AnxietyNCT05334537
Effect of Aromatherapy on Perioperative Anxiety Level in Cesarean Sections
A study testing Aromatherapy in people with Anxiety and Midazolam Overdose, run by Kahramanmaras Sutcu Imam University at 1 site in Turkey (Türkiye).
Trial summary
Spinal anesthesia has been accepted as the first choice for elective cesarean section due to its easy application technique and elimination of the risks of difficult intubation and aspiration. Neuraxial anesthesia is considered superior to general anesthesia in terms of fetal well-being. Read more about this study
- Who is it for?
- Any age, women onlyHealthy volunteers can take part
- Conditions the study is for
- Anxiety, Midazolam Overdose, Breast Feeding
- What is being tested?
- Aromatherapy
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 96 participants
- Where
- 1 siteTurkey (Türkiye)
- Study dates
- 1 Jun 2020to 1 Dec 2021
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages Any age
- Women only
- Healthy volunteers accepted
- Child, Adult, Older adult
Who may be able to join
- Pregnant women who underwent CS with spinal anesthesia
- Ninety-six patients aged between 18 and 45 years,
- With a height of ≥156 centimeters (cm)
- Gestational age of >37 weeks
- The American Society of Anesthesiologists (ASA) II risk group, who were scheduled for elective CS under spinal anesthesia
Who cannot join
- -
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Aromaterapinin Spinal Anestezi Uygulanan Sezaryen Vakalarında Perioperatif Anksiyete Düzeyine Etkisi / The Effect Of Aromatherapy On The Level Of Intraoperative Anxiety In Caesarean Case Under Spinal Anesthesia
Spinal anesthesia has been accepted as the first choice for elective cesarean section due to its easy application technique and elimination of the risks of difficult intubation and aspiration. Neuraxial anesthesia is considered superior to general anesthesia in terms of fetal well-being. The state of having an operation and not being aware of the operation by the patient can cause serious anxiety and fear in the patient. Fear of surgical failure, not fully understanding the anesthesia method, possible risks of anesthesia and expected pain during the postoperative recovery period contribute to the patient's anxiety. Considering the patients undergoing elective surgery under spinal anesthesia, there is a moderate level of anxiety associated with advanced age and female gender. Reducing the stress and anxiety in the patient during elective surgery will reduce the neurohormonal response to surgery and reduce complications. Early skin-to-skin contact with the mother provides many benefits to the newborn, but maternal sedation in the operating room during cesarean delivery should also be within safe limits to avoid early skin-to-skin contact. Aromatherapy relies on the use of essential oils to contribute to physical and psychological well-being. The oils can be massaged into the skin, or inhaled using a steam infusion or burner. Birth pain is a severe pain, and the feeling of pain may increase with tension, fear and anxiety during delivery. Apart from medical methods, many complementary treatments such as acupuncture, reflexology, homeopathy, hypnotherapy, music and aromatherapy are tried to reduce pain and anxiety. Lavender aromatherapy has been shown to significantly reduce anxiety or pain in various surgical procedures. There is a growing literature on the use of lavender aromatherapy as an anxiolytic agent. Based on these findings, the study aimed to contribute to early mother-to-baby contact and breast milk intake by reducing perioperative maternal anxiety and therefore the use of sedative drugs during cesarean section performed under spinal anesthesia with the intraoperative use of lavender aromatherapy. This is the first study to evaluate the effect of aromatherapy on anxiety in cases of cesarean section under anesthesia.
