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Essay: Aromatherapy

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Aromatherapy is the use of concentrated essential oils extracted from herbs, flowers, and other plant parts (cooke and Ernst, 2000). can be absorbed into the body via the skin or the olfactory systemto treat various diseases (Rho et al.,2009). Many studies have found that olfactory stimulation produces immediate changes in physiological parameters such as blood pressure (BP), muscle tension, pupil dilation, blink magnitude, skin temperature, skin blood flow, electrodermal activity, pulse rate, and brain activity (Rho et al.,2009). However, the term was initially used by the French chemist Gattefossé in a book first published in 1936 (cooke and Ernst, 2000). when invented the word after a burn incident spurred his curiosity about the healing power of essential oil. On the heels of Gattefosse’s “discovery” that lavender oil helped to cure his burn. French surgeon Jean Valnet used essential oils to help heal soldiers’ wounds in World War II, proving the medical benefits of aromatherapy (www.aromatherapy.com ). Little is known about the history of aromatherapy, or where it originated specifically, The proponents of aromatherapy lay claim to an ancient tradition of herbal medicine practised in countries such as Egypt and India thousands of years ago (cooke and Ernst, 2000). The Egyptians are credited with developing one of the first distillation machines to extract oils from certain plants: cedarwood, clove, cinnamon, to name a few which were used to embalm the dead . The practice of using infused aromatic oils as a mood enhancer, however, is thought to have roots in China . The Greeks also played a role in the history of aromatherapy. Megallus, a Greek perfumer, developed a fragrance he called megaleion, which consisted of myrrh. The “father of medicine” Hippocrates is said to have practiced aromatherapy (before it was dubbed so) for healing purposes. Greek mythology claims the gods were gifted with the knowledge of perfume and fragrance (www.aromatherapy.com ). National Association for Holistic Aromatherapy NAHA approved schools are required to meet our approved standards for professional aromatherapy education (https://naha.org/education/approved-schools ). There are many approved school for example: 1) Aliphatic Ambrosia, School of Natural Therapies, approved by the Natural Health Practitioners of Canada American College of Healthcare Sciences, Study aromatherapy, herbs, spa management, nutrition & more it is Online, mobile-friendly. 2) Aroma Apothecary Healing Arts Academy Quality professional clinical aromatherapy and healing courses Distant learning and in-classroom training options available, Continuing education provider approved through NAHA, NCBTMB. Director/Instructor has 30+ years holistic clinical training. ( http://www.aromaweb.com/educators/ ). The therapeutic properties of plant oils have long been used to heal and support optimal health and wellness, including to balance emotions, disinfect, and create pleasing environments. Today, the practice of aromatherapy is becoming more popular than ever in the mainstream medical community and in holistic health community (https://achs.edu/panel/department-aromatherapy ). It is now commonly administered by massaging into the skin, and the term aromatherapy usually implies massage with a range of aromatic plant extracts known as essential oils (cooke and Ernst, 2000). People are increasingly using complementary therapies as an adjunct or alternative to conventional treatment options as well as for general health and well being (ching, 2014). Although essential oils have been used for centuries, few studies have looked the safety and effectiveness of aromatherapy in some people ( http://www.umm.edu/health/medical/altmed/treatment/aromatherapy ) but there are many researches and studies approved the safety and quality of aromatherapy.

Method and material: We used Google scholar and clinical trials. Key words: aromatherapy, lavender oil, clinical trials of aromatherapy, clinical uses of aromatherapy(2012-2017), essential oil, risk of aromatherapy.

2012

1(Aromatherapy as an Adjuvant Treatment in Cancer Care

Aromatherapy had positive effects on patient cancer including: anxiety reduction, emotional wellbeing, pain relief and improve the sleep pattern. These improvements were observed on the 2nd and 8th week after treatment. Some side effects founded e.g. increased metabolism, skin irritation, dermatitis and phototoxicity. Lavender and tea tree oil was associated with reversible prepubertal gynecomastia.( Boehm et al, 2012).

