-SP, Brazil II Laboratório de Tecnologia Farmacêutica, Universidade Federal da Paraíba, Caixa Postal , João Pessoa-PB, Brazil ABSTRACT The orange essential oil OEO and its components obtained from Citrus aurantium L.

RESUMO O óleo essencial de laranja OEL e seus constituintes obtidos da Citrus aurantium L. MATERIAL AND METHODS Animals Were used months old male Wistar rats weighing g.

Chemicals The OEO was supplied from International Flavors and Fragrance IFF Ltda. Analysis of the essential oil The OEO was analyzed by gas chromatography. Treatment Groups with 12 rats each were used. Open-field behavioral test The open-field test was originally proposed as a measure of emotionality, with the animals being exposed to excessive light or noise.

Social interaction test This procedure is based on the observation that animals tend to reduce or even suppress their interaction with other animals under conditions of new environments or excessive light. Elevated plus-maze test The maze consists of two open arms and two closed arms by 30 cm high walls.

Statistical analysis Student's t test was used to analyze the behavioral parameters observed in the open-field, as well as the one-way ANOVA, followed by the Tukey's and the Duncan's tests, to analyze the data we obtained in the TSI and the EPM, respectively.

RESULTS Identification of constituents of OEO The chromatographic analysis of the OEO showed a phytochemical profile that confirms the presence of the main classes of components characteristic of the species Citrus aurantium L. Agra MF, Silva KN, Basílio IJLD, França PF, Barbosa-Filho JM Survey of medicinal plants used in the region Northeast of Brazil.

Rev Bras Farmacogn 18 : Almeida RN, Motta SC, Brito FC, Catallani B, Leite JR Anxiolytic like effects of rose oil inhalation on the elevated plus maze test in rats. Pharmacol Biochem Behav Barbosa-Filho JM, Cunha RM, Dias CS, Athayde-Filho PF, Silva MS, Cunha EVL, Machado MIL, Craveiro AA, Medeiros IA GC-MS Analysis and cardiovascular activity of the essential oil of Ocotea duckei.

Candland DK, Campbell BA Development of fear in the rat as measured by behavior in the open-field. J Comp Physiol Psychol Carvalho-Freitas MIR, Costa M Anxiolytic and sedative effects of extracts and essential oil from Citrus aurantium L.

Biol Pharm Bull 25 : De-Souza MM, Garbeloto M, Denez K, Eger-Mangrich I Avaliação dos efeitos centrais dos florais de Bach em camundongos através de modelos farmacológicos específicos. Rev Bras Farmacogn 16 : Ferronatto R, Marchesan ED, Pezenti E, Bednarski F, Onofre SB Atividade antimicrobiana de óleos essenciais produzidos por Baccharis dracunculifolia D.

e Baccharis uncinella D. Rev Bras Farmacogn 17 : File SE, Hyde JR Can social interaction be used to measure anxiety? Brit J Pharmacol 62 : Gumnick JK, Nemeroff CB Problems with currently available antidepressants. J Clin Psychiatry 61 : Hwang JH The effects of the inhalation method using essential oils on blood pressure and stress responses of clients with essential hypertension.

Taehan Kanho Hakhoe Chi Jones GH, Hernandez ID, Kendall DA Dopaminergic and serotonergic function following isolation rearing in rats: study of behavioural responses and postmortem and in vivo neurochemistry.

Pharmacol Biochem Behav 43 : Komori T, Fujiwara R, Tanida M, Nomura J a. Effects of citrus fragrance on immune function and depressive state. Neuroimunomodulat 2 : Komori T, Fujiwara R, Tanida M, Nomura J b. Potential antidepressant effects of lemon odor in rats. Eur Neuropsychopharmacol 5 : Komiya M, Takashi T, Harada E Lemon oil vapor causes an anti-stress effect via modulating the 5-HT and DA activities in mice.

Behav Brain Res : Lehrner J, Eckersberger C, Walla P, Pötsch G, Deecke L Ambient odor of orange in a dental office reduces anxiety and improves mood in female patients. Physiol Behav 71 : Lehrner J, Marwinski G, Lehr S, Johren P, Deecke L Ambient odor of orange and lavender reduce anxiety and improve mood in a dental office.

