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.
Highlights
Postoperative nausea and vomiting (PONV) is one of the most common postoperative complications of general anesthesia in pediatrics
PONV is an unpleasant experience with potential secondary complications such as wound dehiscence, electrolyte abnormalities and aspiration
The study was conducted at the Isaac Walton Killam (IWK) Health Centre in Halifax, Nova Scotia
Summary
Given the encouraging results of the adult studies, we planned to determine feasibility of doing a large-scale study in the pediatric population. Postoperative nausea and vomiting (PONV) is one of the most common postoperative complications of general anesthesia in pediatrics. Pediatric rates of nausea and vomiting are approximately double those of adult patients (approximately 40 %) [1, 2]. PONV is an unpleasant experience with potential secondary complications such as wound dehiscence, electrolyte abnormalities and aspiration. Aromatherapy has been shown to be effective in treating PONV in adults [5–7]. Meta-analysis of four previous studies (215 subjects) failed to show a significant effect
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