Read the detailed description
Patients who were to undergo lavender aromatherapy with an oxygen mask after the birth of the baby were randomly divided into two groups: aromatherapy (A) (n=48) and control (C) (n=48), who inhaled odorless essential oil. Participants were admitted to the preoperative preparation room 20 min before the operation, and their age, height, weight, and ASA risk scores were recorded after their informed consent was obtained. They were monitored and sent to the operating room after their baseline anxiety levels were measured and recorded using the Visual Analog Scale (VAS) for pain and State-Trait Anxiety Inventory (STAI-I). Following local sterilization with the patient in the sitting position, the lumbar (L) region was punctured at the L3-L4 level or the L4-L5 level with a 25-G, 90 mm pencil-point spinal atraumatic needle. After visualization of the cerebral spinal fluid flow, 10 mg of 0.5% bupivacaine (Marcaine® Spinal Heavy 0.5% ampule, AstraZeneca, UK) was administered for spinal anesthesia. Then, after the birth of the baby, two drops of 100% pure medical lavender oil (Lavandula angustifolia) and two drops of odorless baby oil (jojoba and almond oil) was inhaled for 5 min through an oxygen mask by groups A and C, respectively. After 5 min, 2 mg intravenous midazolam for sedation was administred to the patients who gained 1 point from the Ramsey Sedation Scale (RSS). Complications, such as nausea, vomiting, hypotension (mean arterial pressure<60 mmHg), and allergies that developed after aromatherapy, were recorded. At the end of the operation, the dose added to the initial midazolam dose for all patients and the total surgical time were recorded. VAS pain and STAI-I scores were re-evaluated at the third postoperative hour, and the satisfaction levels of each patient after aromatherapy were recorded according to the Likert scale as "very satisfied, satisfied, moderate, and not at all satisfied".
- Conditions
- Anxiety, Midazolam Overdose, Breast Feeding
- Being tested
- Aromatherapy, Placebo oil (odorless baby oil- jojoba and almond oil)
- Keywords
- aromatherapy, lavandula, sedative, spinal anesthesia, Anxiety
- Medical subject headings
- Anxiety Disorders, Breast Feeding
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
AromatherapyOther
Ninety-six patients aged between 18 and 45 years, with a height of ≥156 centimeters (cm), and a gestational age of >37 weeks, in the ASA II risk group, who were scheduled for elective CS under spinal anesthesia, were included in the study. Patients who were to undergo lavender aromatherapy with an oxygen mask after the birth of the baby were randomly divided into two groups: aromatherapy (A) (n=48) and control (C) (n=48), who inhaled odorless essential oil. Participants were admitted to the preoperative preparation room 20 min before the operation, and their age, height, weight, and ASA risk scores were recorded after their informed consent was obtained. They were monitored and sent to the operating room after their baseline anxiety levels were measured and recorded using the Visual Analog Scale (VAS) for pain and State-Trait Anxiety Inventory (STAI-I).
Placebo oil (odorless baby oil- jojoba and almond oil)Other
Ninety-six patients aged between 18 and 45 years, with a height of ≥156 centimeters (cm), and a gestational age of >37 weeks, in the ASA II risk group, who were scheduled for elective CS under spinal anesthesia, were included in the study. Patients who were to undergo lavender aromatherapy with an oxygen mask after the birth of the baby were randomly divided into two groups: aromatherapy (A) (n=48) and control (C) (n=48), who inhaled odorless essential oil. Participants were admitted to the preoperative preparation room 20 min before the operation, and their age, height, weight, and ASA risk scores were recorded after their informed consent was obtained. They were monitored and sent to the operating room after their baseline anxiety levels were measured and recorded using the Visual Analog Scale (VAS) for pain and State-Trait Anxiety Inventory (STAI-I).
| Study group | Role | What they receive |
|---|---|---|
| the aromatherapy group | Experimental | After the birth of the baby, two drops of 100% pure medical lavender oil (Lavandula angustifolia) was inhaled for 5 min through an oxygen mask by groups A and C, respectively. After 5 min, 2 mg intravenous midazolam for sedation was administred to the patients who gained 1 point from the Ramsey Sedation Scale (RSS). Complications, such as nausea, vomiting, hypotension (mean arterial pressure<60 mmHg), and allergies that developed after aromatherapy, were recorded. At the end of the operation, the dose added to the initial midazolam dose for all patients and the total surgical time were recorded. VAS pain and STAI-I scores were re-evaluated at the third postoperative hour, and the satisfaction levels of each patient after aromatherapy were recorded according to the Likert scale as "very satisfied, satisfied, moderate, and not at all satisfied". Receives: Other: Aromatherapy |
| the control group | Placebo comparator | Then, after the birth of the baby two drops of odorless baby oil (jojoba and almond oil) was inhaled for 5 min through an oxygen mask by groups A and C, respectively. After 5 min, 2 mg intravenous midazolam for sedation was administred to the patients who gained 1 point from the Ramsey Sedation Scale (RSS). Complications, such as nausea, vomiting, hypotension (mean arterial pressure<60 mmHg), and allergies that developed after aromatherapy, were recorded. At the end of the operation, the dose added to the initial midazolam dose for all patients and the total surgical time were recorded. VAS pain and STAI-I scores were re-evaluated at the third postoperative hour, and the satisfaction levels of each patient after aromatherapy were recorded according to the Likert scale as "very satisfied, satisfied, moderate, and not at all satisfied". Receives: Other: Placebo oil (odorless baby oil- jojoba and almond oil) |
What is being measured
The primary outcome is the main question the study is designed to answer.
