Implantable Central Venous Port Research Articles

Radiation dose reduction during venous access port implantation: the importance of upgrading equipment and radiation-protection training.

Implantable central venous port systems are widely used in oncology. We upgraded our fluoroscopy machines, and all anesthetists completed two training courses focusing on the risks of ionizing radiation for patients and health workers. This study aimed to evaluate the impact of upgrading the machines and the radiation-protection training on ionizing radiation exposure during venous port system implantation. We retrospectively analyzed consecutive venous port implantations between 2019 and 2022. The older fluoroscopy machines were replaced by two new machines. A first training session about health worker radioprotection was organized. The medical staff completed a second training course focused on protecting patients from ionizing radiation. We defined four distinct time intervals (TI): venous port implantations performed with the old equipment, the new fluoroscopy machines, after the first training course, and after the second training course. The air kerma-area product (KAP) was compared between these four TI and fluoroscopy times and the number of exposures only with the new machines. We analyzed 2587 procedures. A 93% decrease in the median KAP between the first and last TI was noted (median KAP = 323.0mGy.cm2 vs. 24.0mGy.cm2, p < 0.0001). A decrease in the KAP was observed for each of the 11 anesthetists. We also noted a significant decrease in the time of fluoroscopy and the number of exposures. Upgrading the fluoroscopy equipment and completing two dedicated training courses allowed for a drastic decrease patient exposure to ionizing radiation during venous access port implantation by non-radiologist practitioners.

Research progress on nursing of infusion extravasation of implantable central venous port system

Research progress on nursing of infusion extravasation of implantable central venous port system

Application of wireless energy transmission technology into central venous ports with light-emitting diodes.

Implantable central venous (CV) ports are widely used for chemotherapy and parenteral nutrition. Generally, CV ports are used safely; however, some patients suffer from drug leakage around the port septum due to mispuncture. Therefore, we developed a CV port that is visible under the skin. We created a prototype of a CV port using a 3D printer. Three red light-emitting diodes (LEDs) were attached around the septum that made the puncture site visible by applying wireless energy transmission technology using electromagnetic resonance. The CV port was implanted under the skin of pork rose meat. The thickness of the skin of pork loin was measured. Fifteen medical doctors participated in the study to visually confirm the lighted CV port. The visibility of the center of the septum with and without lights was scored 0 as non-diagnostic; 1, slightly visible; 2, well visible; and 3, obviously visible. The visibility with or without lights was assessed. The relationship between the years of experience and the visibility score was assessed. The Wilcoxon test was used for statistical analysis. LEDs were easily transmitted through the skin of pork rose meat. The median visibility scores with or without lights were 2 (range, 1-3) and 3 (range, 1-3), respectively (p = 0.005). No significant relationship was found between experience and visibility score (p = 0.289). CV ports with LEDs can be easily recognized compared with those without LEDs. This technique may contribute to medical safety by improving its visibility to avoid mispuncture.

Safety of Early Bevacizumab Administration after Central Venous Port Placement for Patients with Colorectal Cancer.

Bevacizumab (BEV) requires an adequate withdrawal period to avoid BEV-related complications during major surgery. However, the safety of BEV administration immediately after surgical placement of the central venous (CV) port, a minor surgery, is still unclear. This study aimed to investigate whether BEV is safe when administered early after CV port placement. We retrospectively evaluated 184 patients with advanced colorectal cancer (CRC) treated with a BEV-containing regimen and divided them into two groups according to the interval between CV port implantation and chemotherapy initiation, with the early administration group being ≤7 days and late administration group being >7 days. Complications were then compared between the two groups. The early-administration group was significantly older and had a higher rate of colon cancer than the late-administration group. Overall, 24 (13%) patients developed CV port-related complications. Male sex was a risk factor for complications (odds ratio [OR], 3.154; 95% CI, 1.19-8.36). The two groups showed no significant difference in the frequency of complications (p = 0.84) or patient characteristics (after the inverse probability of treatment weighting, p = 0.537). In conclusion, the frequency of complications is not affected by the timing of BEV initiation after CV port implantation. Thus, early BEV administration after CV port placement is safe.

