Effects of inhaled lavender essential oil on sleep quality, pain, and anxiety in ICU patients after curative hepatocellular carcinoma resection: a quasi-experimental study

Why clinicians should know about it

• Picked for Complementary and Alternative Medicine (paper of the day, 10 September 2026): Quasi‑experimental RCT, improves pain, anxiety, sleep

Abstract

PURPOSE: This study aimed to assess the effects of inhaled lavender essential oil aromatherapy on sleep quality, pain, and anxiety in intensive care unit patients following curative surgery for early-stage hepatocellular carcinoma. METHODS: In this prospective two-group quasi-experimental study, 52 adults who underwent elective curative hepatic resection at a tertiary medical center in northern Taiwan were enrolled between 2022 and 2023. Patients were enrolled sequentially according to the recruitment period, with the control group receiving usual postoperative ICU care alone and the intervention group receiving inhaled lavender aromatherapy as an adjunct to usual postoperative ICU care. On the evenings of postoperative days 1 and 2, two drops of lavender essential oil were applied to gauze held near the patient's nose for 10 breaths and then fixed to the collar from 20:00 until 08:00 the following morning. Sleep quality, pain, and anxiety were assessed using the Richards-Campbell Sleep Questionnaire, Critical Care Pain Observation Tool, and Visual Analogue Scale for Anxiety, respectively, at baseline (T0) and two postoperative follow-up assessments (T1 and T2). Longitudinal changes were analyzed using generalized estimating equations. RESULTS: Fifty-two patients were analyzed (26 per group), with no significant differences in measured demographic or clinical characteristics between groups. In the adjusted GEE analyses, significant group × time interactions were observed for pain (CPOT; Wald χ2 = 23.41, p < .001), anxiety (VAS-A; Wald χ2 = 9.38, p = .009), and sleep quality (RCSQ; Wald χ2 = 8.33, p = .016). At T2, compared with usual care, the lavender aromatherapy group had significantly lower CPOT and VAS-A scores and higher RCSQ scores. The adjusted between-group difference in RCSQ at T2 was 14.81 points (95% CI 4.82-24.80), suggesting a potentially clinically meaningful improvement in sleep quality. CONCLUSIONS: The findings suggest that inhaled lavender essential oil aromatherapy, when used as an adjunct to usual postoperative ICU care, may improve sleep quality and reduce pain and anxiety in patients following curative resection for early-stage hepatocellular carcinoma.

Abstract as published, via PubMed.