2) Essential Oil Inhalation on Blood Pressure and Salivary Cortisol Levels in Prehypertensive and Hypertensive Subjects

83 prehypertensive and hypertensive subjects had been studied about the effects of essential oil inhalation on the 24-hour ambulatory blood pressure and salivary cortisol level. The experimental group(n=28) was asked to inhale an essential oil blended with lavender, ylang-ylang, marjoram, and neroli, the placebo group (n=27)was asked to inhale an artificial fragrance for 24 hours and the control group received no treatment(n=28). The systolic blood pressure (p< 0.001) and diastolic blood pressure (p=0.009) the experimental group measured at home were significantly reduced compared with other group after treatment.In daytime systolic blood pressure during the 24-hour ambulatory blood pressure measurement of the experimental group presented with significant decreases in comparison with the measurements of the placebo.There was no statistically significant difference in the nighttime systolic blood pressure. The daytime diastolic blood pressure during the 24-hour ambulatory blood pressure measurements of the experimental group presented with significant decreases in comparison with the measurements of the placebo group and the control group (p=0.002). At night time no difference in diastolic blood pressure. The experimental group showed significant decreases in the concentration of salivary cortisol in comparison with the concentrations of the other group (p=0.12).and the control group (p<0.001). The inhalation of an essential oil had immediate and continuous effects on the home systolic blood pressure, daytime blood pressure, and the stress reduction.( Hee Kim et al ,2012)

3) Effectiveness of Aromatherapy Evaluated with Subjective and Objective Cognitive Indicators: A Clinical Trial on Young Adults Using Near-infrared Spectroscopy

Based on a study about the effect of aromatherapy on cognitive ability and mood, it was found that the 14 participants who were completing a self-reported questionnaire and multi-dimensional fatigue inventory-20 in a room filled with the fragrance of lavender had a direct effect on working memory, attention concentration and judgment. These results suggest that lavender may improve both cognitive ability and mood. aromatherapy significantly decreased general fatigue (average± standard error of the aromatherapy: 11.6 ±t 0.7, p= 0.039 average t standard error of the control: 13.3±0.7), as well as mental fatigue (average t standard error of the aromatherapy: 10.4 ±0.8,p= 0.012, average ± standard error of the control: 11.9± 0.8). ( Shinno et al ,2012).

4) The effectiveness of aromatherapy massage using lavender oil as a treatment for infantile colic

A group of 40 infants who had an infantile colic were under study of the effect of using lavender oil to do massage for these cases and they were observed once a week in total five times. The result was that the massage was measured in term of changes in the length of time the infants cried per week. comparison of the treatment group infants with infants in the control group, who did not undergo aromatherapy massage, indicated a statistically significant difference between the groups in terms of weekly crying time by observation (Wilks’ Lambda A 0.22, P< 0.05). It was found that the mean weekly crying time for infants in the treatment group started decreasi
ng from the first obse
r vation. In contrast, observations of infants in the control group did not show a change in mean weekly crying time After comparison of the mean weekly crying times measured for the treatment and control groups in the preliminary observation carried out before the aroma- therapy massage with the weekly crying time measurements taken in observations after the start of the massages there were found to be statistically significant differenc l for the treatment group between all measurement take (P< 0.01). However, no s erence was found nificant d between the ents taken for th e control group (P> 0.01) ( Çetinkaya and Başbakkal, 2012)

5) Examination of the Effectiveness of Peppermint Aromatherapy on Nausea in Women Post C-Section

Three groups of women post C-Section were understudy of the effect of peppermint aromatherapy on nausea. The peppermint group inhaled peppermint spirits, the placebo aromatherapy control group inhaled an inert placebo, green-colored sterile water, and the standard antiemetic therapy control group received standard antiemetics. The nausea levels of participants in the peppermint spirits group were significantly lower than those of participants in the other two groups.(Lane et al ,2012)

6) The Effect Of Aromatherapy On Anxiety In Patients Undergoing Hemodialysis

All hemodialysis patients experience some degree of anxiety during hemodialysis. . Anxiety increases morbidity and mortality. In this study, 62 patient devided tow group, half of them inhlated orange oil for 15-20 minute and the others usual care.group who take orange oil shown a decrease in state and trait anxiety compare with the usual care group (p= <0.001). Also,decreased significantly between the first, second, third, and fourth weeks of intervention (p<0.05).Orange oil aromatherapy can reduce state and trait anxiety in hemodialysis patients without any important complications or adverse. (Kanani et al, 2012).

7( Effect of aromatherapy massage on menopausal symptoms: a randomized, placebo-controlled clinical trial

90 women were assigned to an aromatherapy massage group, a placebo massage group, or a control group. The aromatherapy massage group received 30-minute aromatherapy treatment sessions twice a week for 4 weeks with aroma oil, the placebo massage group received the same treatment with plain oil and no treatment was provided to the control group. The results were that both massage and aromatherapy massage were effective in reducing menopausal symptoms. However, aromatherapy massage was more effective than only massage. The The mean baseline level of the menopausal score did not differ among all groups. However, after eight sessions of intervention, the Menopause Rating Scale score differed significantly among the three groups (P < 0.001). Post hoc analysis revealed that women in both the aromatherapy massage group and the placebo massage group had a lower menopausal score than the control group (P < 0.001). When the aromatherapy massage and the placebo massage groups were compared, the menopausal score for the aromatherapy massage group was found to be significantly lower (P < 0.001) than for the placebo group.. ( Darsareh et al ,2012)

8) Aromatherapy and Massage Intrapartum Service Impact on Use of Analgesia and Anesthesia in Women in Labor.

