Utilization of Aromatherapy as First Line Treatment for Nausea and Vomiting in Post Anesthesia Recovery

Post operative patients often have break through nausea and vomiting (PONV) despite receiving ondansetron and/or dexamethasone intraoperatively. Studies show aromatherapy is effective in reducing PONV in the adult population and the use of aromatherapy in children is increasing. This evidence-based quality improvement initiative was implemented in a pediatric setting to measure aromatherapy usage for PONV to minimize antiemetic medication usage.

The Pediatric Post Anesthesia Care Unit (PACU) employed aromatherapy as a first line treatment for PONV. The Nurse Scientist, EBP Coordinator, and the PACU project investigator developed an EBP initiative to look at the feasibility and effectiveness in utilizing aromatherapy prior to offering the patients rescue antiemetic medication.

PACU Staff received education through multiple in-service opportunities. Monthly aromatherapy usage was tracked via a report of staff removal for peppermint aromatherapy sticks from the automated dispensing cabinet. A data report generated from electronic medical records was created to track patients who received antiemetic medications in the PACU. All data was audited by the project investigator to verify accuracy. Data was collected over 18 months and trends were reported to staff and management. Trends and associations between aromatherapy, antiemetic use, and costs were analyzed using Spearman correlation and linear regression.

Data indicated a downward trend in antiemetic medication use as aromatherapy use increased. The number of patients who received aromatherapy significantly increased by 0.19 each month (p=0.017), while the number of patients who received antiemetic medication significantly decreased by 0.35 each month (p<0.001). The spearman correlation coefficient is -0.21 and did not reach statistical significance (p=0.406). However, this initiative led to monthly cost savings which significantly increased by $0.09 per month (p=0.002).

Aromatherapy can be an effective, feasible and low-cost option for pediatric patients experiencing nausea and vomiting in the PACU. Aromatherapy should be offered as a first-line treatment for post-operative patients, prior to rescue antiemetic therapy.