Comparison between patients using aromatherapy and those without aromatherapy
A comparison will be made between the two groups, one group using lavender aromatherapy and one group without aromatherapy. T-tests used to assess whether the two groups are statistically different from each other. Comparisons made by comparing with the midazolam consumption. After 5 minutes from baby's birth, 2 mg intravenous midazolam for sedation was administred to the patients who gained 1 point from the Ramsey Sedation Scale. It is a six category scale that allows the evaluation of the sedation level and was created by Ramsey et al. (score 1: anxious, agitated and restless; score 2: cooperative, oriented and tranquil; score 3: responsive to commands only; score 4: brisk response to a light glabellar tap; score 5: sluggish response to a light glabellar tap or loud auditory stimulus; score 6: means no response).
Measured: Within one hour following the cesarean section
Comparison between patients using aromatherapy and those without aromatherapy
Comparison between two groups for the postoperative 3rd hour STAI-I scores. Ensuring the baby's clean breast milk intake and early mother-infant skin contact
Measured: Postoperative 3rd hour
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted19 Apr 2022
- Study start1 Jun 2020
- Primary completion1 Dec 2021
- Study completion1 Dec 2021
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for AnxietyStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Supportive care
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind
- Who is masked
- Care provider, Investigator
- Enrolment
- 96 participants (actual)
Sponsor and investigators
- Lead sponsor
- Kahramanmaras Sutcu Imam University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Feyza Calisir, Kahramanmaras Sutcu Imam University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT05334537
- Sponsor's protocol ID
- 2020/05-14
- Status last verified
- Apr 2022
- First submitted
- 28 Mar 2022
- Last updated
- 19 Apr 2022
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 19 Apr 2022. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Aromaterapinin Spinal Anestezi Uygulanan Sezaryen Vakalarında Perioperatif Anksiyete Düzeyine Etkisi / The Effect Of Aromatherapy On The Level Of Intraoperative Anxiety In Caesarean Case Under Spinal Anesthesia
- ClinicalTrials.gov ID
- NCT05334537
- Acronym / sponsor ID
- 2020/05-14
- Conditions
- Anxiety, Midazolam Overdose, Breast Feeding
- Keywords
- aromatherapy, lavandula, sedative, spinal anesthesia, Anxiety
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 96 participants (actual)
- Lead sponsor
- Kahramanmaras Sutcu Imam UniversityUniversity, hospital or other
- Study start
- 1 Jun 2020 (actual)
- Primary completion
- 1 Dec 2021 (actual)
- Study completion
- 1 Dec 2021 (actual)
- First posted
- 19 Apr 2022 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Spinal anesthesia has been accepted as the first choice for elective cesarean section due to its easy application technique and elimination of the risks of difficult intubation and aspiration. Neuraxial anesthesia is considered superior to general anesthesia in terms of fetal well-being. The state of having an operation and not being aware of the operation by the patient can cause serious anxiety and fear in the patient. Fear of surgical failure, not fully understanding the anesthesia method, possible risks of anesthesia and expected pain during the postoperative recovery period contribute to the patient's anxiety. Considering the patients undergoing elective surgery under spinal anesthesia, there is a moderate level of anxiety associated with advanced age and female gender. Reducing the stress and anxiety in the patient during elective surgery will reduce the neurohormonal response to surgery and reduce complications. Early skin-to-skin contact with the mother provides many benefits to the newborn, but maternal sedation in the operating room during cesarean delivery should also be within safe limits to avoid early skin-to-skin contact. Aromatherapy relies on the use of essential oils to contribute to physical and psychological well-being. The oils can be massaged into the skin, or inhaled using a steam infusion or burner. Birth pain is a severe pain, and the feeling of pain may increase with tension, fear and anxiety during delivery. Apart from medical methods, many complementary treatments such as acupuncture, reflexology, homeopathy, hypnotherapy, music and aromatherapy are tried to reduce pain and anxiety. Lavender aromatherapy has been shown to significantly reduce anxiety or pain in various surgical procedures. There is a growing literature on the use of lavender aromatherapy as an anxiolytic agent. Based on these findings, the study aimed to contribute to early mother-to-baby contact and breast milk intake by reducing perioperative maternal anxiety and therefore the use of sedative drugs during cesarean section performed under spinal anesthesia with the intraoperative use of lavender aromatherapy. This is the first study to evaluate the effect of aromatherapy on anxiety in cases of cesarean section under anesthesia.