Survey-Based Evaluation of Cancer Patients’ Satisfaction and Discomfort Experienced During Central Venous Port Use

Introduction: The use of central venous port provides a safer and better quality of life for cancer patients undergoing chemotherapy. Refusal of central venous port implantation in patients with inadequate venous access may lead to discontinuation of chemotherapy or even extravasation of peripheral vasculitis and anti-cancer drugs. By doing this survey-based study, it was aimed to determine the reasons before the implantation of central venous port systems, the patient’s satisfaction afterwards, the complications associated with the port system, the discomfort they cause and the expectations of the patients. Patients and Methods: The study was carried out based on a questionnaire and through one-to-one interview by a cardiovascular surgeon with 100 patients who were treated with central venous port in the chemotherapy unit of Eskişehir City Hospital between August 1 and October 31, 2022. Results: Sixty-one percent of the patients cited long-term intravenous therapy and 44% cited inadequate venous access as the cause of port implantation. Ninety-six percent of the participants stated that they were satisfied with their ports. Only six patients stated that they had various problems, but were satisfied overall. When asked about the advantages of using the port, 76% of the patients stated that they no longer had more than one vascular puncture problem and 75% stated that they felt less pain. Fifty-one percent of the patients stated that they felt anxiety before the procedure; the most felt concern was possible complications (13 patients) and the thought that it would cause discomfort in life. Nine patients experienced complications after port implantation. Five patients described port system obstruction and four patients described the development of skin infection. Conclusion: Especially in our country, most patients still do not use central venous ports. The fact that existing fears and anxiety of the patients before the procedure cannot be eliminated with adequate and correct information plays an important role in this. At this point, the operator who performs the surgical procedure in the center where the procedure is performed should inform the patient and the oncology and chemotherapy nurse who give first information to the patient.

Impact of central venous port implantation method and access choice on outcomes.

Although the number of patients who need central venous ports for permanent vascular access is increasing, there is still no "gold standard" for the implantation technique. To identify the implantation technique that should be favored. Two hundred central venous port-implanted patients in a tertiary hospital were retrospectively evaluated. Patients were assigned into two groups according to the access method. The first group comprised patients whose jugular veins were used, and the second group comprised patients whose subclavian veins were used. Groups were evaluated regarding age, sex, application side, primary diagnosis, active follow-up period in the hospital, chemotherapy agents administered, number of complications, and the Clavien-Dindo severity score. The distribution of the variables was tested with the Kolmogorov-Smirnov test and the Mann-Whitney U test. The χ 2 test was used to analyze the variables. There was no statistically significant difference between the groups regarding age, sex, side, number of chemotherapy drugs, and duration of port usage (P > 0.05). Only 2 patients in group 1 had complications, whereas in group 2 we observed 19 patients with complications (P < 0.05). No port occlusion was found in group 1, but the catheters of 4 patients were occluded in group 2. One port was infected in group 1 compared to three infected ports in group 2. Two port ruptures, two pneumothorax, one revision due to a mechanical problem, one tachyarrhythmia during implantation, and four suture line problems were also recorded in group 2 patients. We also showed that it would be sufficient to evaluate and wash ports once every 2 mo. Our results robustly confirm that the jugular vein route is safer than the subclavian vein approach for central venous port implantation.

Percutaneous implantation of peripherally inserted totally implantable venous access systems in the forearm in adolescent patients

BackgroundChildren with different underlying malignant diseases require long-term central venous access. As for port systems in a pectoral position, peripherally implanted port systems in the forearm revealed high levels of technical and clinical success in adult cohorts.ObjectiveTo investigate the technical and clinical outcomes of percutaneous central venous port implantation in the forearm in adolescents.Materials and methodsBetween April 2010 and August 2020, 32 children ages 9 to 17 years with underlying malignancy received 35 totally implantable venous access ports (TIVAPs) in the forearm. All venous port systems were peripherally inserted under ultrasound guidance. Correct catheter placement was controlled by fluoroscopy. As primary endpoints, the technical success, rate of complications and catheter maintenance were analyzed. Secondary endpoints were the side of implantation, vein of catheter access, laboratory results on the day of the procedure, procedural radiation exposure, amount of contrast agent and reasons for port device removal.ResultsPercutaneous TIVAP placement under sonographic guidance was technically successful in 34 of 35 procedures (97.1%). Procedure-related complications did not occur. During the follow-up, 13,684 catheter days were analyzed, revealing 11 complications (0.8 per 1,000 catheter-duration days), Of these 11 complications, 7 were major and 10 occurred late. In seven cases, the port device had to be removed; removal-related complications did not occur.ConclusionPeripheral TIVAP placement in the forearms of children is a feasible, effective and safe technique with good midterm outcome. As results are comparable with standard access routes, this technique may be offered as an alternative when intermittent venous access is required.

