Effect of inhalation aromatherapy with lavender essence on pain associated with intravenous catheter insertion in preschool children: A quasi-experimental study

The effect of aromatherapy with Lavender-Neroli oil and music in management of pediatric dental anxiety: a randomized control trial

AIM

This study aimed to evaluate the efficacy of aromatherapy with Lavender-Neroli essential oil combined with background music in reducing dental anxiety and pain during anesthesia in children.

MATERIALS AND METHODS

A total of 56 children aged 6-10 years old who needed dental treatment with inferior alveolar nerve injection (IANB) were randomly divided into two groups: Group 1 (Experimental, n = 28) aromatherapy with music group, and Group 2 (Control, n = 28) the placebo group. Children in the group 1 were asked to inhale the aromatic blend of Lavender-Neroli essential oil using a nasal mask similar to one that is used for nitrous oxide after modifying it by adding a 3D printed box on its circle hole and listening to their favorite music as a background before 5 min and during anesthesia, meanwhile in the placebo group children were asked to wear an empty nasal mask. Anxiety and pain were been assessed before and after anesthesia using the self-report anxiety scale Facial image scale (FIS), Observational pain assessment scale Face-Legs-Activity-Cry-Consolability (FLACC), heart rate, SPO2 saturation, diastolic and systolic blood pressure.

RESULTS

Dental anxiety and vital signs except SPO2 saturation were significantly lower in the aromatherapy with music group when compared to the control group (p < 0.05), with no differences in pain perception between groups (p = 0.176).

CONCLUSIONS

Aromatherapy with Lavender-Neroli oil combined with music seems to be a useful and safe non-pharmacologic technique for managing dental anxiety in children.

The effect of rose oil aromatherapy and hand-holding on pain due to peripheral intravenous catheter insertion

INTRODUCTION

The study aimed to evaluate the effectiveness of rose oil (Rosa Damascene Mill.) aromatherapy and hand-holding in reducing pain associated with peripheral intravenous catheter insertion.

METHODS

A comparative mixed-method design. A total of 126 patients were included in the study. For the study's quantitative data, sociodemographic characteristics of the patients and the Patient Interview Form for the qualitative data of the Numeric Rating Scale were used. In all patients included in the study, PIVC insertion was performed a single time by the same nurse using a standard procedure. Chi-square and Bonferroni tests were used for comparative statistics.

RESULTS

No statistically significant difference between the groups regarding age, gender, marital status, BMI, and education level (p>0.05). Pain scores: it was 2.40±1.78 in the rose oil group, 3.53±1.98 in the hand-holding group, and 4.88±1.56 in the control group. The difference between the groups regarding pain scores is statistically significant (p=0.001).

CONCLUSIONS

The study determined that rose oil aromatherapy and hand-holding interventions reduce pain during PIVC. However, rose oil aromatherapy was more effective on pain than the hand-holding intervention. (Clinical Trial ID: NCT05425849).

The antibacterial effectiveness of lavender essential oil against methicillin-resistant Staphylococcus aureus: a systematic review

With the overuse and misuse of antibiotics, multi-drug resistant organisms have become a prominent issue in healthcare, increasing morbidity and mortality in affected patients. One such organism of concern is methicillin-resistant Staphylococcus aureus (MRSA) which is a leading cause of a variety of clinical infections. Therefore, in the interest of finding alternate substances to antibiotics, there has been increased interest in the antibacterial properties of lavender essential oil (LEO). This systematic review aims to collate information regarding the antibacterial properties of LEO against S. aureus and MRSA. A systematic search was conducted across four databases between the years 2002 and 2022, and through this, 23 studies were included in this paper. These studies used a variety of methods to ascertain the antibacterial effectiveness of LEO alone or in combination with other substances. Overall, there were mixed results regarding the antibacterial effectiveness of LEO against S. aureus and MRSA, with some studies reporting significant effectiveness, while other studies reporting a minimal to negligible effect. However, findings suggest that LEO works synergistically with other antibacterial substances, and it would be beneficial for additional research to be conducted in this area.

The effect of buzzy®, DistrACTION® cards on reducing pediatric pain and fear during blood collection in the rheumatology polyclinic: A randomized controlled trial

PURPOSE

The aim of this study was to compare the effectiveness of Buzzy® and DistrACTION® Cards in reducing children's pain and fear while taking venous blood samples.

METHODS

This research was designed as a randomized controlled experimental study. The study population consisted of children aged 6-12 years admitted to the Pediatric Rheumatology Diseases Polyclinic in a Faculty of Medicine in Germany. The sample of the study consisted of 96 children (Buzzy® = 32, DistrACTION® Cards = 32, control = 32) who met the patient selection criteria and agreed to participate in the study. The data were obtained using a Child and Family Information Form, the Children Fear Scale (CFS), and the Faces Pain Scale-Revised (FPS-R). The data were evaluated using the Pearson chi-square test, Kruskal-Wallis test, One-way ANOVA test with Bonferroni correction, and Fisher-Freeman-Halton.

