Chenxi Sun,1,2,* Changdong Fei,3,* Ronghua Lin,4,* Xueling Qiu,1,5 Weifeng Wang,1,6 Xiaochen Jiang,1,6 Fan Sun,1,7 Yuchen Wang,1,2 Lu Tang1,8 

1Department of Stomatology, The 960 Th Hospital of People’s Liberation Army of China (PLA), Jinan, 250031, People’s Republic of China; 2School of Nursing, Jinzhou Medical University, Liaoning, 121001, People’s Republic of China; 3 967th Hospital of People’s Liberation Army of China (PLA), Liaoning, 116011, People’s Republic of China; 4Department of Nephrology, the 960th Hospital of People’s Liberation Army of China (PLA), Jinan, 250031, People’s Republic of China; 5School of Nursing, Shandong First Medical University (Shandong Academy of Medical Sciences), Taian, 271016, People’s Republic of China; 6School of Nursing, Shandong Second Medical University, Weifang, 261053, People’s Republic of China; 7School of Nursing, Shandong University of Traditional Chinese Medicine (TCM), Jinan, 250355, People’s Republic of China; 8Postgraduate Training Base of School of Nursing, Jinzhou Medical University (The 960th Hospital of People’s Liberation Army of China (PLA)), Jinan, 250031, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Lu Tang, Department of Stomatology, the 960th Hospital of the People’s Liberation Army of China (PLA), Jinan, People’s Republic of China, Tel +86 15064003655, Email tanglu_office@163.com

Background: Pain and anxiety resulting from needle-related manipulation are major causes of patient refusal and missed optimal treatment. This study focuses on assessing the effectiveness and benefits of aromatherapy in adult patients undergoing needle-related manipulation for pain and anxiety.
Methods: The researchers conducted detailed searches of a total of five databases, the Cochrane Library, Web of Science, Embase Databases, and Scopus, from the period of the library’s construction until November 23, 2024. Inclusion criteria involved adults undergoing needle-related manipulation, aromatherapy as an intervention, and outcome indicators such as pain, anxiety, and satisfaction. And the results were analyzed in subgroups. This study used RevMan 5.4.1 software to analyse the included data.
Results: This meta-analysis and systematic review included a total of 9 studies. A meta-analysis demonstrated that aromatherapy as an intervention significantly reduced pain (MD = − 1.82, 95% CI [− 2.35, − 1.30], p < 0.00001) and anxiety (SMD = − 0.92, 95% CI [− 1.71, − 0.14], p = 0.02) in adult patients undergoing needle-related invasive procedures compared to placebo and conventional interventions. Subgroup analyses indicated aromatherapy reduced pain during needle procedures for arteriovenous fistulae (AVF) and catheter placement, and alleviated anxiety in AVF patients. Lavender oil effectively reduced both pain and anxiety. The 5-minute duration of action is superior to the 3-minute duration of action. Both inhalation and topical application reduced pain.
Conclusion: This meta-analysis supports aromatherapy for needle-related pain relief and targeted anxiety reduction. However, protocol standardization in future RCTs is needed to address high heterogeneity and methodological limitations.

Keywords: pain, anxiety, needle, puncture procedures, aromatherapy, meta-analysis