Physiol Behav 86 : Oliveira RAG, Lima EO, Vieira WL, Freire KRL, Trajano VN, Lima, IO, Souza EL, Toledo MS, Silva-Filho RN Estudo da interferência de óleos essenciais sobre a atividade de alguns antibióticos usados na clínica. Several methods have been suggested towards reducing or controlling this psychological problem related to operation.

Pre-anesthesia assessment in an outpatient clinic as well as visit during hospitalization in the evening just before surgery may reduce preoperative anxiety 8. Besides the advantages of preoperative visit and reassurance of the patient before surgery, premedication with anxiolytic and sedative drugs may reduce preoperative anxiety 9.

On the other hand, the role of anxiolytic premedication remains unclear and postoperative side-effects may result from routine premedication Citrus aurantium , commonly known as sour orange or bitter orange local name in Iran: Nareng is produced in Northern and Southern Iran.

Traditionally, Citrus aurantium is used as an alternative medicine in some countries to treat anxiety, insomnia and as an anticonvulsant, suggesting depressive action upon the central nervous system CNS In an anxiety model study, Citrus aurantium was able to enhance the sleeping time induced by barbiturates.

In animal model, this sedative effect was in accordance with traditional use of citrus aurantium In spite of traditional use of Citrus aurantium for reducing anxiety and its sedative effect in animal model 12 , we believe that preoperative anxiolytic effect of Citrus aurantium blossom has not been studied so far.

The present study was designed to assess the effect of Citrus aurantium blossom on preoperative anxiety in patients scheduled for elective minor surgery. Ethical approval for this study Ethical Committee No.

Yousefi on February 9, Written informed consent was obtained from 60 consecutive outpatients, aged year, ASA physical status I scheduled for lower limb minor operation under general anesthesia. Preoperative visit was done by an anesthetist the day before operation.

Exclusion criteria were coexisting CNS diseases, malignancy, a variety of neuropsychological disorders, use of medications including drugs related to surgery, and any history of smoking or opium addiction, as well as any cardiovascular disease.

None of the patients had previous anesthesia and surgical experiences as well as any history of hospitalization. Routine sedative premedication was not offered to patients participating in this study, instead premedication with either Citrus aurantium blossom distillate CABd or placebo was assumed for two groups of study two hours before operation.

Patients enrolled in this study were assigned into two groups of 30 each; using a computer-base random allocation and double blind manner. Fresh petals and stamens of Citrus aurantium blossoms were collected from adult sour orange plants, existing in south Iran, at Medicinal Plants Research Center of Shahrekord University of Medical Sciences.

Citrus aurantium blossom distillate CABd was obtained by steam distillation and then protected until pharmacological assays. CABd was standardized based on measurement of linalool, total phenolic and flavonoid compounds as follows:.

Linalool concentration was determined by a reversed phase HPLC method C18 column, Agilent, Germany An ultraviolet UV detector was used with wavelength of nm to obtain the chromatograph corresponding to linalool. Mobile phase consisted of 0.

Flow rate was 1. min -1 and injection volume was µL. A standard curve was drawn using the area under the curves resulted from different doses of linalool. The experiment was repeated for three times and the amount of linalool in the sample was determined using this standard curve.

The amount of total phenolic compounds in CABd was determined colorimetrically with the Folin-Ciocalteu reagent, using the method described by Kim A solution of 5 mL CABd or Gallic acid standard phenolic compound was mixed with Folin Ciocalteu reagent diluted with distilled water and aqueous Na 2 CO 3 4 mL, 1 M.

The mixtures were allowed to stand for 15 min and the total phenols were determined by colorimetry at nm. A standard curve was prepared using 0, 50, , , , and mg. Total phenol values were expressed in terms of Gallic acid equivalent mg.

g -1 , which is a common reference compound. The experiment was repeated for three times. The amount of total flavonoids in the CABd was determ ined using colorimetric method as described by Chang A solution of 0.

Then the absorbance of the reaction mixture was measured at nm with a double beam spectrophotometer Unico UV, Japan. The calibration curve was prepared using Rutin solutions at concentrations of 25 to ppm in methanol. Total flavonoids were expressed in terms of Rutin equivalent mg.