FINDINGS

In the study, the average age of the children was 9.21 ± 2.15 years. The Buzzy® group had the lowest pain and procedural fear scores (self-report = 0.88 ± 1.13, 0.31 ± 0.47; parent report = 0.75 ± 0.98, 0.34 ± 0.48, and researcher report = 0.81 ± 1.00, 0.31 ± 0.54, respectively) than the DC, and control groups.

CONCLUSIONS

The Buzzy® method was effective in reducing venipuncture pain and fear in children.

PRACTICE IMPLICATIONS

Nurses can use the Buzzy® methods to help reduce venipuncture pain and fear in children. The clinical trial registration number is NCT05560074. (https://clinicaltrials.gov/ct2/show/study/NCT05560074).

A review of the bioactive components and pharmacological properties of Lavandula species

Lavandula species is a flowering plant that is common in Europe and across the Mediterranean. Lavender has many health benefits for humans. In addition to its use in herbal medicine, it is widely used in the fields of cosmetics, perfumes, foods, and aromatherapy. Google Scholar, PubMed, Scopus, and Web of Science were used to search for relevant material on the phytochemical ingredients, the pharmacologic effects of the ingredients, and the mechanism of action of the Lavandula species identified. These materials were reviewed in order to have access to important updates about the Lavandula species. Lavender as referred to in English contains essential oils, anthocyanins, phytosterols, sugars, minerals, coumaric acid, glycolic acid, valeric acid, ursolic acid, herniarins, coumarins, and tannins. It has been used to treat colic and chest ailments, worrisome headaches, and biliousness, and in cleaning wounds. It has antifungal, antibacterial, neurologic, antimicrobial, anti-parasitic, anti-diabetic, and analgesic effects among others. Lavandula species has prospects for various biological applications, especially with its dermatological application. Advances in drug development would enable characterization of various bioactive constituents; thus, its development and application can have a more positive impact on humanity. Here, we highlighted updated information on the history, distribution, traditional uses, phytochemical components, pharmacology, and various biological activities of Lavandula species.

Music therapy and aromatherapy on dental anxiety and fear: A randomized controlled trial

Background/purpose

Dental anxiety and fear in children are major public health concerns. This study aimed to determine the effectiveness of music therapy combined with aromatherapy, in reducing the children's dental anxiety and fear.

Materials and methods

A total of 128 school-age children aged 10-12 years were randomly allocated into 4 groups: a control group with 32 volunteers, an experimental group that received music therapy, with 33 volunteers, an aromatherapy experimental group with 31 volunteers, and 32 volunteers in an experimental group with music therapy combined with aromatherapy.

Results

The results found that within-group comparisons before and after the experiment revealed the outcomes with a statistically significant change at the 0.05 level of each group as follows. The control group had increased heart rate. The music therapy group showed decreased dental anxiety and fear and systolic blood pressure. The aromatherapy experimental group exhibited increased oxygen saturation. The experimental group receiving music therapy combined with aromatherapy showed decreased dental anxiety and fear, heart rate, and systolic and diastolic blood pressure as well as increased oxygen saturation values. In addition, it was found that music therapy combined with aromatherapy had a co-influence on dental anxiety and fear (F = 22.22, P < 0.001) and oxygen saturation (F = 17.40, P < 0.001), and the two main treatments also significantly influenced these outcomes at the 0.05 level.

Conclusion

The results showed that music therapy in combination with aromatherapy reduced children's anxiety and fear of dental services better than a single treatment.

Use of Aromatherapy for Pediatric Surgical Patients

BACKGROUND

Children having surgery experience distress from a myriad of sources. Aromatherapy may present an opportunity to promote a healing environment and decrease distress for children following surgery.

AIM

Evidence regarding the use of aromatherapy with children is growing. The purpose of this project was to describe our implementation process, subsequent use of and response to aromatherapy for children undergoing surgery.

METHODS

This quality improvement project and subsequent retrospective chart review included all patients with documentation of aromatherapy use over an 8-month period. Data collection included demographic data, patient diagnosis, location, information about which oils were used, for which indications, and any outcome the nurse was able to observe (e.g., improved, no change, worsening of symptoms). A nurse-led workgroup developed and implemented a process for aromatherapy in a limited scope when discomfort, nausea/vomiting, nervousness, and sleep disturbances were reported . Charts of all patients with documented aromatherapy use were reviewed for indication/reason for use, oil, and patient response.

