Abstract Objectives: The objective of this pilot study was to determine the effectiveness of a mixture of essential oils (peppermint, basil, and helichrysum) on mental exhaustion, or moderate burnout (ME/MB) using a personal inhaler. Design: This was a randomized, controlled, double-blind pilot study. Data were collected 3 times a day for 3 weeks (Monday-Friday). The first week was baseline for both groups, the second week was intervention (aromatherapy or placebo), and the third week was washout. Settings/location: Participants used a personal inhaler at home or at work. Subjects: The subjects comprised a convenience sample of 13 women and 1 man who each had self-assessed ME/MB. Interventions: Participants were randomized to receive a personal inhaler containing either a mixture of essential oils or rose water (as used in Indian cooking). Outcome measures: The outcome measures were a 0-10 scale with 10=worst feeling of burnout, 0=no feeling of burnout. There was a qualitative questionnaire rating aroma and a questionnaire listing perceived stressors. Results: While both groups had a reduction in perception of ME/MB, the aromatherapy group had a much greater reduction. Conclusions: The results suggest that inhaling essential oils may reduce the perceived level of mental fatigue/burnout. Further research is warranted.

J Altern Complement Med. 2012 Nov 9. Varney E, Buckle J. 1 Private Practice , Andover, MA.

Background: Aromatherapy is widely used around the world for stress relief. Whether exposure to essential oil increases the risk of cardiovascular events is still unknown. The purpose of this study was to investigate the effect of essential oil on heart rate and blood pressure among solus por aqua (spa) workers. Methods: We recruited 100 healthy workers from various spa centres in Taipei, Taiwan. Between July and August of 2010, three repeated measurements - resting heart rate (HR), systolic blood pressure (SBP), and diastolic blood pressure (DBP) - were taken of each spa worker in our study room. Participants were exposed to essential oil vapour generated from an ultrasonic atomizer in the study room for two consecutive hours. The total volatile organic compound (VOC) level in the study room was measured during the study period. We used a linear mixed-effect model to determine the association between the total VOC level and the participants' HR, SBP, and DBP.Results: For the times from 15 to 60 min after start of exposure, we found that the VOC level was significantly associated with reduced 15-min mean BP and HR. After exposure for more than 1 hour, from 75 to 120 min after start of exposure, we found that the VOC levels were associated with increased 15-min mean BP and HR.Conclusions: Exposure to essential oil for 1 hour was found to be an effective method of relaxation, as indicated by decreases in the HR and BP. Prolonged exposure for longer than 1 hour to essential oils may be harmful to cardiovascular health among spa workers.

Eur J Prev Cardiol. 2012 Nov 29. Chuang KJ, Chen HW, Liu IJ, Chuang HC, Lin LY. Dept of Public Health, School of Med., College of Med./School of Public Hlth College of Public Health and Nutrition, Taipei Med. Uni., Taipei, Taiwan.

The purpose of this study was to investigate the effect of aromatherapy massage on dysmenorrhea. The study used a quasiexperimental design with the subjects as their own control. Every participant applied both aromatherapy massage with lavender oil and placebo massage with odorless liquid petrolatum [soft paraffin]. The population comprised 438 midwifery and nursing students. The 150 students who had declared that they had suffered from dysmenorrhea used a visual analog scale to indicate their level of pain. Higher scores reflected a greater severity of dysmenorrhea. Forty-four students volunteered to participate in the study. When the lavender massage and the placebo massage were compared, the visual analog scale score of the lavender massage was found to decrease at a statistically significant rate. This study showed that massage was effective in reducing dysmenorrhea. In addition, this study showed that the effect of aromatherapy massage on pain was higher than that of placebo massage.

Pain Manag Nurs. 2012 Dec;13(4):236-40. doi: 10.1016/j.pmn.2010.04.002. Epub 2010 Sep 15. Apay SE, Arslan S, Akpinar RB, Celebioglu A. Department of Midwifery, Faculty of Health Sciences, Atatürk University, Erzurum, Turkey. Electronic address: sejder@hotmail.com.

Full Title: Aromatherapy massage on the abdomen for alleviating menstrual pain in high school girls: a preliminary controlled clinical study.

This study investigated the alleviating effects of aromatherapy massage and acetaminophen on menstrual pain in Korean high school girls. Subjects were divided into two groups: the aromatherapy massage (treatment) group (n = 32) and the acetaminophen (control) group (n = 23). Aromatherapy massage was performed on subjects in the treatment group. The abdomen was massaged once using clary sage, marjoram, cinnamon, ginger, and geranium in a base of almond oil. The level of menstrual pain was assessed using a visual analogue scale at baseline and twenty-four hours afterward. The reduction of menstrual pain was significantly higher in the aromatherapy group than in the acetaminophen group. Using multiple regression, aromatherapy massage was found to be more highly associated with reduction in the level of menstrual pain than acetaminophen. These finding suggest that aromatherapy massage may be an effective treatment for menstrual pain in high school girls. However, it could not be verified whether the positive effects derived from the aromatherapy, the massage, or both. Further rigorous studies should be conducted using more objective measures.

Evid Based Complement Alternat Med. 2012;2012:187163. Epub 2011 Sep 22. Hur MH, Lee MS, Seong KY, Lee MK. Department of Nursing, Eulji University, Daejeon 301-746, Republic of Korea.

