Aromatherapy in Reducing PONV for Total Joint Replacement Patients

NCT07281885 | Recruiting DMC

• 1 other identifier: CIRB-2025-242-5
• Study Type: interventional
• Target: 159
• Locations: 1 country
• Sites: 1

Brief Summary

This study investigates the effectiveness of aromatherapy in reducing postoperative nausea and vomiting (PONV) among patients undergoing total joint replacement surgery, as these complications can lead to patient discomfort and prolonged recovery. It is designed as a randomized controlled trial involving 159 participants, who will be divided into three groups: an intervention group receiving aromatherapy patches (lavender-sandalwood or orange-ginger) plus standard care, a placebo group with a placebo patch plus standard care, and a control group receiving standard care alone. PONV will be measured using the Rhodes Index of Nausea, Vomiting, and Retching (RINVR) at baseline, 30 minutes after the intervention, and every 12 hours post-surgery. Additionally, patient satisfaction will be assessed through a 5-point Likert scale survey. The primary outcome of the study is the evaluation of RINVR scores, while the secondary outcome focuses on patient satisfaction levels. Data will be statistically analyzed using two-way ANOVA for repeated measures, with a significance level defined as p \< 0.05. The study aims to determine the viability of aromatherapy as a complementary treatment for PONV, potentially improving postoperative care, enhancing patient satisfaction, and offering a cost-effective alternative to conventional anti emetic treatments if proven effective.

Conditions

Total Joint Replacement Surgery; Postoperative Nausea and Vomiting

Keywords

Aromatherapy; PONV

Outcome Measures

Primary Outcomes (1)

• Postoperative Nausea and Vomiting

  as measured by Rhodes Index of Nausea, Vomiting, and Retching, which consists of 8-item 4-point Likert-scales for nausea, vomiting, and retching symptoms with a total score ranging from 0 to 32 for each time point. The higher scores indicate the higher severity of nausea, vomiting, and retching experienced by the patient.

  Through study completion, an average of 24 hours at 4 timepoints: T0 (baseline at PACU), T1 (up to 30 minutes from applying intervention to reassessment at PACU), T2 (up to 12-hour post-intervention in ward), T3 (up to 24-hour post-intervention in ward).

Secondary Outcomes (1)

• Patient Satisfaction

  Through study completion, an average of 24 hours at 4 timepoints: T0 (baseline at PACU), T1 (up to 30 minutes from applying intervention to reassessment at PACU), T2 (up to 12-hour post-intervention in ward), T3 (up to 24-hour post-intervention in ward).

Study Arms (3)

Aromatherapy patches

EXPERIMENTAL

Standard Care + Use of Aromatherapy Patches

Other: Aromatherapy patches

Placebo patches

PLACEBO COMPARATOR

Standard Care + Use of Placebo Patches

Other: Placebo Patches

Prescribed antiemetic treatment

ACTIVE COMPARATOR

As standard care alone

Drug: Control (Standard treatment)

Interventions

Placebo Patches OTHER

On top of standard care. Placebo patch, which looks like the aromatherapy patch but contains no element of any essential oil, will be attached to the inner side of of the patient's top covered by a plain gauze with micro-pore tape.

Placebo patches

Aromatherapy patches OTHER

Applying aromatherapy patch served as intervention part in addition to standard care. Aromatherapy patch will be attached to the inner side of of the patient's top covered by a plain gauze with micro-pore tape.

Also known as: Lavender-Sandalwood patch, Orange-Ginger patch

Aromatherapy patches

Control (Standard treatment) DRUG

Prescribed antiemetic treatment

Prescribed antiemetic treatment

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Adults aged 18 or above
• Patients scheduled for total joint replacement surgery at the HKBH

You may not qualify if:

• Cognitive impairments
• Allergy to lavender, orange, ginger, or sandalwood
• Allergy to micro-pore tape
• Allergy to opioid medication
• Undergoing other therapeutic treatment for PONV control, except prescribed medications

Sponsors & Collaborators

• Hong Kong Buddhist Hospital: lead
• Queen Elizabeth Hospital, Hong Kong: collaborator

Study Sites (1)

Hong Kong Buddhist Hospital

Wong Tai Sin, Hong Kong, Hong Kong

RECRUITING

Related Publications (13)

• Bode AM, Dong Z. The Amazing and Mighty Ginger. In: Benzie IFF, Wachtel-Galor S, editors. Herbal Medicine: Biomolecular and Clinical Aspects. 2nd edition. Boca Raton (FL): CRC Press/Taylor & Francis; 2011. Chapter 7. Available from http://www.ncbi.nlm.nih.gov/books/NBK92775/

  PMID: 22593941 BACKGROUND

• Chaiyakunapruk N, Kitikannakorn N, Nathisuwan S, Leeprakobboon K, Leelasettagool C. The efficacy of ginger for the prevention of postoperative nausea and vomiting: a meta-analysis. Am J Obstet Gynecol. 2006 Jan;194(1):95-9. doi: 10.1016/j.ajog.2005.06.046.

  PMID: 16389016 BACKGROUND

• Chou FH, Avant KC, Kuo SH, Cheng HF. Assessing the psychometric and language equivalency of the Chinese versions of the Index of Nausea, Vomiting and Retching, and the Prenatal Self-Evaluation Questionnaire. Kaohsiung J Med Sci. 2005 Jul;21(7):314-21. doi: 10.1016/S1607-551X(09)70127-5.

