Inhalation aromatherapy in children and adolescents
Ndao DH, Ladas EJ, Cheng B, Sands SA, Snyder KT, Garvin JH Jr, Kelly KM.. Psychooncology. 2010 Dec 27. http://www.ncbi.nlm.nih.gov/pubmed?term=Inhalation%20aromatherapy%20in%20children%20and%20adolescents%20undergoing%20stem%20cell%20infusion%3A%20results%20of%20a%20placebocontrolled%20double-blind%20tria
The Study: In a placebo controlled, double blind randomized trial, bergamot inhalation aromatherapy was compared with a pleasant smelling shampoo that did not contain essential oils. Both were administered around the time of stem cell infusion in 37 children and adolescents undergoing stem cell transplant to both patients and their parents.
Overall, aromatherapy was not found to be beneficial in reducing nausea, anxiety, or pain. Nausea and pain subsided over the course of the intervention for all children, though nausea remained significantly greater in patients receiving aromatherapy. As administered in this study, bergamot inhalation aromatherapy may have contributed to persistent anxiety following the infusion of stem cells. Although no more effective than placebo, parents receiving aromatherapy showed a significant decrease in their transitory anxiety during the period between the completion of their child’s infusion and one-hour following infusion. These findings suggest the diffusion of bergamot essential oil may not provide suitable anxiolytic and antiemetic effects among children and adolescents undergoing stem cell transplantation.
Limitations: The study population was fairly small. There was a high rate of aromatherapy use pre-intervention, potentially confounding results. In addition, it was hard to differentiate between treatment- or transplant-related effects including anxiety and nausea.
What this Means: This study, in combination with the previous one I posted, provides some opposing evidence for the use of aromatherapy during stem cell transplant. The difference in study design may explain the differing results, as single blinded or nonblinded trials in general supported the aromatherapy intervention. In double-blinded studies, both the study leaders and participants do not know what intervention the patient is receiving; they are the gold standard in research since they remove many factors that could alter data. However, the strong emotional link to the sense of smell makes it extremely difficult to control for in research settings. Since the symptoms measured, primarily anxiety and nausea, are also closely linked to emotions, it is difficult to ascertain any improvement or worsening of symptoms. In addition, this study also showed that essential oils have unknown side effects, possibly nausea and anxiety in this study, that we do not quite understand.
What this Means: This study, in combination with the previous one I posted, provides some opposing evidence for the use of aromatherapy during stem cell transplant. The difference in study design may explain the differing results, as single blinded or nonblinded trials in general supported the aromatherapy intervention. In double-blinded studies, both the study leaders and participants do not know what intervention the patient is receiving; they are the gold standard in research since they remove many factors that could alter data. However, the strong emotional link to the sense of smell makes it extremely difficult to control for in research settings. Since the symptoms measured, primarily anxiety and nausea, are also closely linked to emotions, it is difficult to ascertain any improvement or worsening of symptoms. In addition, this study also showed that essential oils have unknown side effects, possibly nausea and anxiety in this study, that we do not quite understand.
My Take: These two studies, in combination, sort of contradict each other. However, they did use two different essential oils and two different study designs so they are difficult to directly compare. From personal experience, I’ve seen that other scents may have been more likeable to a pediatric population such as peppermint, grapefruit, orange, and lavender. However, bergamot, a citrus, has been described as efficacious for pediatric anxiety and nausea in aromatherapy literature (1,2). While each essential oil has a clinical indication, the CAM practitioners here at Columbia’s pediatric oncology department mostly go by patient preference. The scent of smell is so closely related to emotions Often, they find that individual smells “speak” to a certain patient and provide relief regardless of the initial clinical use. This type of patient-centered treatment allows us more flexibility and better patient care. In the CAM world, it’s our form of patient-centered personalized medicine.
1. Wildwood C. The Encyclopedia of Aromatherapy. Healing Arts Press: Rochester, 1996.
2. Price S, Price PP. Aromatherapy for Babies and Children. Thorsons Publishers: San Francisco, 1996.
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