The Effects of Therapeutic Inhaled Essential Oils on Preoperative Anxiety in Patients undergoing Ambulatory Urological Procedures

To evaluate the efficacy of the Soothing Scents STILL QuickTab therapeutic inhaled essential oil (TIEO) packet on reducing preoperative anxiety in ambulatory surgery patients undergoing urological procedures 

AUTHOR:

Sade Davis, BSN, SRNA, DNP(c) 

Fairfield University, Egan School of Nursing and Health Studies

DATE: January 2021

BACKGROUND

Traditionally, benzodiazepines have been the primary approach for addressing preoperative anxiety, but they come with unintended side effects. In response to this concern, therapeutic inhaled essential oils (TIEO) have emerged as a complementary and non-pharmacological method to alleviate anxiety without the accompanying adverse reactions. 

The Soothing Scents STILL QuickTab, designed for individual use, is one such passive essential oil inhalational device. This innovative product contains a blend of premium-quality natural essential oils, including lavender, bergamot, sweet orange, and ylang-ylang. 

The purpose of this study is to assess the effectiveness of the Soothing Scents STILL QuickTab therapeutic inhaled essential oil (TIEO) packet in mitigating preoperative anxiety among ambulatory surgery patients undergoing urological procedures.

METHODS

Prospective pretest-posttest evidence-based practice project from July 2020 to Jan 2021.

Convenience sample of ambulatory urology surgery patients.

Inclusion criteria for the patient sample included individuals aged 18 years or older, those classified under ASA physical status categories I-III, with no recent use of benzodiazepine or anti-anxiety medications within 24 hours of surgery, and having no olfactory impairments or current psychiatric or cognitive disorders. The study featured educational training sessions for preoperative RNs, with demographic data gathered from the electronic medical record (EMR). Anxiety levels were assessed using the Visual Analog Scale for Anxiety (VAS-A) at two specific time points.

Data analysis was conducted using IBM Statistics SPSS for Mac version 25.

Anxiety scores exhibited a notable decrease of 41%, indicating a significant improvement post-intervention. The correlation analysis revealed a strong positive relationship between pre- and post-intervention scores (r = 0.796, P = .000). On average, the pre-intervention anxiety score was 17.9 mm higher than the post-intervention score, with a 95% confidence interval of [13.42, 22.46]. These findings underscore the efficacy of the intervention in reducing anxiety levels among the study participants.

Pre- and Post-intervention VAS-A Statistics

Statistical Significance

Participants utilized the therapeutic inhaled essential oil (TIEO) for a median duration of 15 minutes (IQR: 15 to 30.25) before the second Visual Analog Scale for Anxiety (VAS-A) assessment. Noteworthy, there were no statistically significant differences in pre- and post-intervention anxiety scores concerning age, gender, ASA physical status classification, or type of surgical procedure (P > .05). The 2-tailed matched paired t-test demonstrated a significant decrease in preoperative anxiety scores following the TIEO intervention (t₄₉ = 7.973, P = .000), affirming the effectiveness of the intervention in anxiety reduction.

Patient Experience Survey Results 

The patient experience survey results indicated a positive response to the use of the STILL QuickTab therapeutic inhaled essential oil (TIEO) packet. Notably, 92% of patients reported feeling calmer after utilizing the TIEO packet. Additionally, a unanimous 100% of patients expressed satisfaction with their experience, finding the scent of the STILL QuickTab TIEO packet pleasant.

DISCUSSION

The therapeutic inhaled essential oil (TIEO) intervention yielded a statistically significant reduction in preoperative anxiety scores (P = .000). Baseline anxiety levels varied among individuals based on factors such as gender, ethnicity, diagnosis, prior experiences, and type of surgery. Notably, females exhibited generally higher anxiety levels than males, with an approximate 36% difference. Comorbidities, such as cancer, were identified as potential influencers of baseline anxiety scores. Patients expressed satisfaction with the TIEO intervention, finding the scent pleasant. However, the study has limitations, including the lack of randomization, absence of privacy, interruptions by staff, and the requirement for face masks, which may impact the overall interpretation of the results.

CONCLUSION

Preoperative anxiety is a common problem which negatively impacts patient satisfaction and outcomes. TIEO Aromatherapy offers a promising solution:

1. Fast-acting, cost-effective, nurse-driven and poses a minimal risk
2. Beneficial in cases where pharmacologic anxiolytics are contraindicated
3. Does not interfere with the anesthetic or surgical plan

Future studies should focus on TIEOs clinical efficacy on intraoperative and postoperative outcomes.

ACKNOWLEDGMENTS

This evidence-based practice project was supported by the gracious donation of the Soothing Scents STILL QuickTabs by Soothing Scents, LLC. 

The author appreciatively acknowledges the beneficial discussions and guidance provided by Dr. Belmont and Dr. Moriber.