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J Reconstr Microsurg 2021; 37(06): 530-540
DOI: 10.1055/s-0041-1724465
Original Article

The Effect of Lavender Oil on Perioperative Pain, Anxiety, Depression, and Sleep after Microvascular Breast Reconstruction: A Prospective, Single-Blinded, Randomized, Controlled Trial

Ronnie L. Shammas
1   Division of Plastic, Maxillofacial, and Oral Surgery, Department of Surgery, Duke University Health System, Durham, North Carolina
,
Caitlin E. Marks
1   Division of Plastic, Maxillofacial, and Oral Surgery, Department of Surgery, Duke University Health System, Durham, North Carolina
,
Gloria Broadwater
2   Department of Biostatistics and Bioinformatics, Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina
,
Elliot Le
1   Division of Plastic, Maxillofacial, and Oral Surgery, Department of Surgery, Duke University Health System, Durham, North Carolina
,
Adam D. Glener
1   Division of Plastic, Maxillofacial, and Oral Surgery, Department of Surgery, Duke University Health System, Durham, North Carolina
,
Amanda R. Sergesketter
1   Division of Plastic, Maxillofacial, and Oral Surgery, Department of Surgery, Duke University Health System, Durham, North Carolina
,
Roger W. Cason
1   Division of Plastic, Maxillofacial, and Oral Surgery, Department of Surgery, Duke University Health System, Durham, North Carolina
,
Kristen M. Rezak
1   Division of Plastic, Maxillofacial, and Oral Surgery, Department of Surgery, Duke University Health System, Durham, North Carolina
,
Brett T. Phillips
1   Division of Plastic, Maxillofacial, and Oral Surgery, Department of Surgery, Duke University Health System, Durham, North Carolina
,
Scott T. Hollenbeck
1   Division of Plastic, Maxillofacial, and Oral Surgery, Department of Surgery, Duke University Health System, Durham, North Carolina
› Author Affiliations Funding This trial was funded by dōTERRA International. The authors have no financial relationship with dōTERRA International.
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Abstract

Background Psychosocial distress, depression, or anxiety can occur in up to 50% of women after a breast cancer diagnosis and mastectomy. The purpose of this study was to assess the potential benefit of lavender oil as a perioperative adjunct to improve anxiety, depression, pain, and sleep in women undergoing microvascular breast reconstruction.

Methods This was a prospective, single-blinded, randomized, controlled trial of 49 patients undergoing microvascular breast reconstruction. Patients were randomized to receive lavender oil or placebo (coconut oil) throughout their hospitalization. The effect of lavender oil on perioperative stress, anxiety, depression, sleep, and pain was measured using the hospital anxiety and depression scale, Richards–Campbell Sleep Questionnaire, and the visual analogue scale.

Results Twenty-seven patients were assigned to the lavender group and 22 patients were assigned to the control group. No significant differences were seen in the perioperative setting between the groups with regard to anxiety (p = 0.82), depression (p = 0.21), sleep (p = 0.86), or pain (p = 0.30) scores. No adverse events (i.e., allergic reaction) were captured, and no significant differences in surgery-related complications were observed. When evaluating the entire cohort, postoperative anxiety scores were significantly lower than preoperative scores (p < 0.001), while depression scores were significantly higher postoperatively as compared with preoperatively (p = 0.005).

Conclusion In the setting of microvascular breast reconstruction, lavender oil and aromatherapy had no significant adverse events or complications; however, there were no measurable advantages pertaining to metrics of depression, anxiety, sleep, or pain as compared with the control group.

Keywords

breast reconstruction - aromatherapy - reconstruction - breast cancer - lavender

Note

This study is registered with ClinicalTrials.gov with identifier no. NCT03093454. An investigational new drug application was filed with the United States Food and Drug Administration for this study.