RESULTS

Results suggest a successful implementation process. Aromatherapy was used by 191 patients (aged 3-22 years). Upset stomach, discomfort, and nervousness were most frequently reported as leading to aromatherapy use. Lavender and peppermint were the most frequently used oils. Of those patients with documented responses, the majority reported improvement.

CONCLUSIONS

We were able to successfully implement a new aromatherapy program as an adjunct to care in children undergoing surgery. No adverse events were reported. Documentation is crucial to evaluating any new service.

The effects of lavandula aromatherapy on pain relief after coronary artery bypass graft surgery: A randomized clinical trial

BACKGROUND AND AIMS

Coronary artery bypass graft surgery (CABG) is a primary treatment in coronary artery disease (CAD). Patients experience pain after CABG. Pain may increase postoperative complications and decrease quality of life (QoL). This study aims to determine the lavandula aromatherapy effect on patients' pain after CABG.

METHODS

98 patients undergoing CABG were randomly assigned to intervention and placebo groups. The intervention group inhaled 5-drops of 20 % lavandula essential oil (LEO) and the placebo group was exposed to 5-drop of distilled water. LEO or distilled water were dropped into a sterile gauze converted to the form of a necklace. The subjects wore necklace for three consecutive days and intervention was performed each 24 h. The pain intensity, systolic blood pressure (SBP), and diastolic blood pressure (DBP) were measured before each intervention and 30 min after it. Also, the mean analgesic intake was recorded. SPSS version 16 was used to analyze the data.

RESULTS

The mean pain score measured in the intervention group showed a more decrease than that obtained in the placebo group after the first and second interventions. Additionally, the mean pain score in the intervention group demonstrated a significant decrease than the placebo group after the second intervention (P=0.008). Moreover, mean SBP after the second intervention (P=0.046) and mean DBP after the first intervention (P=0.029) revealed a significant difference between two groups. Moreover, the intervention group received less analgesic than the placebo group.

CONCLUSIONS

Lavandula aromatherapy can reduce pain and received analgesic dose after CABG.

The effect of topically administered lavender aromatherapy on the pain of insulin injection in diabetic patients: a double-blind randomized controlled clinical trial

BACKGROUND

Needle phobia occurs in more than half of diabetic patients due to the pain caused by frequent insulin injections. Therefore, this study evaluated the effect of topically administered lavender aromatherapy on the pain of insulin injections in diabetic patients.

METHODS

In this double-blind randomized controlled and experimental study, patients who met the study criteria were divided into three groups; topical lavender oil (n = 60), placebo (n = 60), and control (n = 60) groups. The data were collected using the "Patient Information Form", the "Follow-up Form", the "Verbal Category Scale (VCS)", and the "Visual Analogue Scale (VAS)".

RESULTS

The results revealed no significant difference between the patients in the topical lavender oil group before and during the insulin injection in terms of VAS and VCS pain scores (p > 0.05). In the placebo and control groups, the mean VAS and VCS pain scores during insulin injection were found to be significantly higher than before insulin injection (p < 0.05). Besides, the mean VAS and VCS scores during insulin injection were significantly higher in the placebo and control groups than the topical lavender oil group (p < 0.05).

DISCUSSION

: The study showed that patients who were administered topical lavender oil felt less pain after insulin injection than those in the placebo and control groups. Therefore, topically applied lavender aromatherapy can be easily used for pain control in insulindependent diabetic patients (clinical trial number NCT04767737).

The effect of lavender on stress in individuals: A systematic review and meta-analysis

BACKGROUND

Lavender is considered as one of the medicinal plants to manage stress. Although many preliminary studies evaluated the effect of lavender on individuals' stress level, to the best of our knowledge, we did not find a study that summarizes the results. Therefore, the present study aimed to estimate the Pooled effect of lavender on the stress level of individuals using systematic review and meta-analysis.

METHOD

A systematic literature review based on PRISMA 2020 was performed on the SID, MagIran, Embase, PubMed, Scopus, Web of Science (WoS) databases, and Google Scholar motor engine using related MeSH/Emtree and ‎Free Text words,‎ including "Lavender*", "Lavandula*", "Stress*", "Stress Disorders, Traumatic", and "Stress, Psychological" with no time limitation until August 2021: We also searched two Iranain free local resourses including MagIran https://www.magiran.com and Scientific Information Database (SID) https://www.sid.ir. The quality assessment of studies was performed using JBI checklist. Heterogeneity among studies was quantified using I² index and Random Effects model was used to combine the data and perform the meta-analysis.

