Aromatherapy for the treatment of PONV in children: a pilot RCT

Abstract

BackgroundPostoperative nausea and vomiting (PONV) is one of the most common postoperative complications of general anesthesia in pediatrics. Aromatherapy has been shown to be effective in treating PONV in adults. Given the encouraging results of the adult studies, we planned to determine feasibility of doing a large-scale study in the pediatric population.MethodsOur group conducted a pilot randomized controlled trial examining the effect of aromatherapy on post-operative nausea and vomiting in patients 4–16 undergoing ambulatory surgery at a single center. Nausea was defined as a score of 4/10 on the Baxter Retching Faces Scale (BARF scale). A clinically significant reduction was defined as a two-point reduction in Nausea. Post operatively children were administered the BARF scale in 15 min internals until discharge home or until nausea score of 4/10 or greater. Children with nausea were randomized to saline placebo group or aromatherapy QueaseEase™ (Soothing Scents, Inc, Enterprise, AL: blend of ginger, lavender, mint and spearmint). Nausea scores were recorded post intervention.ResultsA total of 162 subjects were screened for inclusion in the study. Randomization occurred in 41 subjects of which 39 were included in the final analysis. For the primary outcome, 14/18 (78 %) of controls reached primary outcome compared to 19/21 (90 %) in the aromatherapy group (p = 0.39, Eta 0.175). Other outcomes included use of antiemetic in PACU (control 44 %, aromatherapy 52 % P = 0.75, Eta 0.08), emesis (Control 11 %, 9 % aromatherapy, P = 0.87, Eta = 0.03). There was a statistically significant difference in whether subjects continued to use the intervention (control 28 %, aromatherapy 66 %, p-value 0.048, Eta 0.33).ConclusionAromatherapy had a small non-significant effect size in treating postoperative nausea and vomiting compared with control. A large-scale randomized control trial would not be feasible at our institution and would be of doubtful utility.Trial registrationClinicalTrials.gov NCT02663154.

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

“…Essential oils were already successfully used in treatment of several conditions such as releasing of pain associated with chronical conditions or with medical procedures [4], reducing postoperative nausea or autonomic response to pain [5,6,7] for possible symptom relief in people with cancer [8,9] and even to treat pediculosis in children [10]. Many studies were performed on pediatric patients and no side effects were described.…”

The Use of Aromatherapy to Reduce Chemotherapy-Induced Nausea in Children With Cancer: A Randomized, Double-Blind, Placebo-Controlled Trial

“…These findings are contradictory to reports of improved nausea with the use of ginger aromatherapy in adults after surgery, but concur with a similar study in children. Kiberd et al (2016) reported that ginger aromatherapy did not significantly decrease postoperative nausea and vomiting in 39 children after general anesthesia. However, in the oncology population, others have concluded that oral ginger root capsules were effective in reducing the severity of acute and delayed CINV in children and adolescents with bone tumors (Pillai et al, 2011), and that six-gingerol assisted in relieving acute CINV in adults with solid tumors (Konmun et al, 2017).…”

“…A review of the literature on aromatherapy use for nausea and vomiting demonstrated evidence that inhaling the aromas of essential oils reduced the incidence and severity of nausea and vomiting and decreased antiemetic requirements for patients in various settings (Lua & Zakaria, 2012). A small randomized controlled pilot study of 41 patients examined the effect of QueaseEase™ on postoperative nausea and vomiting using the Baxter Retching Face scale (Kiberd et al, 2016). This pilot study reported that aromatherapy had a small nonsignificant effect in treating nausea and vomiting (Kiberd et al, 2016).…”

“…A small randomized controlled pilot study of 41 patients examined the effect of QueaseEase™ on postoperative nausea and vomiting using the Baxter Retching Face scale (Kiberd et al, 2016). This pilot study reported that aromatherapy had a small nonsignificant effect in treating nausea and vomiting (Kiberd et al, 2016). However, few reports exist in the specialty of oncology, and fewer still in pediatric oncology.…”

Management strategies for the treatment and prevention of postoperative/postdischarge nausea and vomiting: an updated review

“…spearmint, peppermint, ginger, lavender, and blended orange and peppermint) has also been demonstrated to provide benefits in reducing PONV and PDNV when added to a standard antiemetic treatment regimen 296 , 308 – 313 . However, there are other authors who have not found any evidence that aromatherapy decreases PONV 314 – 318 .…”