Publication History

Received: 13 July 2020

Accepted: 19 November 2020

Article published online:
06 February 2021

© 2021. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 Orr JP, Sergesketter AR, Shammas RL. et al. Assessing the relationship between anxiety and revision surgery following autologous breast reconstruction. Plast Reconstr Surg 2019; 144 (01) 24-33
    CrossrefPubMedGoogle Scholar
  • 2 Metcalfe KA, Zhong T, Narod SA. et al. A prospective study of mastectomy patients with and without delayed breast reconstruction: long-term psychosocial functioning in the breast cancer survivorship period. J Surg Oncol 2015; 111 (03) 258-264
    CrossrefPubMedGoogle Scholar
  • 3 Nissen MJ, Swenson KK, Ritz LJ, Farrell JB, Sladek ML, Lally RM. Quality of life after breast carcinoma surgery: a comparison of three surgical procedures. Cancer 2001; 91 (07) 1238-1246
    CrossrefPubMedGoogle Scholar
  • 4 Goldberg JA, Scott RN, Davidson PM. et al. Psychological morbidity in the first year after breast surgery. Eur J Surg Oncol 1992; 18 (04) 327-331
    PubMedGoogle Scholar
  • 5 Roth RS, Lowery JC, Davis J, Wilkins EG. Psychological factors predict patient satisfaction with postmastectomy breast reconstruction. Plast Reconstr Surg 2007; 119 (07) 2008-2015 , discussion 2016–2017
    CrossrefPubMedGoogle Scholar
  • 6 Rendon JL, Hodson T, Skoracki RJ, Humeidan M, Chao AH. Enhanced recovery after surgery protocols decrease outpatient opioid use in patients undergoing abdominally based microsurgical breast reconstruction. Plast Reconstr Surg 2019; 145 (03) 645-651
    CrossrefPubMedGoogle Scholar
  • 7 Marcusa DP, Mann RA, Cron DC. et al. Prescription opioid use among opioid-naive women undergoing immediate breast reconstruction. Plast Reconstr Surg 2017; 140 (06) 1081-1090
    CrossrefPubMedGoogle Scholar
  • 8 Roy-Byrne P, Sullivan MD, Sherbourne CD. et al. Effects of pain and prescription opioid use on outcomes in a collaborative care intervention for anxiety. Clin J Pain 2013; 29 (09) 800-806
    CrossrefPubMedGoogle Scholar
  • 9 Semenkovich K, Chockalingam R, Scherrer JF. et al. Prescription opioid analgesics increase risk of major depression: new evidence, plausible neurobiological mechanisms and management to achieve depression prophylaxis. Mo Med 2014; 111 (02) 148-154
    PubMedGoogle Scholar
  • 10 Scherrer JF, Svrakic DM, Freedland KE. et al. Prescription opioid analgesics increase the risk of depression. J Gen Intern Med 2014; 29 (03) 491-499
    CrossrefPubMedGoogle Scholar
  • 11 Fayazi S, Babashahi M, Rezaei M. The effect of inhalation aromatherapy on anxiety level of the patients in preoperative period. Iran J Nurs Midwifery Res 2011; 16 (04) 278-283
    PubMedGoogle Scholar
  • 12 Braden R, Reichow S, Halm MA. The use of the essential oil lavandin to reduce preoperative anxiety in surgical patients. J Perianesth Nurs 2009; 24 (06) 348-355
    CrossrefPubMedGoogle Scholar
  • 13 Lee YL, Wu Y, Tsang HW, Leung AY, Cheung WM. A systematic review on the anxiolytic effects of aromatherapy in people with anxiety symptoms. J Altern Complement Med 2011; 17 (02) 101-108
    CrossrefPubMedGoogle Scholar