  PMID: 16089309 BACKGROUND

• Cardia GFE, Silva-Filho SE, Silva EL, Uchida NS, Cavalcante HAO, Cassarotti LL, Salvadego VEC, Spironello RA, Bersani-Amado CA, Cuman RKN. Effect of Lavender (Lavandula angustifolia) Essential Oil on Acute Inflammatory Response. Evid Based Complement Alternat Med. 2018 Mar 18;2018:1413940. doi: 10.1155/2018/1413940. eCollection 2018.

  PMID: 29743918 BACKGROUND

• Ford C, Park LJ. Assessing and managing nausea and vomiting in adults. Br J Nurs. 2020 Jun 11;29(11):602-605. doi: 10.12968/bjon.2020.29.11.602. No abstract available.

  PMID: 32516043 BACKGROUND

• Gress K, Urits I, Viswanath O, Urman RD. Clinical and economic burden of postoperative nausea and vomiting: Analysis of existing cost data. Best Pract Res Clin Anaesthesiol. 2020 Dec;34(4):681-686. doi: 10.1016/j.bpa.2020.07.003. Epub 2020 Jul 18.

  PMID: 33288118 BACKGROUND

• A Pilot Randomized Control Trial to Assess the Impact of Lavender on Anxiety and Comfort After Cesarean Birth and the Barriers Encountered. MCN Am J Matern Child Nurs. 2022 Mar-Apr 01;47(2):E3. doi: 10.1097/NMC.0000000000000807. No abstract available.

  PMID: 35202019 BACKGROUND

• Jin Z, Gan TJ, Bergese SD. Prevention and Treatment of Postoperative Nausea and Vomiting (PONV): A Review of Current Recommendations and Emerging Therapies. Ther Clin Risk Manag. 2020 Dec 31;16:1305-1317. doi: 10.2147/TCRM.S256234. eCollection 2020.

  PMID: 33408475 BACKGROUND

• Marsh E, Millette D, Wolfe A. Complementary Intervention in Postoperative Care: Aromatherapy's Role in Decreasing Postoperative Nausea and Vomiting. J Holist Nurs. 2022 Dec;40(4):351-358. doi: 10.1177/08980101211065555. Epub 2021 Dec 15.

  PMID: 34905993 BACKGROUND

• Amirshahi M, Behnamfar N, Badakhsh M, Rafiemanesh H, Keikhaie KR, Sheyback M, Sari M. Prevalence of postoperative nausea and vomiting: A systematic review and meta-analysis. Saudi J Anaesth. 2020 Jan-Mar;14(1):48-56. doi: 10.4103/sja.SJA_401_19. Epub 2020 Jan 6.

  PMID: 31998020 BACKGROUND

• Rhodes VA, McDaniel RW. The Index of Nausea, Vomiting, and Retching: a new format of the lndex of Nausea and Vomiting. Oncol Nurs Forum. 1999 Jun;26(5):889-94.

  PMID: 10382187 BACKGROUND

• Singh JR, Rand EB, Erosa SC, Cho RS, Sein M. Aromatherapy for Procedural Anxiety in Pain Management and Interventional Spine Procedures: A Randomized Trial. Am J Phys Med Rehabil. 2021 Oct 1;100(10):978-982. doi: 10.1097/PHM.0000000000001690.

  PMID: 33443859 BACKGROUND

• Trambert R, Kowalski MO, Wu B, Mehta N, Friedman P. A Randomized Controlled Trial Provides Evidence to Support Aromatherapy to Minimize Anxiety in Women Undergoing Breast Biopsy. Worldviews Evid Based Nurs. 2017 Oct;14(5):394-402. doi: 10.1111/wvn.12229. Epub 2017 Apr 10.

  PMID: 28395396 BACKGROUND

MeSH Terms

Conditions

Postoperative Nausea and Vomiting

Condition Hierarchy (Ancestors)

Postoperative Complications; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Nausea; Signs and Symptoms, Digestive; Signs and Symptoms; Vomiting

Study Officials

• Choi Wan CHAN, APN (NURSING)

  Hong Kong Buddhist Hospital

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Choi Wan CHAN, APN (NURSING)

CONTACT

852-2339; cw.chan1@ha.org.hk

Victor CHEUNG, EOII(MDSSC)

CONTACT

852-3506; ckl414@ha.org.hk

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: After completion of written informed consent, participants would be randomly assigned to one of three groups (Intervention, Placebo, Control) by a designated clerical staff according to a blocked randomization list. Outcome assessors were independent, not knowing information regarding condition or grouping of participants.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Advanced Practice Nurse, Principal Investigator

Model Details: Paralleled Randomized Controlled Trial

Study Record Dates

• First Submitted: December 2, 2025
• First Posted: December 15, 2025
• Study Start: September 1, 2025
• Primary Completion (Estimated): December 1, 2026
• Study Completion (Estimated): December 1, 2026
• Last Updated: January 7, 2026

Record last verified: 2026-01

Data Sharing

• IPD Sharing: Will not share

Locations

HK (1)