Effectiveness of a flow confirmation study of a central venous port of the upper arm versus the chest wall in patients with suspected system-related mechanical complications

BackgroundIf mechanical complications associated with a central venous port (CVP) system are suspected, evaluation with a flow confirmation study (FCS) using fluorescence fluoroscopy or digital subtraction angiography should be performed. Evaluations of mechanical complications related to CVP of the chest wall using FCS performed via the subclavian vein have been reported. However, the delayed complications of a CVP placed in the upper arm have not been sufficiently evaluated in a large population. We evaluated the effectiveness of FCS of CVPs implanted following percutaneous cannulation of the subclavian (chest wall group) or brachial (upper arm group) vein.MethodsA CVP was implanted in patients with advanced cancer requiring chemotherapy. FCS was performed if there were complaints suggestive of CVP dysfunction when initiating chemotherapy.ResultsCVPs were placed in the brachial vein in 390 patients and in the subclavian vein in 800 patients. FCS was performed in 26/390 (6.7%) patients in the upper arm group and 40/800 (5.0%) patients in the chest wall group. The clinical characteristics of the patients were similar in both groups. The duration of CVP implantation until FCS was significantly shorter in the upper arm group (136 ± 96.6 vs. 284 ± 260, p = 0.022). After FCS, the incidence of CVP removal/reimplantation being deemed unnecessary was higher in the upper arm group (21/26 [80.8%] vs. 26/40 [65.0%], p = 0.27). In the upper arm group, no cases of catheter kinking or catheter-related injury were observed, and the incidence of temporary obstruction because of blood clots that could be continued using CVP was significantly higher than that in the chest wall group (10/26 [38.5%] vs. 4/40 [10.0%], p = 0.012).ConclusionsFCS was effective in evaluating CVP system-related mechanical complications and deciding whether removal and reimplantation were required in both groups.

Maim, death cases following the installation of vascular access devices filed with specialized forensic medicine commissions of Tehran, Iran, 2013-2018, (A descriptive study).

Implantation of vascular access devices is of great importance in critically ill patients or those vulnerable to clinical worsening. The aim of this study was to identify the complications of implantation of vascular access leading to complaints from patients, in the forensic medicine commissions of Tehran. The present descriptive-cross sectional study was performed on all cases that died from implantation of vascular access devices and complaints about permanent local complications caused by this procedure, filed with the forensic medicine commissions of Tehran in period of 2013-2018, based on selected variables, and the results were statistically analyzed using the chi-square and Fisher exact tests in SPSS Version 18. A p-value of <0.01 was considered statistically significant. All alleged deaths were due to implantation of central venous port placed in a large vein in the neck, and most organ failure cases were attributed to anterior forearm deformity. The most common cause of death was acute cardiac death; internal bleeding was observed in 14% of them. Most complaints of death were filed against general surgery and anesthesia assistants, and most complaints about peripheral venipuncture were against trainee nurses. The present study findings were significantly different in terms of cannulation site, age, cause of death, type of local complication (p<0.01). This study shows, as patients become more aware, complaints from physicians about implantation of vascular access, in the judicial authority are also on the rise. Therefore, in choosing these patients, Venice should be treated more carefully.

Basic Procedure Technique and Management of Complication During the Placement of Central Venous Port Implantation

Basic Procedure Technique and Management of Complication During the Placement of Central Venous Port Implantation

Risk factors and change in the nutritional status in patients who develop catheter‐related bloodstream infection following implantation of a totally implantable central venous catheter port

Risk factors and change in the nutritional status in patients who develop catheter‐related bloodstream infection following implantation of a totally implantable central venous catheter port

Impact of chest subcutaneous fat on the occurrence of central venous port-related infectious complications in cancer patients

