Aromatherapy Versus Gum Chewing on Preoperative Anxiety

Study Overview
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Brief Summary
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Investigators hypothesized that the use of blend aromatherapy and gum chewing before surgery would reduce preoperative anxiety as assessed by the Speilberger State-Trait Anxiety Inventory (STAI) questionnaire and provide non pharmacological methods to decrease postoperative sore throat, postoperative nausea & vomiting and postoperative pain.

Detailed Description
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A written informed consent will be taken from the patients.patients will be assigned randomly to three groups (30 subjects each) either with preoperative aromatherapy (Group A) or gum chewing (Group G) or control group (Group C) to assess the preoperative anxiety and postoperative sore throat, nausea & vomiting and pain control between the three studied groups.

Official Title
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Effect of Aromatherapy Versus Gum Chewing on Preoperative Anxiety in Females Undergoing Gynecological Laparoscopy: A Randomized Controlled Trial

Conditions
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Anxiety

Intervention / Treatment
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* Other: Aromatherapy
* Other: Gum Chewing
* Other: Controlled


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Educated adult females American Society of Anesthesiologists (ASA) physical status I-II Listed for elective gynecological laparoscopy surgery under general anesthesia and endotracheal tube (ETT) Exclusion Criteria: Impaired pharyngeal or esophageal function Phenylketonuria (contraindication to the sweetener aspartame in chewing gum) A fall upper or lower denture (not feasible to chew gum) A history of preoperative sore throat, upper respiratory tract illness Using steroid or analgesia within the last 48 hour Chronic smokers Receiving warfarin, heparin, full dose 325 mg aspirin, or clopidogrel A history or diagnosis of bleeding diatheses Any known allergies to ginger or lavender Having head or neck surgery History of difficult intubation Pregnant women

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 40 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Aromatherapy<br>Designated blend aromatherapy (ginger & lavender) and patient will be asked to inhale deeply and simulate like chewing gum for 5 minutes. | Other: Aromatherapy<br>* Three drops of the designated blend aromatherapy (ginger & lavender) will be placed on a 2-inch by 2-inch impermeable, backed gauze pad and patient will be asked to inhale deeply and simulate like chewing gum for 5 minutes.<br>|
| Experimental: Gum Chewing<br>Patients will chew gum (sugar free) and inhale deeply with inert gauze for 5 minutes. | Other: Gum Chewing<br>* Patients will chew gum (sugar free) and inhale deeply with inert gauze for 5 minutes.<br>|
| Other: Placebo<br>Patient will simulate like chewing gum and inhale deeply with inert gauze for 5 minutes. | Other: Controlled<br>* Patients will inhale deeply with inert gauze and simulate like chewing gum for 5 minutes.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Preoperative anxiety scale assessed by STAI questionnaire | The STAI takes less than 5 minutes to complete and can be scored in less than 2 minutes. There are 20 questions (I feel calm, secure, tense, strained, at ease, upset, am presently worrying over possible misfortunes, satisfied, frightened, uncomfortable, self-confident, nervous, jittery, indecisive, relaxed, content, worried, confused, steady and pleasant) where people rate their anxiety from one (not at all) to four (very much so), and scores range from 20 to 80. For example, low anxiety is 20 to 37, moderate anxiety is 38 to 44, and high anxiety is 45 to 80. Assessment will be done at two times; first time (before study intervention)15 minutes preoperatively in the holding area as a baseline with recoding systolic blood pressure, diastolic blood pressure, heart rate and respiratory rate. Second time; (after study intervention) in the operating room before induction of anesthesia | Preoperative 15 minutes | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Postoperative sore throat (POST) score | On arrival in the post anesthesia care unit, the patient is immediately evaluated for the presence of postoperative sore throat (POST); time 0 hour using a standardized scale. The severity of POST is graded on a 4-point scale ranging from 0 to 3; 0 being no sore throat, 1 being mild discomfort (complains only with questioning), 2 being moderate sore throat (complains on their own), and 3 being severe sore throat (change in voice, hoarseness, and throat pain). Evaluations will be recorded at 0, 1, 2, 4, 6, 12 and 24 hours after surgery. Patients with score ≥2; will be given dexamethasone 4 mg and parecoxib 40 mg. | Postoperative 24 hour | 
| Postoperative nausea and vomiting (PONV) score | The post anesthesia care unit (PACU) nurses will assess and document postoperative nausea and vomiting (PONV) using a Verbal Descriptive Scale, which correlates to visual analog nausea scores, with an objective measure of severity: 0 = no PONV: patient reports no nausea and has had no emesis episodes; 1 = mild PONV: patient reports nausea but declines antiemetic treatment; 2 = moderate PONV: patient reports nausea and accepts antiemetic treatment; and 3 = severe PONV: nausea with any emesis episode (retching or vomiting). The score will be obtained at 0, 1, 2, 4, 6, 12 and 24 hours after PACU arrival. In the PACU, ondansetron 4 mg IV will be given for score ≥2. | Postoperative 24 hour |