  • 14 Brum LF, Elisabetsky E, Souza D. Effects of linalool on [(3)H]MK801 and [(3)H] muscimol binding in mouse cortical membranes. Phytother Res 2001; 15 (05) 422-425
    CrossrefPubMedGoogle Scholar
  • 15 Hossain SJ, Aoshima H, Koda H, Kiso Y. Fragrances in oolong tea that enhance the response of GABAA receptors. Biosci Biotechnol Biochem 2004; 68 (09) 1842-1848
    CrossrefPubMedGoogle Scholar
  • 16 Kritsidima M, Newton T, Asimakopoulou K. The effects of lavender scent on dental patient anxiety levels: a cluster randomised-controlled trial. Community Dent Oral Epidemiol 2010; 38 (01) 83-87
    CrossrefPubMedGoogle Scholar
  • 17 Muzzarelli L, Force M, Sebold M. Aromatherapy and reducing preprocedural anxiety: A controlled prospective study. Gastroenterol Nurs 2006; 29 (06) 466-471
    CrossrefPubMedGoogle Scholar
  • 18 Perry R, Terry R, Watson LK, Ernst E. Is lavender an anxiolytic drug? A systematic review of randomised clinical trials. Phytomedicine 2012; 19 (8,9): 825-835
    CrossrefPubMedGoogle Scholar
  • 19 Heidari Gorji MA, Ashrastaghi OG, Habibi V, Charati JY, Ebrahimzadeh MA, Ayasi M. The effectiveness of lavender essence on strernotomy related pain intensity after coronary artery bypass grafting. Adv Biomed Res 2015; 4: 127
    CrossrefPubMedGoogle Scholar
  • 20 Kim JT, Ren CJ, Fielding GA. et al. Treatment with lavender aromatherapy in the post-anesthesia care unit reduces opioid requirements of morbidly obese patients undergoing laparoscopic adjustable gastric banding. Obes Surg 2007; 17 (07) 920-925
    CrossrefPubMedGoogle Scholar
  • 21 Salamati A, Mashouf S, Sahbaei F, Mojab F. Effects of inhalation of lavender essential oil on open-heart surgery pain. Iran J Pharm Res 2014; 13 (04) 1257-1261
    PubMedGoogle Scholar
  • 22 Sharif-Askary B, Hompe E, Broadwater G, Anolik R, Hollenbeck ST. The effect of enhanced recovery after surgery pathway implementation on abdominal-based microvascular breast reconstruction. J Surg Res 2019; 242: 276-285
    CrossrefPubMedGoogle Scholar
  • 23 Delgado DA, Lambert BS, Boutris N. et al. Validation of digital visual analog scale pain scoring with a traditional paper-based visual analog scale in adults. J Am Acad Orthop Surg Glob Res Rev 2018; 2 (03) e088
    PubMedGoogle Scholar
  • 24 Richards KC, O'Sullivan PS, Phillips RL. Measurement of sleep in critically ill patients. J Nurs Meas 2000; 8 (02) 131-144
    CrossrefPubMedGoogle Scholar
  • 25 Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand 1983; 67 (06) 361-370
    CrossrefPubMedGoogle Scholar
  • 26 Höferl M, Hütter C, Buchbauer G. A pilot study on the physiological effects of three essential oils in humans. Nat Prod Commun 2016; 11 (10) 1561-1564
    PubMedGoogle Scholar
  • 27 Nagai K, Niijima A, Horii Y, Shen J, Tanida M. Olfactory stimulatory with grapefruit and lavender oils change autonomic nerve activity and physiological function. Auton Neurosci 2014; 185: 29-35
    CrossrefPubMedGoogle Scholar
  • 28 Cho EH, Lee MY, Hur MH. The effects of aromatherapy on intensive care unit patients' stress and sleep quality: a nonrandomised controlled trial. Evid Based Complement Alter Med 2017; 2017: 2856592
    PubMedGoogle Scholar
  • 29 Karadag E, Samancioglu S, Ozden D, Bakir E. Effects of aromatherapy on sleep quality and anxiety of patients. Nurs Crit Care 2017; 22 (02) 105-112