601 nulliparous women and 478 multiparous women; aromatherapy and massage intrapartum service group) were retrospectively analyzed in comparison with the birth records of an equal number of similar women (comparison group). The results: In the Aromatherapy and Massage Intrapartum Service Impact group, overall analgesia usage was higher for transcutaneous electrical stimulation at 34%, compared with 15.9% (p<0.001 allowing for parity), and for nitrous oxide and oxygen at 87.6%, compared with 80.8% (p<0.001). Pethidine use did not differ after adjustment for parity at 30.1%, compared with 24.2% (p=0.27) in the Aromatherapy and Massage Intrapartum Service Impact and comparison groups, respectively. Rates were lower in the AMIS group for epidural anesthesia at 29.7%, compared with 33.8% (p=0.004 allowing for parity) in the comparison group; spinal anesthesia at 6%; compared with 12.1% (p<0.001) in the comparison group; and general anesthesia at 0.8%, compared with 2.3% (p=0.033) in the comparison group. Aromatherapy and Massage Intrapartum Service Impact group appears to have a positive impact on reducing rates of all types of intrapartum anesthesia. The Service is a beneficial addition to conventional midwifery practice that may influence mode of delivery and reduce general anesthesia rates.( Dhany et al ,2012)

9) Aromatherapy in treatment of behavioral problems in dementia

We aimed to fill the literature gap by identifying the clinical benefits of aromatherapy in older adults with dementia, and its efficacy in reducing behavioral and psychological symptoms of dementia based on available randomized controlled trials. A systematic review of 11 clinical trials shortlisted from electronic databases from 1995 to 2011 was carried out. The randomized controlled trials showed that aromatherapy had positive effects on reduction of behavioral and psychological symptoms of dementia, improvement cognitive functions, increasing quality of life, enhancing independence of activities of daily living and so on. However, adverse effects were noted in some studies. ( Fung et al ,2012).

2013

1) The Effect of Inhalation of Aromatherapy Blend containing Lavender Essential Oil on Cesarean Postoperative Pain.

this study purpose was to compare the analgesic efficacy of postoperative lavender oil aromatherapy in 60 pregnant women divided to tow groups randomly. the study eventually show that Patients in the Lavender group had less postoperative pain in four (P = 0.008), eight (P = 0.024) and 12 (P = 0.011) hours after first medication than the placebo group. the decreased heart rate with analgesia were significantly higher in the Lavender group (P = 0.001). In the placebo group, the use of diclofenac suppositories for complete analgesia was also significantly higher than the Lavender group (P = 0.008).finally,The inhaled Lavender essence may be used to treat pain after cesarean section, but it is not recommended as the sole pain management. ( Olapour et al., 2013).

2) Effect of aromatherapy with orange essential oil on salivary cortisol and pulse rate in children during dental treatment: A randomized controlled clinical trial.

the study purpose was to showed the effect of aromatherapy with orange essential oil on the treatment of anxiety in children during dental treatment. The study used thirty children (10 boys, 20 girls) aged between 6_9 years to investigate and prove the study, the study show that the difference in means of salivary cortisol and pulse rate between treatment under orange odor and treatment without aroma was 1.047 ± 2.198 nmol/l and 6.73 ± 12.3 (in minutes), which was statistically significant using paired t-test (P = 0.014, P = 0.005, respectively).eventually: It seems that the use of aromatherapy with natural essential oil of orange could reduce salivary cortisol and pulse rate due to child anxiety state. (jafarzadeh et al., 2013)

3) Investigating the Effect of Aromatherapy in Patients with Renal Colic.

