Dear Editors,

I read with great interest the article of Tanvisut et al. in a recent issue of the Journal [1]. The authors performed a randomized controlled trial on 104 patients undergoing labor and concluded that aromatherapy is helpful in reducing pain in latent and early active phase, and may be used as an adjunctive method for labor pain control without serious side effects. The authors should be commended for performing a well-designed study in an important topic (e.g., acute pain) in patients undergoing labor [2, 3]. In addition, the current emphasis on the need to reduce the use of opioids using multimodal analgesic strategies makes the topic very relevant in obstetric medicine [4, 5].

The study of Tanvisut et al. was well conducted; however, there are questions regarding the study that need to be clarified to further confirm the author’s results. First, it is unclear why the patients did not receive neuraxial analgesia as this is the standard of care to control labor pain in many countries. Second, the aromatherapy group received more meperidine than the control group. It would be important to include meperidine usage and dose in the study analysis as this drug can directly affect the author’s main study outcomes. Lastly, the authors evaluated pain at three time periods but did not adjust their analysis to avoid Type I errors.

I would welcome comments to address the aforementioned issues as they were not discussed by the authors as this would further substantiate the findings of this important study.