Detailed description
Patients who were to undergo lavender aromatherapy with an oxygen mask after the birth of the baby were randomly divided into two groups: aromatherapy (A) (n=48) and control (C) (n=48), who inhaled odorless essential oil. Participants were admitted to the preoperative preparation room 20 min before the operation, and their age, height, weight, and ASA risk scores were recorded after their informed consent was obtained. They were monitored and sent to the operating room after their baseline anxiety levels were measured and recorded using the Visual Analog Scale (VAS) for pain and State-Trait Anxiety Inventory (STAI-I). Following local sterilization with the patient in the sitting position, the lumbar (L) region was punctured at the L3-L4 level or the L4-L5 level with a 25-G, 90 mm pencil-point spinal atraumatic needle. After visualization of the cerebral spinal fluid flow, 10 mg of 0.5% bupivacaine (Marcaine® Spinal Heavy 0.5% ampule, AstraZeneca, UK) was administered for spinal anesthesia. Then, after the birth of the baby, two drops of 100% pure medical lavender oil (Lavandula angustifolia) and two drops of odorless baby oil (jojoba and almond oil) was inhaled for 5 min through an oxygen mask by groups A and C, respectively. After 5 min, 2 mg intravenous midazolam for sedation was administred to the patients who gained 1 point from the Ramsey Sedation Scale (RSS). Complications, such as nausea, vomiting, hypotension (mean arterial pressure<60 mmHg), and allergies that developed after aromatherapy, were recorded. At the end of the operation, the dose added to the initial midazolam dose for all patients and the total surgical time were recorded. VAS pain and STAI-I scores were re-evaluated at the third postoperative hour, and the satisfaction levels of each patient after aromatherapy were recorded according to the Likert scale as "very satisfied, satisfied, moderate, and not at all satisfied".
Study design
- Primary purpose
- Supportive care
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (care provider, investigator)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| the aromatherapy group | Experimental | Other: AromatherapyAfter the birth of the baby, two drops of 100% pure medical lavender oil (Lavandula angustifolia) was inhaled for 5 min through an oxygen mask by groups A and C, respectively. After 5 min, 2 mg intravenous midazolam for sedation was administred to the patients who gained 1 point from the Ramsey Sedation Scale (RSS). Complications, such as nausea, vomiting, hypotension (mean arterial pressure<60 mmHg), and allergies that developed after aromatherapy, were recorded. At the end of the operation, the dose added to the initial midazolam dose for all patients and the total surgical time were recorded. VAS pain and STAI-I scores were re-evaluated at the third postoperative hour, and the satisfaction levels of each patient after aromatherapy were recorded according to the Likert scale as "very satisfied, satisfied, moderate, and not at all satisfied". |
| the control group | Placebo comparator | Other: Placebo oil (odorless baby oil- jojoba and almond oil)Then, after the birth of the baby two drops of odorless baby oil (jojoba and almond oil) was inhaled for 5 min through an oxygen mask by groups A and C, respectively. After 5 min, 2 mg intravenous midazolam for sedation was administred to the patients who gained 1 point from the Ramsey Sedation Scale (RSS). Complications, such as nausea, vomiting, hypotension (mean arterial pressure<60 mmHg), and allergies that developed after aromatherapy, were recorded. At the end of the operation, the dose added to the initial midazolam dose for all patients and the total surgical time were recorded. VAS pain and STAI-I scores were re-evaluated at the third postoperative hour, and the satisfaction levels of each patient after aromatherapy were recorded according to the Likert scale as "very satisfied, satisfied, moderate, and not at all satisfied". |
Who may qualify
- Sex
- Female only
- Healthy volunteers
- Accepted
- Age groups
- Child, Adult, Older adult
Key inclusion criteria (5 listed)
- Pregnant women who underwent CS with spinal anesthesia
