Effects of inhalation aromatherapy on anxiety and nausea in children undergoing stem cell transplantation (SCT)

Background: SCT is increasingly common in the treatment of children with malignant and non-malignant disorders. Though often lifesaving, SCT is a period of great distress for both parent and child. Methods: IRB approval was obtained for a double-blind, placebo-controlled randomized study evaluating the effect of the respiratory administration of bergamot essential oil on anxiety, nausea, and pain among children undergoing SCT for the treatment of malignant and non-malignant disorders and their parents. 40 children between 5-21 years of age and scheduled to undergo SCT were enrolled from 1/2002-5/2005 after obtaining consent; 37 (93%) children (27M/10F) were evaluable. Patients were assessed at time of recruitment, prior to infusion, upon infusion completion, and one hour post-infusion using the Spielberger State-Trait Anxiety Inventory (STAI) for parents and the STAIC, Children's Behavioral Style Scale (CBSS), visual analogue scale (VAS) for pain and nausea, and the Emotionality Activity Sociability and Impulsivity instrument (EASI) for children. Results: Children in the treatment group experienced greater baseline pain (p=0.04) and greater anxiety (p=0.05) and nausea (p=0.03) one hour post-infusion, however baseline pain differences between groups were no longer significant. Parental anxiety declined in both groups but did not reach statistical significance. Child's monitoring coping style was predictive of transitory anxiety post-infusion (p=0.01). Conclusion: These results suggest the diffusion of a bergamot essential oil may not provide suitable anxiolytic or antiemetic effects among children following stem cell infusion. Additional supportive care interventions are needed during SCT among parents with elevated anxiety and patients with greater information seeking coping styles.