RESULTS

In the initial search, 1520 articles were found. After excluding the irrelevant studies, finally, 21 articles with a sample size of 791 in the intervention group and 804 in the control group were included in the meta-analysis. As a result of combining the studies, stress score after using lavender in the intervention group showed a significant decrease of 0.63 ± 0.13 (95% CI) more than that in the control group (P < 0.001). The results of subgroup analysis demonstrated that the highest standardized mean difference (SMD) before and after the intervention in the intervention group compared to the control group was related to L. angustifolia species with 0.73 ± 0.22, student groups with 2.27 ± 1.34, and diagnostic tool of Perceived Stress Scale (PSS) with 0.82 ± 0.42, indicating that the difference between the groups was statistically significant (P < 0.001).

CONCLUSION

The pooled estimation of this systematic reiew and meta-analysis revealed that lavender significantly reduces individuals' stress. Therefore, it seems that the use of lavender can be considered as a part of a stress management programs, especially in student groups.

Aromatherapy in Nursing and Midwifery Practice: A Scoping Review of Published Studies Since 2005

Background: Since the 1990's aromatherapy has been a popular adjunct to nursing and midwifery care in a variety of health care settings. Objective: The scoping review seeks to identify and confirm the benefits of incorporating aromatherapy into holistic nursing and midwifery practice Design: A scoping review using PRISMA-ScR of experimental studies where care is provided to the patient by a registered nurse or midwife. Settings and participants: Any health care setting where nurses or midwives provide care. Review Methods: A multi- engine search using a range of MeSH and non-MeSH terms with the Boolean search [AND]. Inclusion criteria were; publication date from 2005-2021, study involved aromatherapy as an intervention, conducted in a clinical nursing or midwifery environment and the published article is available in full in English. Excluded were; single patient cases, animal studies, in vitro studies, use of essential oils internally or a whole plant extract was used or use was non-nursing/midwifery related. Results: 124 studies met the inclusion criteria (n = 19188), classified into seven themes. Conclusion: The evidence supports the use of aromatherapy within a range of nursing and midwifery practices enhancing a holistic model of care. Impact: This scoping review contributes evidence to support the inclusion of aromatherapy into holistic nursing and midwifery practice.

Effects of inhalation aromatherapy as a complementary therapy in pediatric patients in the clinical practice: A systematic review

BACKGROUND

Inhalation aromatherapy is a complementary therapy in different clinical settings, but there is little evidence about its effectiveness in childcare.

OBJECTIVE

To assess the effectiveness of inhalational aromatherapy in the care of hospitalized pediatric patients.

METHODS

Systematic review of clinical trials and quasi-experimental studies, based on PRISMA recommendations, searching Medline, Web of Science, Scopus, SciELO, LILACS, CINAHL, Science Direct, EBSCO, and updated databases. The Down and Black 2020, RoB 2020 CLARITY, and ROBINS-I 2020 scales were used through the Distiller SR software to verify the studies' internal validity and risk of bias.

RESULTS

From 446 articles identified, 9 fulfilled the inclusion criteria. Seven were randomized controlled trials (RCTs), one pilot RCT, and one non-randomized quasi-experimental trial. Different outcomes were analyzed, with pain being the most frequently measured variable. None of the 6 studies that evaluated pain showed significant effects with inhalation aromatherapy. Additionally, non-significant effects were found regarding nausea, vomiting, and behavioral/emotional variables.

CONCLUSIONS

The findings are still inconclusive, and more evidence is required from future studies with high methodological quality, blinding, and adequate sample sizes.

Effectiveness of lavender inhalation aromatherapy on pain level and vital signs in children with burns: a randomized controlled trial

BACKGROUND

Burns are a source of pain, which cannot be fully treated with medications.

OBJECTIVES

This study aims is to test the effectiveness of lavender oil inhalation aromatherapy applied before dressing change on vital signs and pain levels of children with burns.

DESIGN

This randomized controlled study was held between May 2018 and May 2019. A total of 108 children who met the inclusion criteria were studied in three groups: Lavender-15 Group inhaled lavender oil for 15 min before dressing (n:36), Lavender-60 Group inhaled lavender oil for 60 min before dressing (n:36), and Control Group inhaled jojoba (placebo) oil for 15 min before dressing (n:36). Baseline pain levels and vital signs of the children were measured before inhalation. Pain levels and vital signs of the children were re-measured at the 1st and 30th minutes after dressing.

RESULTS

There was no significant difference between the groups in terms of pain levels (p = 0.750) and vital signs before dressing. In post-dressing measurements, the number of respiration (after 1 min p = 0.000, after 30 min p = 0.000), heart rate (after 1 min p = 0.000, after 30 min p = 0.000), mean arterial blood pressure (after 1 min p = 0.010, after 30 min p = 0.000) and pain levels (after 1 min p = 0.000, after 30 min p = 0.000) were lower in the Lavender groups compared to the placebo group.

DISCUSSION

The result of this research reveals that inhalation aromatherapy which applied before dressing in children with burns affects the reduction of pain levels and stabilization of vital signs.