the study aimed to investigate the effect of rose essential oil as a supplementary and adjunctive therapy for the relief of renal colic. Eighty patients who were diagnosed with renal colic in the emergency room were included in the study, with ages ranging from 19 to 64 years. Half of the patients (n=40) were treated with conventional therapy, while the other half (n=40) were given aromatherapy (rose essential oil) in addition to conventional therapy. The study show that The Visual Analog Scale ( VAS) values prior to the start of therapy, and 10 and 30 minutes after therapy were 8.18 ± 1.36, 5.60 ± 2.02, and 3.75
± 2.08 for the conventional therapy
plus placebo group, while for the conventional therapy plus aromatherapy group, the VAS values were 8.63 ± 1.03, 4.25 ± 1.72, and 1.08 ± 1.07, respectively. There was no statistically significant difference between the starting VAS values of the two groups, but the VAS values 10 or 30 minutes after the initiation of therapy were statistically lower in the group that received conventional therapy plus aromatherapy. This study demonstrated that rose essential oil therapy in addition to conventional therapy effectively reduces renal colic pain. (Ayan et al., 2013)

4) Does lavender aromatherapy alleviate premenstrual emotional symptoms? a randomized crossover trial.

the study purpose was to investigate the effects of aromatherapy on premenstrual symptoms using lavender. Seventeen women (20.6 ± 0.2 years) with mild to moderate subjective premenstrual symptoms participated in study, this experiment measured heart rate reflecting autonomic nerve activity and the Profile of Mood States as a psychological index before and after the aromatic stimulation, Subjects were examined on two separate groups in the late-luteal phases. The study show that Only a 10-min inhalation of the lavender scent significantly increased the high frequency (HF) power reflecting parasympathetic nervous system activity in comparison with water (aroma effect: F = 4.50, p = 0.050; time effect: F = 5.59, p = 0.017; aroma x-time effect: F = 3.17, p = 0.047). The rate of increase in HF power was greater at 10-15 min (p = 0.051) and 20-25 min (p = 0.023) in the lavender trial than in the control trial with water. In addition, the Profile of Mood States (POMS) tests revealed that inhalation of the aromatic lavender oil significantly decreased two subscales-depression-dejection (p = 0.045) and confusion (p = 0.049)-common premenstrual symptoms, in the late-luteal phase, as long as 35 min after the aroma stimulation. lavender aromatherapy could alleviate premenstrual emotional symptoms. (Matsumoto et al., 2013).

5) Effects of Aromatherapy on the Anxiety, Vital Signs, and Sleep Quality of Percutaneous Coronary Intervention Patients in Intensive Care Units.

this study aimed to investigate the effect of aromatherapy on the anxiety, sleep, and blood pressure (BP) of percutaneous coronary intervention (PCI) patients in an intensive care unit (ICU). Fifty-six patients with PCI in ICU were evenly allocated to either the aromatherapy or conventional nursing care. Aromatherapy essential oils were blended with lavender, roman chamomile, and neroli with a 6: 2: 0.5 ratio. Participants received 10 times treatment before PCI, and the same essential oils were inhaled another 10 times after PCI. the study show that aromatherapy group showed significantly low anxiety (t = 5.99, P < .001) and improving sleep quality (t = -3.65, P = .001) compared with conventional nursing intervention. The systolic BP of both groups did not show a significant difference by time or in a group-by-time interaction; however, a significant difference was observed between groups (F = 4.63, P = .036). The diastolic BP did not show any significant difference by time or by a group-by-time interaction; however, a significant difference was observed between groups (F = 6.93, P = .011). finally, the aromatherapy effectively reduced the anxiety levels and increased the sleep quality of PCI patients admitted to the ICU. (Mi-Yeon Choet et al., 2013)

6) Aromatherapy as Treatment for Postoperative Nausea: A Randomized Trial.

The Postoperative nausea (PON) is a common complication of anesthesia and surgery. The primary aim of this study was to treat patients experiencing post-operative nausea after ambulatory surgery. The study used essential oil of ginger, blend of essential oils of ginger, spearmint, peppermint, and cardamom, or isopropyl alcohol to show the effect of aromatherapy in reduction of postoperative nausea after anesthesia and surgery, the study eventually show that the total of 1151 subjects were screened for inclusion; 303 subjects reporting nausea were enrolled (26.3%), and 301 meeting protocol were analyzed (26.2%). The change in nausea level was significant for the blend (P < 0.001) and ginger (P = 0.002) versus saline but not for alcohol (P < 0.76). The number of antiemetic medications requested after aromatherapy was also significantly reduced with ginger or blend aromatherapy versus saline (P = 0.002 and P < 0.001, respectively). The Aromatherapy is promising as an inexpensive, noninvasive treatment for post-operative nausea that can be administered and controlled by patients as needed. (Hunt et al., 2013)

7) Effect of Aromatherapy Abdominal Massage on Alleviating Menstrual Pain in Nursing Students: A Prospective Randomized Cross-Over Study.