PurposeThere is no concrete evidence to support the association between the amount of subcutaneous fat area (SFA) in the central venous port-insertion site (precordium) and port-related complications. We aimed to investigate the relationship between SFA in the midclavicular line and postoperative infectious complications in patients undergoing port-insertion surgery.MethodsThis was a single-institute and historical cohort study of 174 patients who underwent first central venous port implantation surgery for chemotherapy between January 2014 and December 2018. SFA in the midclavicular line was measured using preoperative computed tomography scans. The patients were divided into three groups according to SFA amount tertiles, and we investigated the association of SFA with infectious and all-cause complication events within 1 year.ResultsWithin a median follow-up of 306 days, the patients with intermediate SFA had significantly higher infection-free survival than those with low and high SFA (low vs. intermediate vs. high: 80.4% vs. 97.7% vs. 83.4%, respectively, p=0.034). In contrast, there was no significant difference in the overall complication-free survival among the groups (low vs. intermediate vs. high: 80.4% vs. 88.9% vs. 81.8%, respectively, p=0.29). Low SFA was independently associated with high risk of infectious complications (hazard ratio, 9.45; 95% confidence interval, 1.07–83.22, p=0.043).ConclusionLow SFA in the midclavicular line was an independent risk factor for infectious complications in the chemotherapy setting. This practical indicator can be useful for optimizing patients’ nutritional status and when considering other types of vascular access to support administration of intravenous chemotherapy.

Use of catheter with 2-methacryloyloxyethyl phosphorylcholine polymer coating is associated with long-term availability of central venous port

Central venous port (CVP) is a widely used totally implantable venous access device. Recognition of risks associated with CVP-related complications is clinically important for safe, reliable, and long-term intravenous access. We therefore investigated factors associated with CVP infection and evulsion, including the device type. A total of 308 consecutive patients with initial CVP implantation between January 2011 and December 2017 were retrospectively reviewed, and the association of clinical features with CVP-related complications were analyzed. Intraoperative and postoperative complications occurred in 11 (3.6%) and 39 (12.7%) patients, respectively. The overall rate of CVP availability at six months was 91.4%. Malignancy and 2-Methacryloyloxyethyl phosphorylcholine (MPC) polymer-coated catheter use were negatively associated with the incidence of CVP infections. Accordingly, malignancy and MPC polymer-coated catheter use were independent predictors for lower CVP evulsion rate (odds ratio, 0.23 and 0.18, respectively). Furthermore, both factors were significantly associated with longer CVP availability (hazard ratio, 0.24 and 0.27, respectively). This retrospective study identified factors associated with CVP-related complications and long-term CVP availability. Notably, MPC polymer-coated catheter use was significantly associated with a lower rate of CVP infection and longer CVP availability, suggesting the preventive effect of MPC coating on CVP infection.

Safety and feasibility of 3-month interval access and flushing for maintenance of totally implantable central venous port system in colorectal cancer patients after completion of curative intended treatments.

Patients with colorectal cancer (CRC) treated with curative intent surgery undergo continuous fluorouracil (5-FU) infusion-based chemotherapy using totally implantable central venous port system (TICVPS) in cases with high risk of recurrence. Approximately 30% of patients relapse after therapy completion, especially within 2 years. Hence, many patients with high risk CRC keep the TICVPS for 6 to 24 months after treatment with regular intervals of TICVPS flushing. However, little is known about the proper interval duration of the port. The aim of this study is to investigate whether a 3 months extended interval is safe and if port maintenance is feasible.A retrospective cohort was compiled of patients with CRC who underwent curative intent surgery and perioperative chemotherapy using TICVPS between 2010 and 2017. The primary end point was TICVPS maintenance rate, including maintenance of TICVPS for at least 6 months, planned TICVPS removal after 6 months, and regaining the use of TICVPS at the time of recurrence.A total of 214 patients with CRC underwent curative intent treatments during the study period. Among them, 60 patients were excluded, including 6 patients for early recurrence within 3 months and 54 patients with violation of flushing interval. Finally, 154 patients were analyzed. Mean flushing interval was 98.4 days (95% confidence interval [CI], 96.2–100.6; range, 60–120). In December 2018, 35 patients kept the TICVPS, 92 patients had planned removal, 25 patients reused the TICVPS, and 2 patients had to unexpectedly remove the TICVPS due to site infection and pain. Thus, the functional TICVPS maintenance rate was 98.8% (152/154). Thirty-eight patients relapsed, and 30 patients were treated with intravenous chemotherapy. Among them, 25 patients (83.3%) reused the maintained TICVPS without a reinsertion procedures.Our study demonstrated that 3-month interval access and flushing is safe and feasible for maintaining TICVPS during surveillance of patients with CRC. An extended interval up to 3 months can be considered because it is compatible with CRC surveillance visit schedules.