The Effects of Lavender and Citrus aurantium on Anxiety and Agitation of the Conscious Patients in Intensive Care Units: A Parallel Randomized Placebo-Controlled Trial

Background

Conscious patients admitted to intensive care units (ICU) suffer from anxiety and agitation for various reasons, which can affect their recovery processes.

Aims

To compare the effects of lavender and Citrus aurantium essential oils on anxiety and agitation of conscious patients admitted to ICUs.

Design

A randomized parallel placebo-controlled trial.

Methods

One hundred and fifty conscious patients admitted to ICUs were selected by convenience sampling and were randomly divided into three groups, groups of lavender aromatherapy and Citrus aurantium aromatherapy, in addition to the routine care and inhalation of five drops of lavender or Citrus aurantium essential oils for 30 minutes. The placebo group, in addition to routine care, was provided with 5 drops of normal saline for 30 minutes. Anxiety was assessed with the state subscale of State-Trait Anxiety Inventory, and agitation was examined with Richmond Agitation-Sedation Scale before, immediately, one hour, and three hours after the intervention.

Results

All three groups suffered from relatively severe state anxiety before the intervention. The level of anxiety in the lavender and Citrus aurantium groups was significantly lower than that of the placebo group immediately and three hours after the intervention (P < 0.05). No significant difference was observed between the two groups of lavender and Citrus aurantium. The majority of the samples in all three groups were agitated before the intervention, but agitation of all three groups decreased after the intervention. Restless/agitation reduced significantly in all three groups. Although restless/agitation of the lavender and Citrus aurantium groups reduced more than that of the placebo, no significant difference was found between the three groups.

Conclusion

The results of the present study showed the positive effects of lavender aromatherapy and Citrus aurantium aromatherapy on reducing the anxiety of patients admitted to ICUs. Relevance to Clinical Practice. Aromatherapy can be used as an effective and safe intervention to reduce anxiety in ICUs.

Impact of inhalation aromatherapy with Damask Rose (Rosa damascena) on stress, anxiety and hemodynamic parameters of patients undergoing coronary angiography: a single blind randomized clinical trial

OBJECTIVES

Coronary arteries angiography is used commonly for diagnosing cardiovascular diseases. In spite of the low risk of coronary artery angiography method, it could lead to stress, anxiety and consequently hemodynamic changes in patients. This study aimed to assess the effects of inhalation aromatherapy with Rosa damascena on stress, anxiety, and hemodynamic parameters of patients undergoing coronary angiography.

METHODS

A single-blind randomized clinical trial was conducted on 98 patients in Besat Educational Hospital, Hamadan, Iran. Before coronary angiography, patients at aromatherapy group inhaled five drops of 40% Rosa damascena for 20 min and in the control group, patients inhaled distilled water. Stress, anxiety, and hemodynamic parameters were measured before and after the intervention using DASS-21 questionnaire and checklist.

RESULTS

Data were analysed by SPSS 16 software using descriptive and inferential statistics such as paired t-test and non-parametric tests. There were significant differences in terms of stress and anxiety severity in patients at aromatherapy group (p=0.005) and control group (p=0.001). There were significant differences in terms of hemodynamic parameters such as heart rate (p=0.001), mean arterial pressure (p=0.001), systolic (p=0.003) and diastolic blood pressure (p=0.001) and SpO₂ (p=0.02).

CONCLUSIONS

Inhalation aromatherapy with Rosa damascena can significantly decrease stress and anxiety severity and improve hemodynamic parameters of patients undergoing coronary angiography.

REGISTRY NUMBER

This study has registered with the number IRCT201702019759N8 at Iranian Registry Clinical Trial.

Effects of lavender and Citrus aurantium on pain of conscious intensive care unit patients: A parallel randomized placebo-controlled trial

BACKGROUND

Conscious patients admitted to intensive care units (ICUs) suffer from pain for various reasons, which can affect their recovery process.

OBJECTIVE

The present study compared the effects of aromatherapy with Citrus aurantium and lavender essential oils against placebo for reducing pain in conscious intensive care patients.

DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS

This study was a parallel randomized placebo-controlled trial. The ICUs of two educational hospitals in Kerman in Southeastern Iran were the study setting. One hundred and fifty conscious intensive care patients were randomly divided into three groups using a stratified block randomization method. Two groups received aromatherapy with essential oils: one with lavender and the other with C. aurantium; these patients received a 30-minute therapy session using their assigned essential oil on the second day of their intensive care stay. The placebo group used 5 drops of normal saline instead of essential oil during their session.

MAIN OUTCOME MEASURES

Patient's pain was assessed using a visual analog scale before the aromatherapy intervention, as well as immediately after and one and three hours after intervention.