the study purpose was to show the effect of aromatherapy message on a group of nursing students who are suffering of primary dysmenorrhea. in the first treatment phase, group 1 (n=48) received aromatherapy abdominal massage once daily for seven days prior to menstruation using the essential oils (cinnamon, clove, rose, and lavender in a base of almond oil). Group 2 (n=47) received the same intervention but with placebo oil (almond oil). In the second treatment phase, the two groups switched to alternate regimen. Level and duration of pain and the amount of menstrual bleeding were evaluated at the baseline and after each treatment phase. During both treatment phases, the level and duration of menstrual pain and the amount of menstrual bleeding were significantly lower in the aromatherapy group than in the placebo group.finally,the aromatherapy is effective in alleviating menstrual pain, its duration and excessive menstrual bleeding. Aromatherapy can be provided as a nonpharmacological pain relief measure and as a part of nursing care given to girls suffering of dysmenorrhea, or excessive menstrual bleeding. (Marzouk et al., 2013).

2014

1)The Effect of Lemon Inhalation Aromatherapy on Nausea and Vomiting of Pregnancy: A Double-Blinded, Randomized, Controlled Clinical Trial

A pregnant woman may be affected by nausea and vomiting that may affect her mental and physical health. using herbal medication during pregnancy in the form of lemon and aromatherapy is the subject of this study. A set of 100 pregnant women that are affected by such problem were randomly divided into intervention and control groups treated by lemon essential oil and placebo respectively to inhale it whenever they felt nausea, investigation of the nausea, vomiting and retch intensity before 24 hours and during the four days of treatment by Pregnancy-Unique Quantification of Emesis and Nausea-24. There was a statistically significant difference between the two groups in the mean scores of the nausea and vomiting on the second and fourth days (P = 0.017 and P = 0.039, respectively). The means in the second and fourth days in the intervention group were lower than the control group, in intragroup comparison with ANOVA in the five intervals showed a significant difference in each group (P > 0.001 and P = 0.049 respectively), so as a conclusion this clinical trial confirms the effectiveness of lemon scent and aromatherapy in reducing the symptoms. (kia et al., 2014)

2) Effect of lavender inhalation on the symptoms of primary dysmenorrhea and the amount of menstrual bleeding: A randomized clinical trial

A set of 96 female students were suffering from level two or three dysmenorrhea. The experiment was taken in Tehran university of medical sciences at 2011. The sampling criteria are as follow single, with regular menstrual cycles, no genital disorder , no systemic disease, etc. The time for the follow up was four menstrual cycles. Then we randomize the subjects into two groups : placebo ( n = 48 ) who inhale sesame oil only and experimental ( n= 48 ) who inhaled lavender based on sesame oil . The methods were used to analyze the data were
ordinal logistic regression
and generalized estimating equation . Sanitary towels were used to measure the amount of menstrual bleeding and questionnaire was the way used to measure the severity of dysmenorrhea symptoms . As a result, the level of dysmenorrhea has been lowered in the group using lavender compared to the placebo. the bleeding during menstrual has been reduced compared to the placebo but its statistically insignificant (p=0.25). the difference in observed of blood clot among the sample were not significant ( p=0.666) . As a conclusion of this study lavender inhalation showed an effectiveness in reliving dysmenorrhea symptoms with no side effects. (Dehkordi et al., 2014 )

3) The effect of lavender aromatherapy on pain perception and intrapartum outcome in primiparous women.

The authors in this study measures the effectiveness of lavender aromatherapy in primigravida women intrapartum outcome and pain intensity perception . A set of 160 participants were divided into two groups , the control groups received 2 ml of distilled water , while the aroma group received a mixture of 0.1 ml of

lavender essential oil mixed with 1 ml of distilled water .Visual Analogue Scale was used to measure the pain intensity perception at 30 and 60 minutes afterwards and before the intervention , as a final result at 30 and 60 minutes after the intervention. As a result, the mean pain intensity were lower in the aroma group than the control group ( p = 0.001 ) . As a conclusion of this study , labor pain could be decreased by using aromatherapy with no effectiveness on the Apgar score and the duration of labor phases . ( Kaviani et al ., 2014 )

4(The Effect of 1,8-Cineole Inhalation on Preoperative Anxiety: A Randomized Clinical Trial.

