Contents lists available at ScienceDirect Complementary Therapies in Medicine journal homepage: www.elsevier.com/locate/ctim The effectiveness of familiar olfactory stimulation with lavender scent and glucose on the pain of blood sampling in term neonates: A randomized controlled clinical trial Naghmeh Razaghi a , Seyedeh Zahra Aemmi b,c, *, Akram Sadat Sadat Hoseini d , Hasan Boskabadi e , Tahereh Mohebbi f , Monir Ramezani a a Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran b Department of Nursing, Nursing and Midwifery School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran c Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran d Department of Pediatric Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran e Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran f Hashemi Nezhad Hospital, Mashhad University of Medical Sciences, Mashhad, Iran ARTICLE INFO Keywords: Blood specimen collection Glucose Lavandula Neonate Pain ABSTRACT Objective: Neonates are exposed to multiple painful invasive procedures. Pain management in neonates is an ethical and important task for nurses. This study aimed to evaluate the effectiveness of familiar olfactory sti- mulation with lavender scent and glucose on the pain of blood sampling in term neonates. Design: A randomized, single blind clinical trial. Setting: Hashemi Nezhad Hospital (Mashhad, Iran). Intervention: Before and during blood sampling, one group was exposed to the scent of lavender (n = 40), the second group received 2 ml of edible glucose 30 % (n = 40), two minutes before the blood sampling, and the third group received no specific intervention (n = 40). Main outcome measures: Simultaneously with needle insertion, the Douleur Aigue du Nouveau-ne (DAN) scale was used to calculate the pain score. The duration of crying (in seconds) was measured from start to end (si- lence). Results: The study participants’ mean age was 5.49 ± 2.13 days; 60 % of them were girls, and 65.8 % had the gestational age of 38–39 weeks. The mean pain scores were 4.47 ± 1.81, 4.80 ± 1.92, and 5.97 ± 1.94 in the aromatherapy group, the glucose group, and the control group respectively (p < 0.001). No significant differ- ence was recorded between the groups regarding the crying time (P = 0.12). Conclusions: Our findings suggest that use of aromatherapy with lavender and edible glucose as easy and ap- plicable nursing care can reduce the pain of blood sampling in term neonates and can be considered as effective interventions in neonate pain management, although more research is recommended. 1. Introduction Hospitalized neonates may experience a mean of 10–16 painful procedures per day. Research suggested that neonates have ability to detect, process, and respond to pain stimuli 1 and they may be more sensitive and vulnerable to pain than older children and adults. 2 Blood sampling is considered one of the painful procedures that performed for nearly all term and preterm neonates and causes the pain and distress for them. 3 The experience of repeated, prolonged and cumulative painful procedures can affect the development of the nociceptive system and lead to an enhanced response to painful stimuli in the post- infancy stage. 4–6 The acute physiological, behavioral, metabolic, and hormonal re- sponses caused by pain may have long-term and negative effects on the neurological and behavioral developments. 7–9 Since this pain can lead to hemodynamic instability, decreased oxygenation, or increased in- tracranial pressure 10,11 and to respect and observe the ethical issues, pain management (analgesic interventions to prevent or minimize) is essential. In fact, effective pain prevention and treatment have been recommended as the standard of care and a human right for all, https://doi.org/10.1016/j.ctim.2019.102289 Received 4 July 2019; Received in revised form 20 December 2019; Accepted 20 December 2019 ⁎ Corresponding author at: Department of Nursing, Nursing and Midwifery School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. E-mail address: aammiz1@mums.ac.ir (S.Z. Aemmi). Complementary Therapies in Medicine 49 (2020) 102289 Available online 26 December 2019 0965-2299/ © 2019 Elsevier Ltd. All rights reserved. T