The retention time of linalool with the condition described in Methods section was 2. The amount of linalool in the sample was 10 ppm part per million. Total phenolic contents of CABd were 33 ± 0. g -1 equivalent to Gallic acid and the total flavonoids in CABd were 29 ± 0.

gr -1 equivalent to Rutin. The average amounts of total flavonoid and phenolic compounds were 29 ± 0. g -1 Rutin and 33 ± 0. gr -1 Gallic acid , respectively. The linalool concentration in the sample was 10 ppm. Finally, the concentrations of total flavonoid, phenolic compound and linalool in CABd were 29 mg.

mL -1 and 0. mL -1 , respectively. Preoperatively, all patients were admitted to the same holding area near the operating room while waiting for outpatient surgery. For all subjects the environment, the nursing staff and the anesthesiologist as well as the psychologist were the same in the holding area.

As a baseline, preoperative anxiety was assessed using both State-Trait Anxiety Inventory STAI-state and Amsterdam Preoperative Anxiety and Information Scale APAIS by an expert psychologist. Heart rate HR and blood pressure BP were also obtained two hours before operation just before premedication in the holding area by a nurse anesthetist.

Then subjects of the two groups received oral CABd 1 mL. kg -1 as test C - group or Saline solution 1 mL. kg -1 as placebo P - group , respectively; according to a computer based randomization just after collecting the baseline values.

Two hours later right before inducing anesthesia anxiety was assessed using the same methods by other anesthesiologist and psychologist who were blinded to the groups and patients' baseline values. The State-Trait Anxiety Inventory STAI is a item self report measure that contains 20 items measuring state anxiety and 20 items measuring trait anxiety 2.

Total scores for state and trait sections separately range from 20 to 80 with higher scores denoting higher levels of anxiety. Amsterdam Preoperative Anxiety and Information Scale APAIS consist of 6 questions and ranged from In this study, we used state component of STAI rage and sum C component of APAIS range to evaluate preoperative anxiety.

Both heart rate HR and blood pressure BP , which have been widely used as dependent variables in behavioral studies to alter levels of anxiety and are frequently cited as physiological indices of stress in psychology, aviation medicine, and anesthesia 2 were obtained in two steps as baseline and just before induction of general anesthesia.

Regarding the normal distribution of variables, the data between groups were analyzed using Chi-Square and independent t tests and the data within groups were analyzed using paired t test. Sixty patients were enrolled and completed the study.

Chi-Square test demonstrated no significant difference among male and female distribution between groups. According to independent t test no significant differences were seen between groups in terms of age, baseline values of STAI-state, APAIS, and baseline hemodynamic values.

Table I. Hemodynamic variables except pulse rate in group P , were not changed within the two groups after pre-medication when paired t test was used. Tables II and III. Preoperative anxiety is not only an unpleasant emotional state but may lead to significant psychological and physiological disorders The main finding of this study is that the anxiolytic effect of Citrus aurantium blossom distillate CABd when used orally was highly significant as measured by STAI-state and APAIS.

Both STAI-state and APAIS were decreased by CABd. On the other hand, neither STAI-state nor APAIS was changed in the placebo group.

We found no studies related to the effect of CABd on preoperative anxious situation or even anxiolytic effect of this herbal medicine in human in the literature review. Only a few studies reported that some similar components of citrus may reduce anxiety 17, Lehrner et al.

Although the main components of the essential oil in their study, demonstrated by gas chromatography, was in part different from that obtained in our study, the essential similar component was limonene, a flavonoid compound, which could be addressed as anxiolytic component.

Citrud this Remarkable, Citrus aurantium for anxiety have examined the effect of Citrus aurantium L. essential Cigrus Citrus aurantium for anxiety anxiety and aurantiium interaction with dopaminergic pathways. Essential oil of Citrus aurantium L. was injected intraperitonealy at doses of 0. Subcutaneous injection of haloperidol was administered on the fifth day, 30 minutes before the injection of the essential oil. The anxiety-related behavior of mice was then assessed by elevated plus-maze test.