An examination has been done on patients with anxiety about the effect of inhalation of eucalyptus and its constituents , the study was applied at a set of 62 patients who exposed to inhale limonene , 1,8-cineole , or eucalyptus oil , with the measurement of state-trait anxiety inventory , anxiety-visual analog scale ,profile of mood states , pain-visual analog scale , pulse rate and blood pressure before and after inhalation, ( p> 0.001 ) , (P = 0.005) , and ( p > 0.001 ) respectively . As a result , there is a significant decrease in the pain-visual analog scale after the inhalation of these several groups of aromas . Finally , there is a great effect of 1,8-cineole to dismiss the anxiety associated with operations . (Kim et al. , 2014 )

5(Aromatherapy: Does It Help to Relieve Pain, Depression, Anxiety, and Stress in Community-Dwelling Older Persons?

A programme for four-weeks at the community-dwelling elderly people has been done for older persons with chronic pain to investigate the effectiveness of the aromatherapy in the reduction of pain and negative emotions after collecting their levels . A set of 82 participants , in the control group were 38 participants (30 females,8 males) while in the intervention group were 44 ( 37 females , 7 males ) . On a 10-point scale the pain scores were : 5.24 (SD 2.14) for control group and 4.75 (SD 2.32) for intervention group before the programme . The pain score of the intervention group was slightly decreased , in the intervention group there was a significant depletion of the negative emotions ( p > 0.05 ) . As a final result of this programme , aromatherapy is an effective tool for the reduction of pain , anxiety , stress levels and depression among community-dwelling older adults . (Tang and Tse ,2014 )

6 ( Influence of Counseling Intervention on the Effectiveness of Aromatherapy with Bergamot Oil in Healthy Women Volunteers Measured with a Brain Monitoring System.

Improving the mood could be enhanced by aromatherapy , counseling from the pharmacist about aromatherapy may be requested , evaluation of the influence of counseling the aromatherapy and its effectiveness at a set of 14 healthy young women .A self-reported questionnaire was completed by the participants (feeling of drowsiness and general fatigue , motivation ) and multi-dimensional fatigue inventory-20 with the fragrance of bergamot filled over the place in a room . By means of near-infrared spectroscopy measurement of change in stress , blood flow in the inferior frontal cortex was evaluated , Improvement of activity and motivation were significantly shown by multi-dimentional fatigue inventory-20 with counseling much more compared to aromatherapy only , no significant difference noted after self-reported questionnaire .Compared to exposure to aromatherapy alone , aromatherapy with counseling was reported a significant decrease of rational blood flow in the inferior frontal cortex (p<0.01, p<0.05). From near-infrared spectroscopy measurements the value of the laterality index was derived , which is regarded to be a measure of stress , was reduced indicating that bergamot oil reduces stress when used with counseling . Generally , the effectiveness of aromatherapy markedly increased as a result indicated with counseling intervention . (ISAWA et al., 2014 )

7( The effect of aromatherapy with rose oil on primary dysmenorrhea.

One of the most common gynecologic complaint is primary dysmenorrhea which may cause several problems on several aspects of life , the aim of this study is discover the effect of the aroma of rose oil massage on primary dysmenorrhea . In a randomized controlled trial , a set of 75 students from Tehran University of Medical Sciences , randomly selected three dormitories and students In each dormitory were also divided into three groups randomly Rose oil massage , unscented Almond oil massage , and massage only group . Evaluation of pain severity have been done by visual analogue scale before and after intervention . At first day of menstruation in two subsequent cycles , all three groups received massage . Statistical Package for the Social Sciences software , version 20 were used for date analyzing . As a result , pain was decreased in the first cycle . There was a significant difference between rose oil and only massage groups ( p = 0.01 ) , while the decrease was not significantly different in Rose oil and Almond groups ( p = 0.581 ). Pain was decreased significantly in the three groups Rose oil and Almond oil groups with p >0.05 in the second cycle , and Rose oil and massage only groups with p = 0.001 . Finally , the severity of primary dysmenorrhea can be decreased using the massage with rose oil .However , additional research is needed . (shahr et al., 2014 )

2015

1 (Effects of aromatherapy on sleep quality and anxiety of patients

A randomized controlled study was completed in 60 patients in southeast of turkey . the patient in the mediation group were given 2% of lavender essential oil via inhalation to evaluate the sleep quality and anxiety . in the control group they administered without the inhalation of lavender essential oil . as comparison between the two group the patient in the controlled and mediation group before and after the mediation showed statistically significant differences in the change in favors of the mediation group ( P < 0.05 ) .the result show : lavender essential oil increase quality of sleep and reduce level of anxiety in patient with coronary artery disease . (karadage et al., 2015)

