Effects of aromatherapy on patient satisfaction with procedural abortion at less than 10 weeks' gestation: a randomized controlled trial.

OBJECTIVE: To compare satisfaction with procedural abortion prior to 10 weeks' gestation in patients randomized to lavender essential oil aromatherapy versus placebo (jojoba oil).

STUDY DESIGN: This randomized trial compared lavender aromatherapy versus placebo in patients undergoing procedural abortion <10 weeks' gestation. Participants self-administered and inhaled oil during their procedures. Our primary outcome was composite mean score on the Iowa Satisfaction with Anesthesia Scale (ISAS). Participants completed the State-Trait Anxiety Inventory, a visual analog scale (VAS) reporting maximum procedural pain, and reported post-procedure aromatherapy acceptability.

RESULTS: We analyzed 112 participants randomized to aromatherapy (n=57) versus placebo (n=55). Baseline characteristics were similar between groups. We found no difference in overall satisfaction (mean ISAS scores aromatherapy: 0.72±0.96 vs. placebo: 0.46±0.98, p=0.17) or maximum procedural pain (median VAS score aromatherapy: 65 (range:4-95) vs. placebo: 63 (range:7-97), p=0.91). Independent predictors of satisfaction included use of oral sedation (B: 0.36; 95%CI: 0.04 to 0.69), state anxiety (B: -0.45; 95%CI: -0.79 to -0.10), and maximum procedural pain (B: -0.17; 95%CI: -0.25 to -0.09). The aromatherapy participants were significantly more likely to have found inhaling scented oil helpful during their procedure (71.9% vs. 45.5%; p=0.005), and would recommend it to a friend who needed a procedural abortion (86.0% vs. 56.4%; p=0.0005) compared to those in the placebo group. Additionally, patients in the aromatherapy group were significantly more likely to agree with the statement, "If I need another procedural abortion, I would want to inhale scented oil during my procedure" (87.7% vs. 70.9%; p=0.03).

CONCLUSION: The adjunctive use of lavender aromatherapy during first trimester procedural abortion does not improve satisfaction with anesthesia, but is highly valued by patients.

IMPLICATIONS: Oral opioids as an adjunct to standard analgesics during procedural abortion (ibuprofen and paracervical block) do not decrease pain and non-opioid options are lacking. Given current limited anesthesia options, aromatherapy could serve as an affordable and acceptable non-opioid adjunct to current standard of care during procedural abortion.