[Dislodgement of a long-term inserted catheter from the connecting parts of an implantable central venous port in a child with hemophilia].

A central venous access device (CVAD) was implanted in a child with hemophilia for long-term replacement therapy with factor VIII. Four years and eight months after its insertion, malfunction was observed. Further study revealed migration of the transected catheter to both the pulmonary arteries. The retrieved catheter displayed a tear and dislodgement at the anastomosis between the port and catheter. To the best of our knowledge, no case of extensive CVAD damage in children with hemophilia has been reported. Patients with CVAD malfunction are often asymptomatic; however, this condition could lead to a fatal outcome. Therefore, clinicians need to be aware of this complication.

An analysis of totally implantable central venous port system infections in an urban tertiary referral center

A frequent complication of central venous port systems (CVP) is infection (CVP-I), either local (CVP-LI) or a life-threatening blood stream infection (CVP-BSI). We examined the course of CVP-I including results of an antibiotic eradication attempt of CVP-BSI. We investigated adults with CVP-I from 2010 to 2018 who had to undergo port explantation or were treated by a combination of systemic antibiotics and antibiotic lock therapy (ALT). In nine years we diagnosed 206 CVP-I (CVP-LI: 52; CVP-BSI: 152). In 146 patients with CVP-I the port system was primary explanted, while 56 patients received antibiotics/ALT. 79% of Gram negative pathogens and 50% of coagulase negative staphylococci (CoNS) were eradicated. Failure of antibiotic treatment was more often associated with short time span since CVP implantation, neutropenia and polymicrobial infection. All patients with non-neoplastic disease survived, while 18/173 patients (10%) with underlying malignant disease had a fatal outcome in the same hospital stay.

Length of Stay Predicts Risk of Early Infection for Hospitalized Patients Undergoing Central Venous Port Placement

To compare early totally implantable central venous port catheter-related infection rates after inpatient vs outpatient placement and to determine whether the risk associated with inpatient placement is influenced by length of hospital stay. In this single-institution retrospective study, 5,301 patients (3,618 women; mean age 57 y) underwent port placement by interventional radiologists between October 2004 and January 2018. The 30-day infection rate was compared between inpatients and outpatients using survival analysis. Among inpatients, the effect of time from admission to port placement and from placement to discharge was analyzed using a survival regression tree. The 30-day infection rate was 3.6% (95% confidence interval [CI]= 1.9%-6.1%) among 386 inpatients and 1.0% (95% CI= 0.7%-1.3%) among 4,915 outpatients (hazard ratio [HR]= 3.6, 95% CI= 2.0-6.6, P < .001). Inpatient placement was a significant risk factor after accounting for covariates in multivariate analysis (HR= 2.2, 95% CI= 1.0-4.7, P= .05) and controlling for demographic differences by propensity score matching (HR= 2.8, 95% CI= 1.0-7.8, P= .04). Infection rate was 11% (95% CI= 4.7%-22%) among 65 inpatients in whom time from admission to placement was ≥ 7 days, 5.1% (95% CI= 1.9%-11%) among 129 inpatients in whom admission to placement was < 7 days and time to discharge was > 3 days, and 0% (95% CI= 0%-2.1%) among 192 inpatients in whom admission to placement was < 7 days and time to discharge was ≤ 3 days (P < .001). Inpatient port placement was associated with a higher risk of early infection. However, a clinical decision tree based on shorter length of stay before and after placement may identify a subset of hospitalized patients not at increased risk for infection.

445P - Safety and feasibility of extending flushing interval every 3 months for maintenance of TICVPS in CRC patients after completion of curative intended treatments