2) Effects of Bergamot Essential Oil Aromatherapy on Mood States and Salivary Cortisol Levels-Bergamot essential oil is commonly used against psychological stress and anxiety in aromatherapy. Endocrinological, physiological, and psychological effects of Bergamot essential oil vapor inhalation on 41 healthy females were tested using a random crossover study design . The primary aim of the present study was to obtain first clinical evidence for these psychological and physiological effects. salivary cortisol of all 3 conditions Rest , Rest +Water vapor, and Rest +Water + Bergamot essential oil were found to be significantly distinct (p = 0.003). In the subsequent mu
ltiple comparison test, the sa
livary cortisol value of Rest +Water + Bergamot essential oil was significantly lower when compared to the rest setup.(watanabe et al.,2015)

3) Effects of inhaled ginger aromatherapy on chemotherapy-induced nausea and vomiting and health-related quality of life in women with breast cancer

The study’s purpose was to assess the Effects of inhaled ginger aromatherapy on chemotherapy-induced nausea and vomiting and health-related quality of life in women with breast cancer , Sixty female patients completed the study The nausea score was significantly lower after ginger essential oil inhalation compared to placebo during acute phase (P = 0.040) , Similarly, there was no significant effect of aromatherapy on vomiting P = 0.594 , However, a statistically significant change from baseline for global health status (P < 0.001) was detected after ginger essential oil inhalation A clinically relevant 10 points improvement on role functioning (P = 0.002) and appetite loss (P < 0.001) were also documented while patients were on ginger essential oil. (Lua et al., 2015 )

4(Effect of lavender aromatherapy on hemodynamic indices among patients with acute coronary syndrome

The study’s purpose was to assess the Effect of lavender aromatherapy on hemodynamic indices among patients with acute coronary syndrome , The study was performed in 110 patients with acute coronary syndrome at risk for hemodynamic instability secondary to anxiety and stress. Aromatherapy may have positive effects on hemodynamic status and can help reduce blood pressure and heart rate. Results : There was a downward trend of systolic and diastolic blood pressures and heart rate changes across the seven measurement time-points in both groups. However, there was no significant difference between the study groups regarding systolic blood pressure (P value = 0.586), diastolic blood pressure (P value = 0.557) and heart rate (P value = 0.846). ( Nategh et al ., 2015 )

5)The effect of aromatherapy massage with lavender oil on severity of primary dysmenorrhea

This study was performed using clinical trial method on 80 eligible students whose level of pain was measured by visual analogue scale before the intervention. Each participant, in the first days of menstruation, randomly received two types of massage with lavender and placebo oil , Results: A significant decrease in visual analogue scale score after lavender massage was reveal in comparison with placebo massage. In addition, statistically the effect of lavender massage on the severity of primary dysmenorrhea was higher than that of placebo massage (P < 0.001). feedback of this study showed that lavender oil massage decreases primary dysmenorrhea and it can be used as an effective herbal drug . (Bakhtshirin et al., 2015 )

6)The Effect of Aromatherapy with Lavender Essential Oil on Depression, Anxiety and Stress in Hemodialysis Patients

consideration of the effect of aromatherapy with lavender essential oil on depression, anxiety and stress rates in hemodialysis patients .This study was a randomized controlled clinical trial performed on 60 patients undergoing , 33(60%) of the participants were male, and 53(96.4%) were married hemodialysis in Tehran . After the intervention, the scores of depression (P<0.001) and stress (P<0.04) significantly decreased in the intervention group in comparison with control group; but the reduction in the anxiety score was not statistically significant. Aromatherapy with lavender essential oil might reduce depression and stress among hemodialysis patients. Therefore, this method can be used as a complementary method with less complication to improve the quality of life of these patients ( Tayebi et al., 2015 )

7) Effect of Inhalation of Aroma of Geranium Essence on Anxiety and Physiological Parameters during First Stage of Labor in Nulliparous Women

In study, was carried out on 100 nulliparous women . The women were randomly assigned to two groups of equal size, one experimental group (geranium essential oil) and one control (placebo) group. Anxiety levels were measured before and after intervention. And they finding The mean anxiety score decreased significantly after inhalation of the aroma of geranium essential oil. There was also a significant decrease in diastolic blood pressure. There was good result in geranium essential oil group for anxiety (p=0.001) , systolic blood pressure SBP (p=0.08) ,diastolic blood pressure DBP (P=0.005),pulse rate (p=0.056) and respiratory rate (p=0.52) comparing to control group anxity (p=0.003), SBP (p=0.28), DBP (p=0.03), pulse rate (0.13) and respiratory rate (p=0.79). Aroma of essential oil of geraniums can effectively reduce anxiety during labor and can be recommended as a non-invasive anti-anxiety aid during childbirth. ( Fakari et al., 2015)