    CrossrefPubMedGoogle Scholar
  • 30 Ni CH, Hou WH, Kao CC. et al. The anxiolytic effect of aromatherapy on patients awaiting ambulatory surgery: a randomized controlled trial. Evid Based Complement Alter Med 2013; 2013: 927419
    PubMedGoogle Scholar
  • 31 Stea S, Beraudi A, De Pasquale D. Essential oils for complementary treatment of surgical patients: state of the art. Evid Based Complement Alter Med 2014; 2014: 726341
    CrossrefPubMedGoogle Scholar
  • 32 Olapour A, Behaeen K, Akhondzadeh R, Soltani F, Al Sadat Razavi F, Bekhradi R. The effect of inhalation of aromatherapy blend containing lavender essential oil on cesarean postoperative pain. Anesth Pain Med 2013; 3 (01) 203-207
    CrossrefPubMedGoogle Scholar
  • 33 Kim JT, Wajda M, Cuff G. et al. Evaluation of aromatherapy in treating postoperative pain: pilot study. Pain Pract 2006; 6 (04) 273-277
    CrossrefPubMedGoogle Scholar
  • 34 Gedney JJ, Glover TL, Fillingim RB. Sensory and affective pain discrimination after inhalation of essential oils. Psychosom Med 2004; 66 (04) 599-606
    CrossrefPubMedGoogle Scholar
  • 35 Tan YZ, Lu X, Luo J. et al. Enhanced recovery after surgery for breast reconstruction: pooled meta-analysis of 10 observational studies involving 1,838 patients. Front Oncol 2019; 9: 675
    CrossrefPubMedGoogle Scholar
  • 36 Offodile II AC, Gu C, Boukovalas S. et al. Enhanced recovery after surgery (ERAS) pathways in breast reconstruction: systematic review and meta-analysis of the literature. Breast Cancer Res Treat 2019; 173 (01) 65-77
    CrossrefPubMedGoogle Scholar
  • 37 Fatiregun OA, Olagunju AT, Erinfolami AR, Fatiregun OA, Arogunmati OA, Adeyemi JD. Anxiety disorders in breast cancer: prevalence, types, and determinants. J Psychosoc Oncol 2016; 34 (05) 432-447
    CrossrefPubMedGoogle Scholar
  • 38 Zainal NZ, Nik-Jaafar NR, Baharudin A, Sabki ZA, Ng CG. Prevalence of depression in breast cancer survivors: a systematic review of observational studies. Asian Pac J Cancer Prev 2013; 14 (04) 2649-2656
    CrossrefPubMedGoogle Scholar
  • 39 Karakoyun-Celik O, Gorken I, Sahin S, Orcin E, Alanyali H, Kinay M. Depression and anxiety levels in woman under follow-up for breast cancer: relationship to coping with cancer and quality of life. Med Oncol 2010; 27 (01) 108-113
    CrossrefPubMedGoogle Scholar
  • 40 Andersen BL, Yang HC, Farrar WB. et al. Psychologic intervention improves survival for breast cancer patients: a randomized clinical trial. Cancer 2008; 113 (12) 3450-3458
    CrossrefPubMedGoogle Scholar
  • 41 Fann JR, Thomas-Rich AM, Katon WJ. et al. Major depression after breast cancer: a review of epidemiology and treatment. Gen Hosp Psychiatry 2008; 30 (02) 112-126
    CrossrefPubMedGoogle Scholar
  • 42 Gopie JP, Timman R, Hilhorst MT, Hofer SO, Mureau MA, Tibben A. The short-term psychological impact of complications after breast reconstruction. Psychooncology 2013; 22 (02) 290-298
    CrossrefPubMedGoogle Scholar
  • 43 Kim MS, Kim SY, Kim JH, Park B, Choi HG. Depression in breast cancer patients who have undergone mastectomy: a national cohort study. PLoS One 2017; 12 (04) e0175395
    CrossrefPubMedGoogle Scholar