RESULTS

The mean pain score of the lavender group was 40.01 before the aromatherapy intervention and fell to 39.40, 30.60 and 23.68 immediately after the intervention, and at hour one and three post-intervention, respectively. The mean pain score of the C. aurantium group was 45.48 before the intervention and was reduced to 32.34 at three hours after the intervention. The mean pain of the placebo group decreased from 42.80 before the intervention to 35.20 at three hours after the intervention. Pain scores of all groups decreased during the study (P < 0.001). The mean pain of the lavender group was significantly lower than that of the placebo group at three hours after the intervention.

CONCLUSION

The results of this study showed that aromatherapy with lavender essential oil reduced pain in conscious ICU patients. Our data could not justify the use of C. aurantium for reducing pain in this population.

TRIAL REGISTRATION

No. IRCT20170116031972N9 (https://en.irct.ir/trial/40827).

Pain Control with Lavender Oil in Premature Infants: A Double-Blind Randomized Controlled Study

Objectives: Aromatherapy has become popular in pain control in recent years compared with other complementary methods. Lavender (Lavandula angustifolia Miller) is a fragrant essential oil used in aromatherapy for its antibacterial, antifungal, muscle-relaxing, and analgesic effects. The smell of lavender oil, known for its soothing effect on adults, has not been adequately investigated in regards to pain control in premature infants. The purpose of our study was to assign the effect of the scent of lavender oil on pain in preterm infants during heel lancing. Design: A double-blind randomized controlled clinical study. Settings/Location: The study was conducted in a third-level neonatal intensive care unit of Bezmialem Vakif University Hospital from March 2019 to November 2019. It consisted of two groups. Subjects: Sixty-one premature babies (24-37 weeks of gestation) were enrolled in the study. Interventions: Heel stick sampling for metabolic screening was used for both study groups. The interventions were performed by two experienced nurses. Heart rate, oxygen saturation, and the baby's facial expression were recorded by a camera 3 min before the intervention, during the sampling, and 3 min after the procedure. After collecting the data, the head researcher and the assistant researcher separately watched the videos and scored them by using the Premature Infant Pain Profile-Revised (PIPP-R). Outcome measures: The difference of pain scores (PIIP-R) between two groups. Results: There was a statistically significant difference between the two groups in terms of PIPP-R scores during and after the sampling (p = 0.008 and p = 0.03 respectively). The PIPP-R scores at the beginning of the procedure were not found to be significantly different between the groups (p > 0.05). Conclusions: Inhalation of lavender scent is effective in pain control in premature infants. It is safe and low cost; it does not interfere with medical care.

Aroma Acupoint Therapy for Symptom Management with Adolescent Patients: Early Experiences from School-Based Health Centers

Objectives: The American Academy of Pediatrics has long recognized a need for more resources for integrative medicine for health care providers and for patients. The aim of this study was to introduce Aroma Acupoint Therapy (AAT)-a relatively new integrative medicine modality using essential oils to activate acupoints-and to describe the early experiences of providers using AAT for adolescents at school-based health centers (SBHCs). Materials and Methods: This was a case series of 15 adolescents treated with 1 of 2 AAT specific protocols plus standard medical therapy between April 2018 and February 2019 at SBHCs. Of these 15 patients, ages 12-19, 14 were female. Clinical characteristics and treatment courses were abstracted by retrospective review of the patients' electronic medical records. The main outcomes and measures for this research were clinical characteristics, treatment courses and pre- and post-treatment pain scores for adolescents treated with AAT. Results: All 15 patients had nonspecific symptoms, including headaches, menstrual cramps, nausea, shortness of breath, chest pain, back pain, or dizziness. Pain scores were recorded in 8 of 15 encounters, and suggested improvements in most patients. Subjective documentation by the providers also suggested that most of these patients had reduced symptoms. Conclusions: With the call for nonopiate and integrative approaches to pain management, there is an urgent need to study the effectiveness of such modalities, such as AAT. It is safe, inexpensive, easy to learn, and is well-received by both health care providers and patients.

The effects of lavender aromatherapy on stress and pain perception in children during dental treatment: A randomized clinical trial

BACKGROUND AND PURPOSE

Reducing dental anxiety is a major aspect of childmanagement in dental visits. This crossover randomized clinical trial was designed to determine the effect of lavender aromatherapy on anxiety level during dental treatment and pain perception during dental injection in children.

MATERIALS AND METHODS

Twenty-four children aged 7-9 years received restorative treatment with lavender aromatherapy in the intervention session and without aroma in the control session. Salivary cortisol and pulse rate were measured to evaluate child's anxiety level and the Face Rating Scale (FRS) was used for assessing the pain perception during injection in both visits.