BackgroundColorectal cancer (CRC) patients treated with curative intended surgery undergo 5-FU continuous infusion based chemotherapy using totally implantable central venous port system (TICVPS) in case of high-risk of recurrence. Approximately 30% patients relapse after the completion of therapy, especially within 2 years. Hence, many of high-risk CRC patients keep the TICVPS during 6-24 months after treatment, with regular intervals of TICVPS flushing. The manufacturer recommends monthly flushing for maintain TICVPS, however the interval of flushing lacks scientific evidence. The aim of this study is to investigate whether the extended maintenance intervals is safe and feasible. MethodsA retrospective cohort was conducted in CRC patients who underwent curative intended surgery and perioperative chemotherapy using TICVPS between 2010 and 2017. Patient were enrolled if TICVPS was maintained at least 6 months with 3-month interval flushing using heparin, while patient who were recurred within 1 month, removed TICVPS within 6 months without definitive causes, or violation of flushing interval were excluded. The primary end points were the functional TICVPS maintenance rate. ResultsA total of 214 CRC patients underwent curative intended treatments during the study period. Among them, 6 patients (early recurrence within 1 month) and 54 patients (violation of flushing interval) were excluded, finally 154 patients were analyzed. Mean flushing interval was 98.4 days. At the Dec 2018, 35 patients kept the TICVPS, 92 were planned removal, and 25 were reused the TICVPS, while two patients had to unexpectedly remove due to TICVPS site infection and pain. Thus, the functional TICVPS maintenance rate was 98.8%. 38 patients were relapsed and 30 were treated with intravenous chemotherapy. Among them, 25 patients (83.3%) were reused the existing TICVPS without re-insertion procedure. ConclusionsOur study demonstrated that 3-month interval flushing is safe and feasible in CRC patients. Extended time interval up to 3 months might be considered because it is compatible with CRC surveillance visit schedules and convenient for patients. Legal entity responsible for the studyThe authors. FundingHas not received any funding. DisclosureAll authors have declared no conflicts of interest.

Evaluation of complications of totally implantable central venous port system insertion

The aim of the present study was to describe the procedure of totally implantable central venous port system (TICVPS) insertion performed at our center and investigate associated complications. The study retrospectively evaluated 827 patients who underwent a single-type TICVPS insertion from January 2013 to July 2015. The length of the procedure, long-term device function, angle (chamber-to-tip) and complications of TICVPS, including infection, skin erosion, occlusion, malposition and thrombosis, were analyzed from the patients' medical records. A total of 843 TICVPS insertions were performed in 827 patients. The TICVPS implantation was successful in all cases (100%). A total of 34 cases (4.0%) with complications were recorded. Complications at the chamber insertion site occurred in 11 patients (1.3%), including 5 infection (0.6%) and 6 erosion cases (0.7%). All patients with chamber insertion site infection were treated by administration of antibiotics and dressing. Of the patients in which chamber insertion site erosion occurred, 2 were subjected to TICVPS removal and reinsertion and 4 were treated with debridement, irrigation and resuture. The most common type of complication was catheter-associated (2.3%; n=19). Among these cases, 7 had catheter-associated infection (0.8%), 8 had catheter migration (1.0%) confirmed by chest radiography, 4 had catheter-associated thrombosis (0.5%) and 2 had chamber malposition (0.3%). The present retrospective study on TICVPS, which used a relatively large cohort, demonstrated a low complication rate (4.0%) compared with that reported in previous studies (5–20%). A well-designed procedure, experienced vascular surgeons, an aseptic operating room environment, ultrasound-guided puncture, a wide angle (chamber-to-tip) and the use of fluoroscopy with contrast agent may reduce the complication rate of TICVPS insertion.

Effect of Inhalation Aromatherapy on Procedural Pain and Anxiety After Needle Insertion Into an Implantable Central Venous Port Catheter: A Quasi-Randomized Controlled Pilot Study.

Needle insertion into an implantable central venous port catheter may lead to procedural pain and anxiety in cancer patients. The aim of this study was to determine the effects of inhalation aromatherapy on procedural pain and anxiety after needle insertion into an implantable central venous port catheter. This study included 123 cancer patients who were scheduled to undergo chemotherapy. Patients were randomly assigned to either the lavender group (n = 41), the eucalyptus group (n = 41), or a control group (n = 41). Participants in the intervention groups inhaled 3 drops of essential oil for 3 minutes before needle insertion into an implantable venous port catheter. Patients in the control group received no intervention before needle insertion. Data were collected using the visual analog scale (VAS) and State Anxiety Inventory. The average VAS scores of the lavender group were significantly lower than those of the control group (P < .05). There were no significant differences in the average VAS scores between the eucalyptus group and the control group (P > .05). In addition, the average State Anxiety Inventory scores of the lavender group, the eucalyptus group, and the control group were not significantly different (P > .05). Inhalation aromatherapy with lavender may be an effective technique to relieve pain related to needle insertion into an implantable central venous port catheter. Inhalation aromatherapy with lavender oil may be useful in the management of procedural pain levels during needle procedure. However, further randomized controlled trials are needed to validate this study.