Effects of inhaled lavender essential oil on sleep quality, pain, and anxiety in ICU patients after curative hepatocellular carcinoma resection: a quasi-experimental study.
Lu Y, Tsai P, Hu Y, Hsu W • Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer • 2026
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.
Key Findings
Results
Lavender aromatherapy produced a statistically significant group-by-time interaction for pain as measured by the Critical Care Pain Observation Tool.
Wald χ2 = 23.41, p < .001 in adjusted GEE analyses
At T2 (postoperative day 2 morning), the lavender aromatherapy group had significantly lower CPOT scores compared with usual care
Intervention consisted of two drops of lavender essential oil applied to gauze held near the patient's nose for 10 breaths, then fixed to the collar from 20:00 to 08:00
26 patients per group, enrolled sequentially between 2022 and 2023 at a tertiary medical center in northern Taiwan
Results
Lavender aromatherapy produced a statistically significant group-by-time interaction for anxiety as measured by the Visual Analogue Scale for Anxiety.
Wald χ2 = 9.38, p = .009 in adjusted GEE analyses
At T2, the lavender aromatherapy group had significantly lower VAS-A scores compared with the usual care group
Anxiety was assessed at baseline (T0), and two postoperative follow-up assessments (T1 and T2)
No significant differences in measured demographic or clinical characteristics were observed between groups at baseline
Results
Lavender aromatherapy produced a statistically significant group-by-time interaction for sleep quality as measured by the Richards-Campbell Sleep Questionnaire.
Wald χ2 = 8.33, p = .016 in adjusted GEE analyses
The adjusted between-group difference in RCSQ at T2 was 14.81 points (95% CI 4.82–24.80), described as 'a potentially clinically meaningful improvement in sleep quality'
At T2, the lavender aromatherapy group had significantly higher RCSQ scores compared with usual care
Sleep quality was assessed using the Richards-Campbell Sleep Questionnaire at baseline and two follow-up time points
Methods
The study enrolled 52 adults who underwent elective curative hepatic resection and were admitted to the ICU postoperatively.
Prospective two-group quasi-experimental design with sequential enrollment according to recruitment period
Patients had early-stage hepatocellular carcinoma and underwent curative surgery at a tertiary medical center in northern Taiwan between 2022 and 2023
Control group received usual postoperative ICU care alone; intervention group received inhaled lavender aromatherapy as an adjunct
Longitudinal changes were analyzed using generalized estimating equations (GEE)
No significant differences in measured demographic or clinical characteristics were found between groups
Methods
The lavender aromatherapy intervention was administered on the evenings of postoperative days 1 and 2 using a standardized protocol.
Two drops of lavender essential oil were applied to gauze held near the patient's nose for 10 breaths
The gauze was then fixed to the patient's collar from 20:00 until 08:00 the following morning
The intervention was delivered on postoperative days 1 and 2 (evenings), corresponding to assessment time points T1 and T2
The intervention was used as an adjunct to, not a replacement for, usual postoperative ICU care
What This Means
This research suggests that having ICU patients inhale lavender essential oil after liver cancer surgery may meaningfully improve their sleep, reduce their pain, and lower their anxiety. The study followed 52 Taiwanese adults recovering in the ICU after surgery to remove early-stage liver tumors. Half received standard ICU care, while the other half also had lavender oil applied to gauze near their nose for 10 breaths each evening, with the gauze then clipped to their collar overnight for two nights after surgery. By the second postoperative day, patients in the lavender group reported better sleep quality, less pain, and less anxiety compared to those receiving standard care alone.
The improvement in sleep quality was notable: the adjusted difference between groups on the sleep quality scale was nearly 15 points, which the researchers describe as potentially clinically meaningful. Pain and anxiety outcomes also showed statistically significant differences favoring the lavender group. Because this was a quasi-experimental study (patients were not randomly assigned to groups but enrolled sequentially by time period), the design is less rigorous than a randomized controlled trial, which is an important limitation when interpreting these results.
This research suggests that inhaled lavender aromatherapy is a simple, low-cost, and non-invasive addition to post-surgical ICU care that could benefit patients' comfort and recovery experience. The findings may be particularly relevant for cancer surgery patients who face the combined stresses of pain, anxiety, and sleep disruption in the ICU environment. Further randomized controlled trials with larger sample sizes would help confirm these preliminary findings.
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Lu Y, Tsai P, Hu Y, Hsu W. (2026). Effects of inhaled lavender essential oil on sleep quality, pain, and anxiety in ICU patients after curative hepatocellular carcinoma resection: a quasi-experimental study.. Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer. https://doi.org/10.1007/s00520-026-11184-x