8) The Efficacy of Aromatherapy in the Treatment of Postdischarge Nausea in Patients Undergoing Outpatient Abdominal Surgery

– the purpose of this study was to explore the effectiveness of the aromatherapy product Quease Ease for decreasing post discharge nausea in patient undergoing outpatient abdominal surgery. Inform consent was obtained from a convenience sample of adult patient scheduled for outpatient abdominal surgery procedures the post discharge nausea group had more female participants (72% vs 42%, p = 0.02 ) ,on the other hand participant that were less than 50 years of age ( 84% vs 53% , p = 0.02 ) .this study found that the aromatherapy Quease Ease was an effective treatment of post discharge nausea .participant reported a decrease in nausea scale ( 0 to 10 ) after use the Quease Ease ; for ( 47%) of the patient episodes experienced , a nausea scale of 0 after using Quease Ease . (Mcilvoy et al., 2015).

9) The Effect of Lavender Oil in Patients with Renal Colic

he purpose of the study was To assess the usability of lavender oil as an adjuvant in the medical treatment of pain due to renal stones. One hundred patients age 19–64 years diagnosed with renal colic were included in the study. Group 1 (n=50) received standard medical therapy and group 2 (n=50) received aromatherapy (lavender oil) in addition to the standard medical treatment. In both groups, the severity of the pain was graded between 0 (no pain) and 10 (severe pain) by using the visual analogue scale (VAS).The VAS values at the beginning and at 10 and 30 minutes in group 1 were 7.70±1.61, 5.02±2.20, and 2.89±1.96, respectively; in group 2, the values were 7.83±2.02, 4.42±2.46, and 2.20±1.74, respectively. The VAS values for the male patients in group 1 at the beginning and at 10 and 30 minutes were 7.61±1.47, 4.80±2.00, and 2.67±1.74; in the female patients, the values were 7.81±1.80, 5.40±2.41, and 3.72±1.94. For the male patients in group 2, the VAS values at the beginning and at 10 and 30 minutes were 8.25±2.01, 4.93±2.72, and 2.96±1.90, respectively; for the female patients, the values were 7.52±1.94, 4.15±1.95, and 1.21±0.91, respectively. Results are presented as mean±SD. Although there was no significant difference between the VAS values at the beginning and at 10 minutes in both groups, the VAS values at 30 minutes in the group receiving aromatherapy plus conventional treatment were statistically significantly low.which is a non pharmacologic treatment method, as an adjuvant to conventional treatment methods will help decrease pain, particularly in female patients (Hilal et al., 2015 )

10) Effectiveness of aromatherapy in reducing test anxiety among nursing students

– The objective of this study was to identify the effectiveness of aromatherapy in decreasing test anxiety levels in nursing students. This experimental trial study’s sample consisted of 2nd year nursing students (n=154) at Faculty of Health Sciences As a result of the study, it was found that State-Trait Anxiety Inventory mean scores of the students in the experimental group was lower than the mean s
cores of the students in the contr
ol group, and the difference between the groups was statistically significant (p<0.05). It was determined that the lavender essential oil has effects on test anxiety. (Kavurmacı et al., 2015 )

11) The effects of Red rose essential oil aromatherapy on athletes’ sleep quality before the competition

this study was to examine the effects of Red rose essential oil aromatherapy on athletes’ sleep quality before the competition. 20 players were selected by available sample (Male age =30). Rose oil aromatherapy was performed for 4 nights in the experimental group. Three drops of Rose essential oil was dropped on subjects’ pillow every night. They inhaled those for 8 hours. The control group did not inhale aromas. The results showed that the intervention Rose essential oil aromatherapy had no significant effects on athletes’ sleep quality before the competition (p=1.0). (Atashi1 et al., 2015 )

12) effect of lavender aromatherapy massage on severity and symptoms of primary dysmenorrheal

the aim of this study was to determine the effect of lavender essential oil on severity of pain and symptoms of primary dysmenorrheal . the study was performed in 60 student , before the intervention there was not difference in the two groups . mean pain severity of dysmenorrheal was reduced in two cycles after of intervention comparing to the placebo group (p <0.001) there was significant differences between experimental and control groups in the frequency of systemic symptoms of dysmenorrhea (p <0.05 ) Using Lavender aromatherapy massage is effective in decreasing the severity of menstrual pain and systemic symptoms (Beiranvand et al., 2015).

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