RESULTS

The treatment effect on salivary cortisol, pulse rate, and FRS score was -8.01 ± 0.92 nmol/l, -11.17 ± 1.28 (in minutes), and -2.00 ± 0.41 respectively, which was statistically significant (P < 0.001).

CONCLUSION

Lavender aromatherapy can decrease dental anxiety and experienced pain in dental setting.

Can lavender oil inhalation help to overcome dental anxiety and pain in children? A randomized clinical trial

Aromatherapy with essential oils can be used to relieve children. The aim of this study was to evaluate the correlations between psychological and physiologic findings after lavender oil inhalation among children assigned to undergo tooth extraction. A total of 126 children aged between 6 and 12 years were enrolled in the study. The groups were randomly divided into control and lavender groups. The lavender group inhaled 100% lavender oil for 3 min before the interventions, the control group received no prior application. Psychological assessments were made using face image scale (FIS), Face, Legs, Activity, Cry, Consolability (FLACC) and Wong-Baker pain rating scale (WBS). Physiologic changes were assessed using vital signs evaluations. All parameters were noted prior to applications, after inhalation, anesthesia injection, and tooth extraction. The lavender group showed significant lower anxiety and pain scores after tooth extraction (p < 0.05). Significantly lower levels of blood pressures and a significant pulse rate drop were found after inhalation in the lavender group. A statistically significant increase in heart rate was observed after anesthesia injection and tooth extraction in the control group (p < 0.05).Conclusion: Lavender oil can be preferred as a treatment of choice in routine pediatric dentistry.Trial registration number: NCT04115891 (Lavender Oil Inhalation Help to Overcome Dental Anxiety Among Children)What is Known:• Dental anxiety is the most common factor that causes children to have difficulty with the dentist and their parents during treatment.• Aromatherapy with essential oils can be used to relieve children.What is New:• Aromatherapy with lavender oil relieves the child by reducing the level of anxiety and facilitates dental treatment.• During surgical procedures such as local anesthesia and tooth extraction, lavender oil inhalation decreases pain levels of children.

Avaliação dos conhecimentos para o tratamento não farmacológico da dor

Las intervenciones para el alivio del dolor se clasifican en farmacológicas y no farmacológicas; las primeras incluyen la administración de fármacos analgésicos y las segundas utilizan terapias complementarias. El objetivo de este estudio fue diseñar y validar un instrumento de medición denominado “Conocimiento sobre intervenciones no farmacológicas para el alivio del dolor” para evaluar el nivel de conocimientos sobre intervenciones no farmacológicas para el manejo del dolor en un grupo de enfermeras profesionales y auxiliares de enfermería de una institución de salud de Bucaramanga, Colombia. Métodos:  El instrumento se desarrolló en dos fases; la primera fase consistió en la búsqueda bibliográfica para el diseño, la validación facial y de contenido por expertos. En la segunda fase se evalúo la confiabilidad prueba- reprueba de la versión final del cuestionario. Resultados:  La versión final del cuestionario contempla seis dimensiones propuestas por el Instituto Nacional de Medicina Alternativa de Estados Unidos con un total de 30 ítems. La confiabilidad de este instrumento fue baja (Índice Kappa-Cohen <0.60) en el 80% de los ítems. Conclusión:  Este es el primer instrumento diseñado para medir los conocimientos sobre intervenciones no farmacológicas para el alivio del dolor en enfermeras y auxiliares de enfermería en nuestro país, sin embargo, se requiere continuar con procesos que permitan mejorar su confiabilidad y evaluar su validez.          

Effect Of Peppermint Essence On The Pain And Anxiety Caused By Intravenous Catheterization In Cardiac Patients: A Randomized Controlled Trial

BACKGROUND

The effects of the peppermint essence on the pain and anxiety caused by intravenous catheterization have not been studied yet. The aim of this study was to determine effect of inhaling peppermint essence on the pain and anxiety.

METHODS

In this study, 80 cardiac patients were selected through convenient sampling and randomly allocated to aromatherapy and control groups. Data gathering tools were numeric pain rating scale and visual analogue scale for anxiety. The aromatherapy and control groups received inhaled aromatherapy with peppermint essence and distilled water, respectively.

RESULTS

Mean severity of the pain in the aromatherapy and control groups was 2.95±0.98 and 3.42±1.33, respectively. The difference was statistically significant (p=0.048). The mean score of anxiety before the intervention in the aromatherapy and control groups was 3.75±1.08 and 4.70±1.43, respectively; these figures after the intervention were 2.32±0.97 and 2.10±1.42, respectively. The two groups were not significantly different before and after the intervention in terms of the level of anxiety. However, the level of anxiety before and after the intervention was significantly different in each group (p<0.001).

CONCLUSION

Aromatherapy attenuated the pain and anxiety caused by intravenous catheterization. Before catheterization, peppermint essence aromatherapy is recommended.