Objectives To evaluate the effects of the aroma of essential oil of lavender against placebo on subjects' pain perceptions and levels of anxiety when undergoing elective cosmetic facial injections of botulinum toxin type A (BOTOX(®) COSMETIC) for the correction of glabellar wrinkles. Methods Subjects (N = 30) who had not previously received any cosmetic facial injections were randomized to essential oil of lavender aroma exposure or to placebo during elective cosmetic facial injections of BOTOX(®) (12 U) for the correction of glabellar wrinkles. Evaluations of subjects' pain perceptions and levels of anxiety assessed by the Spielberger State-Trait Anxiety Inventory, heart rate (HR), and blood pressure (BP) measurements were taken at baseline, before, and after injections. Results Subjects exposed to essential lavender oil showed a significant reduction in HR after the injection as compared to the pre-injection HR. Subjects exposed to the placebo did not show any significant difference in BP or HR between pre-injection and postinjection. Conclusions Although essential oil of lavender did not have an effect on the subjects' perception of pain during a facial injection, subjects showed significant increases in parasympathetic activity when exposed to the lavender aroma. Lavender aromatherapy has the potential to ease anxiety in patients undergoing minimally invasive facial cosmetic procedures.

J Cosmet Dermatol. 2011 Jun;10(2):89-93. doi: 10.1111/j.1473-2165.2011.00554.x. Grunebaum LD, Murdock J, Castanedo-Tardan MP, Baumann LS. University of Miami Miller School of Medicine, Miami, Florida, USA Baumann Cosmetic and Research Institute, Miami Beach, Florida, USA.

Objectives The objective of this review is to systematically review the evidence for the effectiveness of aromatherapy in the treatment of high blood pressure. Methods Twelve databases were searched from their inception through December 2009. Controlled trials testing aromatherapy in patients with hypertension of any origin that assessed blood pressure were considered. The selection of studies, data extraction and validations were performed independently by two reviewers. Results One randomized clinical trial (RCT) and four non-randomized controlled clinical trials (CCTs) met our inclusion criteria. The one RCT included tested the effects of aromatherapy as compared with placebo and showed significant reduction of systolic blood pressure and diastolic blood pressure. All of the four CCTs showed favourable effects of aromatherapy. However, all of the CCTs also had a high risk of bias. Conclusion The existing trial evidence does not show convincingly that aromatherapy is effective for hypertension. Future studies should be of high quality with a particular emphasis on designing an adequate control intervention.

J Eval Clin Pract. 2010 Jul 29. Hur MH, Lee MS, Kim C, Ernst E. Professor, School of Nursing, Eulji University, Daejeon, South Korea.

Full TitlePromoting Sleep by Nursing Interventions in Health Care Settings: A Systematic Review.

Background: Sleep disturbances are common problems among individuals in hospitals and institutions. Although several studies have explored this phenomenon, there is still a lack of knowledge about the effectiveness of sleep-promoting nursing interventions. This systematic review aims to describe and evaluate the effectiveness of sleep-promoting nursing interventions in health care settings. Approach: A systematic review was performed. In June 2009, a literature search was carried out in the following databases: Academic Search Elite, CINAHL, the Cochrane Library and MedLine/PubMed. Fifty-two references were identified and after critical appraisal, nine studies were selected. A compilation of the results and the outcomes of the interventions were carried out. Furthermore, the evidence strength of the interventions was assessed. Findings: Little evidence for the nursing interventions, sleep hygiene, music, natural sound and vision, stimulation of acupoints, relaxation, massage and aromatherapy is found. However, large effect size of interventions were found when using massage, acupuncture and music, natural sounds or music videos. The use of sleep hygiene and relaxation, on the other hand, produced only small effects. Conclusion: The lack of high evidence strength for the nursing interventions together with the uncertainty about their effects calls for more research before implementing these interventions into clinical practice.

Worldviews Evid Based Nurs. 2010 Oct 12. doi: 10.1111/j.1741-6787.2010.00203.x. Hellström A, Willman A. Amanda Hellström, Doctoral Student, School of Health Science, Blekinge Institute of Technology, Karlskrona, and Department of Health Sciences, Lund University, Lund; Cecilia Fagerström, Senior Lecturer, School of Health Science, Blekinge Institute of Technology, Karlskrona; Ania Willman, Professor, School of Health Science, Blekinge Institute of Technology, Karlskrona, all in Sweden.

Full Title: Aromatherapy alleviates endothelial dysfunction of medical staff after night-shift work: preliminary observations.

Night-shift work causes mental stress and lifestyle changes, and is recognized as a risk of cardiovascular diseases associated with impaired endothelial function. Aromatherapy is becoming popular as a complementary therapy that is beneficial for mental relaxation. The purpose of this study was to investigate the effect of aromatherapy on the endothelial function of medical staff after night-shift work. This study consisted of 19 healthy medical personnel (19 men, mean age 32±7 years), including 11 physicians and 8 technicians. Aromatherapy was performed for 30?min by inhalation of the essential oil of lavender. Flow-mediated dilation (FMD) of the brachial artery was measured three times in each subject: on a regular workday, and after night-shift work before and immediately after aromatherapy. A control study was performed to assess the effect of a 30-min rest without aromatherapy. The mean value of sleep time during night-shift work was 3.3±1.3?h. FMD after night-shift work was lower than on a regular workday (10.4±1.8 vs. 12.5±1.7%, P<0.001), which improved after aromatherapy (11.8±2.5%, P=0.02 vs. before aromatherapy). FMD was stable in the control study (10.1±1.9 vs. 10.1±2.2%, P=0.9). This study demonstrated that night-shift work impaired endothelial function in medical staff, an effect that was alleviated by short-term aromatherapy.Hypertension Research advance online publication, 25 November 2010; doi:10.1038/hr.2010.228.

Hypertens Res. 2010 Nov 25. Shimada K, Fukuda S, Maeda K, Kawasaki T, Kono Y, Jissho S, Taguchi H, Yoshiyama M, Yoshikawa J. Department of Medicine, Cardiovascular Division, Osaka Ekisaikai Hospital, Osaka, Japan.