Relaxing Environment Lowers Anxiety During Chemodenervation: a Randomized Trial.

[IMPORTANCE] Intradetrusor chemodenervation with onabotulinumtoxinA (BOTOX) injections, a common office-based procedure for overactive bladder (OAB), is associated with patient anxiety and discomfort. Aromatherapy and music have been shown to decrease procedure-related anxiety and pain with improved satisfaction.

[OBJECTIVES] The objectives of this study were to determine whether a relaxing environment consisting of lavender aromatherapy, calming music, and dim lighting compared with a typical office environment decreases patients' anxiety level before undergoing intradetrusor chemodenervation. We hypothesized that a relaxing environment would decrease patients' anxiety level before the procedure as measured by the Visual Analog Scale (VAS). Secondary outcomes included the VAS for pain, satisfaction, and staff energy level.

[STUDY DESIGN] This was a single-center randomized trial of women receiving office intradetrusor chemodenervation for overactive bladder. Participants were randomized to receive their procedures in a relaxing versus typical office environment. Eighty patients were needed to detect a clinically significant 12 mm difference on the anxiety VAS. Staff completed a preclinic and postclinic Burnout Battery VAS to measure change in their energy level during the day.

[RESULTS] Patients in the relaxing environment reported a clinically significant reduction in anxiety (-13.8 ± 18.1 vs -4.7 ± 14.7, P = 0.015). Pain was lower for the relaxing environment group, although it did not reach statistical significance (21.9 vs 28.9, P = 0.261). Satisfaction scores were high in both groups (91.4 vs 89.3, P = 0.599) and not significantly different. The procedure room environment did not affect staff energy levels.

[CONCLUSIONS] A relaxing environment of lavender aromatherapy, calming music, and dim lighting is a noninvasive, easily implemented technique to decrease patients' anxiety before office intradetrusor chemodenervation.