Aromatherapy improves nausea, pain, and mood for patients receiving pediatric palliative care symptom-based consults: A pilot design trial

OBJECTIVE

The role of aromatherapy in supportive symptom management for pediatric patients receiving palliative care has been underexplored. This pilot study aimed to measure the impact of aromatherapy using validated child-reported nausea, pain, and mood scales 5 minutes and 60 minutes after aromatherapy exposure.

METHODS

The 3 intervention arms included use of a symptom-specific aromatherapy sachet scent involving deep breathing. The parallel default control arm (for those children with medical exclusion criteria to aromatherapy) included use of a visual imagery picture envelope and deep breathing. Symptom burden was sequentially assessed at 5 and 60 minutes using the Baxter Retching Faces scale for nausea, the Wong-Baker FACES scale for pain, and the Children's Anxiety and Pain Scale (CAPS) for anxious mood. Ninety children or adolescents (mean age 9.4 years) at a free-standing children's hospital in the United States were included in each arm (total n = 180).

RESULTS

At 5 minutes, there was a mean improvement of 3/10 (standard deviation [SD] 2.21) on the nausea scale; 2.6/10 (SD 1.83) on the pain scale; and 1.6/5 (SD 0.93) on the mood scale for the aromatherapy cohort (p < 0.0001). Symptom burden remained improved at 60 minutes post-intervention (<0.0001). Visual imagery with deep breathing improved self-reports of symptoms but was not as consistently sustained at 60 minutes.

SIGNIFICANCE OF RESULTS

Aromatherapy represents an implementable supportive care intervention for pediatric patients receiving palliative care consults for symptom burden. The high number of children disqualified from the aromatherapy arm because of pulmonary or allergy indications warrants further attention to outcomes for additional breathing-based integrative modalities.

Antimicrobial Activity of Six Essential Oils Against a Group of Human Pathogens: A Comparative Study

Essential oils are concentrated natural extracts derived from plants, which were proved to be good sources of bioactive compounds with antioxidative and antimicrobial properties. This study followed the effect of some commonly used essential oils in micellar and aqueous extract on some of the most common pathogenic bacteria. Frankincense, myrtle, thyme, lemon, oregano and lavender essential oils were tested against Staphylococcus aureus, Enterococcus faecalis, Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa. Both micellar and aqueous extracts were used for determination of their minimal inhibitory (MIC) and bactericidal concentrations (MBC). The most active oils were oregano, thyme, lemon and lavender, while the least active were frankincense and myrtle. Oregano oil presented up to 64 times lower MICs/MBCs than ethylic alcohol, if considered as standard, on all bacteria. Most susceptible bacteria were the Gram-positive cocci, including methicillin resistant S. aureus, while the most resistant was P. aeruginosa. With some exceptions, the best activity was achieved by micelles suspension of essential oils, with MICs and MBCs ranging from 0.1% to > 50% v/v. Only oregano and lavender aqueous extracts presented bactericidal activity and only on K. pneumoniae (MIC = 6.3%). Thyme, lemon and oregano oils present significantly lower overall average MICs for their micellar form than for their aqueous extracts. The present results may suggest some formulas of colloid or micelle suspensions of whole essential oils such as oregano, thyme or lemon oil, that may help in antimicrobial fight. Aqueous extracts of oregano or thyme oil with good antibacterial activity could also be used in selected cases.

Plants of the GenusLavandula: From Farm to Pharmacy

The Lavandula genus, belonging to the Lamiaceae, includes 39 species, with nearly 400 registered cultivars. Lavandula are worldwide plants that occur over the Mediterranean, Europe, North Africa, southwest Asia to southeast India. Lavandula plants have been used since ancient time to flavor and preserved food, to treat diseases including wound healing, sedative, antispasmodic, microbial and viral infections. Numerous researches have described the chemical composition and the primary components of lavender oils are the monoterpenoids (linalool, linalyl acetate, 1,8-cineole, β-ocimene, terpinen-4-ol, and camphor), sesquiterpenoids (β-caryophyllene and nerolidol) and other terpenoid compounds (e.g., perillyl alcohol). The high concentrations of linalyl acetate make them attractive in perfumery, flavoring, cosmetics and soap industries. Currently, data on the antimicrobial activity of lavender plants have been scientifically confirmed. Indeed, lavender essential oils possess wide spectra of biological activities such as antispasmodic, carminative, analgesic, sedative, hypotensive, antiseptic, antimicrobial, antifungal, antidiuretic and general tonic action. In addition, clinical studies support their uses as treatment of health conditions. However, further clinical studies are necessary to define the magnitude of the efficacy, mechanisms of action, optimal doses, long-term safety, and, potential side effects of lavender plants.