- Ninety-six patients aged between 18 and 45 years,
- With a height of ≥156 centimeters (cm)
- Gestational age of >37 weeks
- The American Society of Anesthesiologists (ASA) II risk group, who were scheduled for elective CS under spinal anesthesia
Key exclusion criteria (1 listed)
- -
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| AromatherapyNinety-six patients aged between 18 and 45 years, with a height of ≥156 centimeters (cm), and a gestational age of >37 weeks, in the ASA II risk group, who were scheduled for elective CS under spinal anesthesia, were included in the study. Patients who were to undergo lavender aromatherapy with an oxygen mask after the birth of the baby were randomly divided into two groups: aromatherapy (A) (n=48) and control (C) (n=48), who inhaled odorless essential oil. Participants were admitted to the preoperative preparation room 20 min before the operation, and their age, height, weight, and ASA risk scores were recorded after their informed consent was obtained. They were monitored and sent to the operating room after their baseline anxiety levels were measured and recorded using the Visual Analog Scale (VAS) for pain and State-Trait Anxiety Inventory (STAI-I). | Other | the aromatherapy group |
| Placebo oil (odorless baby oil- jojoba and almond oil)Ninety-six patients aged between 18 and 45 years, with a height of ≥156 centimeters (cm), and a gestational age of >37 weeks, in the ASA II risk group, who were scheduled for elective CS under spinal anesthesia, were included in the study. Patients who were to undergo lavender aromatherapy with an oxygen mask after the birth of the baby were randomly divided into two groups: aromatherapy (A) (n=48) and control (C) (n=48), who inhaled odorless essential oil. Participants were admitted to the preoperative preparation room 20 min before the operation, and their age, height, weight, and ASA risk scores were recorded after their informed consent was obtained. They were monitored and sent to the operating room after their baseline anxiety levels were measured and recorded using the Visual Analog Scale (VAS) for pain and State-Trait Anxiety Inventory (STAI-I). | Other | the control group |
Primary outcome
Comparison between patients using aromatherapy and those without aromatherapy
Time frame: Within one hour following the cesarean section
A comparison will be made between the two groups, one group using lavender aromatherapy and one group without aromatherapy. T-tests used to assess whether the two groups are statistically different from each other. Comparisons made by comparing with the midazolam consumption. After 5 minutes from baby's birth, 2 mg intravenous midazolam for sedation was administred to the patients who gained 1 point from the Ramsey Sedation Scale. It is a six category scale that allows the evaluation of the sedation level and was created by Ramsey et al. (score 1: anxious, agitated and restless; score 2: cooperative, oriented and tranquil; score 3: responsive to commands only; score 4: brisk response to a light glabellar tap; score 5: sluggish response to a light glabellar tap or loud auditory stimulus; score 6: means no response).
Comparison between patients using aromatherapy and those without aromatherapy
Time frame: Postoperative 3rd hour
Comparison between two groups for the postoperative 3rd hour STAI-I scores. Ensuring the baby's clean breast milk intake and early mother-infant skin contact
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 19 Apr 2022.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Aromatherapy in people with Anxiety and Midazolam Overdose, run by Kahramanmaras Sutcu Imam University at 1 site in Turkey (Türkiye).
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 5 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 19 Apr 2022. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Turkey (Türkiye). Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Comparison between patients using aromatherapy and those without aromatherapy (time frame: Within one hour following the cesarean section). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 19 Apr 2022.