de jong m., lucas c., bredero h., van adrichem l., tibboel d. & van dijk m. (2011) Does postoperative M technique (R) massage with or without mandarin oil reduce infants distress after major craniofacial surgery? Journal of Advanced Nursing68(6), 17481757. Abstract Aim. This article is a report of a randomized controlled trial of the effects of M technique (R) massage with or without mandarin oil compared to standard postoperative care on infants levels of pain and distress, heart rate and mean arterial pressure after major craniofacial surgery. Background. There is a growing interest in non-pharmacological interventions such as aromatherapy massage in hospitalized children to relieve pain and distress but well performed studies are lacking. Methods. This randomized controlled trial allocated 60 children aged 336 months after craniofacial surgery from January 2008 to August 2009 to one of three conditions; M technique (R) massage with carrier oil, M technique (R) massage with mandarin oil or standard postoperative care. Primary outcome measures were changes in COMFORT behaviour scores, Numeric Rating Scale pain and Numeric Rating Scale distress scores assessed from videotape by an observer blinded for the condition. Results. In all three groups, the mean postintervention COMFORT behaviour scores were higher than the baseline scores, but differences were not statistically significant. Heart rate and mean arterial pressure showed a statistically significant change across the three assessment periods in all three groups. These changes were not related with the intervention. Conclusions. Results do not support a benefit of M technique (R) massage with or without mandarin oil in these young postoperative patients. Several reasons may account for this: massage given too soon after general anaesthesia, young patients fear of strangers touching them, patients not used to massage.