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Stress reduction and analgesia in patients exposed to calming music postoperatively: a randomized controlled trial

Published online by Cambridge University Press:  13 April 2005

U. Nilsson ,
M. Unosson  and
N. Rawal
U. Nilsson
Affiliation:
Örebro University Hospital, Department of Anaesthesiology and Intensive Care, Örebro, Sweden Faculty of Health Science, Department of Medicine and Care, Division of Nursing Science, Linköping, Sweden
M. Unosson
Affiliation:
Faculty of Health Science, Department of Medicine and Care, Division of Nursing Science, Linköping, Sweden
N. Rawal
Affiliation:
Örebro University Hospital, Department of Clinical Medicine, Division of Anaesthesiology, Örebro, Sweden
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Abstract

Summary

Background and objectives: This randomized controlled trial was designed to evaluate, first, whether intra- or postoperative music therapy could influence stress and immune response during and after general anaesthesia and second, if there was a different response between patients exposed to music intra- or postoperatively.

Method: Seventy-five patients undergoing open hernia repair as day care surgery were randomly allocated to three groups: intraoperative music, postoperative music and silence (control group). Anaesthesia and postoperative analgesia were standardized and the same surgeon performed all the operations. Stress response was assessed during and after surgery by determining the plasma cortisol and blood glucose levels. Immune function was evaluated by studying immunoglobulin A (IgA) levels. Patients' postoperative pain, anxiety, blood pressure (BP), heart rate (HR) and oxygen saturation were also studied as stress markers.

Results: There was a significantly greater decrease in the level of cortisol in the postoperative music group vs. the control group (206 and 72 mmol L−1 decreases, respectively) after 2 h in the post anaesthesia care unit. The postoperative music group had less anxiety and pain and required less morphine after 1 h compared with the control group. In the postoperative music group the total requirement of morphine was significantly lower than in the control group. The intraoperative music group reported less pain after 1 h in the post anaesthesia care unit. There was no difference in IgA, blood glucose, BP, HR and oxygen saturation between the groups.

Conclusion: This study suggests that intraoperative music may decrease postoperative pain, and that postoperative music therapy may reduce anxiety, pain and morphine consumption.

Keywords

MUSIC THERAPY, intraoperative, postoperativeHORMONES, cortisolBLOOD GLUCOSEIMMUNOGLOBULIN APAIN, measurement, postoperativeANXIETY
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 22 , Issue 2 , February 2005 , pp. 96 - 102
Copyright
2005 European Society of Anaesthesiology

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References

Kiecolt-Glaser JK, Page GG, Marucha PT, MacCallum RC, Glaser R. Psychological influences on surgical recovery. Perspectives from psychoneuroimmunology. Am Psychol 1998; 53: 1209–1218.Google Scholar
Kain ZN, Zimolo Z, Heninger G. Leptin and perioperative neuroendocrinological stress response. J Clin End Metab 1999; 84: 2438–2442.Google Scholar
Özalp G, Sarioglu R, Tuncel G, Aslan K, Kadiogullari N. Preoperative emotional states in patients with breast cancer and postoperative pain. Acta Anaesth Scand 2003; 47: 26–29.Google Scholar
Schricker T, Carli F, Schreiber M, et al. Propofol/sulfentanil anesthesia suppresses the metabolic and endocrine response during, not after, lower abdominal surgery. Anesth Analg 2000; 90: 450–455.Google Scholar
Navarro-Zorraquino M, Lozano R, Deus J, et al. Determination of the immunoglobulin E postoperative variation as a measure of surgical injury. World J Surg 2001; 25: 585–591.Google Scholar
Uzunköy A, Coskun A, Akinci OF, Kocyigit A. Systematic stress responses after laparoscopic or open hernia repair. Eur J Surg 2000; 166: 467–471.Google Scholar
Nilsson U, Rawal N, Uneståhl LE, Zetterberg C, Unosson M. Improved recovery after music and therapeutic suggestions during general anaesthesia: a double blind randomised controlled trial. Acta Anesth Scand 2001; 45: 812–817.Google Scholar
Nilsson U, Rawal N, Enqvist B, Unosson M. Analgesia following music and therapeutic suggestions in the PACU in ambulatory surgery: a randomised controlled trial. Acta Anesth Scand 2003; 47: 278–283.Google Scholar
Good M, Stanton-Hicks M, Grass A, et al. Relief of postoperative pain with jaw relaxation, music and their combination. Pain 1999; 81: 163–172.Google Scholar
Good M, Cranston Anderson G, Stanton-Hicks M, et al. Relaxation and music reduce pain after gynaecologic surgery. Pain Manage Nurs 2002; 3: 61–70.Google Scholar
Nilsson U, Rawal N, Unosson M. A comparison of intra-operative or postoperative exposure to music – a controlled trial of the effect on postoperative pain. Anaesthesia 2003; 58: 699–703.Google Scholar
Miluk Kolasa B, Obminski Z, Stupnicki R, Golec L. Effects of music treatment on salivary cortisol in patients exposed to pre-surgical stress. Exp Clin End 1994; 102: 118–120.Google Scholar
Miluk-Kolasa B, Matejek M, Stupnicki R. The effect of music listening on changes in selected physiological parameters in adult pre-surgical patients. J Music Ther 1996; 33: 208–218.Google Scholar
McCraty R, Atkinson MM, Rein G. Music enhances the effect of positive emotional states on salivary IgA. Stress Med 1996; 12: 167–175.Google Scholar
Kuhn D. The effect of active and passive participation in musical activity on the immune system as measured by salivary immunoglobulin A (SigA). J Music Ther 2002; 39: 30–39.Google Scholar
Melander B. Relaxing Music. Stockholm: THETA, 2002.
Benotsch EG, Lutgendorf SK, Watson D, Fick LJ, Lang EV. Rapid anxiety assessment in medical patients: evidence for the validity of verbal anxiety rating. Ann Behav Med 2000; 22: 199–203.Google Scholar
Lundeberg T, Lund I, Dahlin L, et al. Reliability and responsiveness of three different pain assessments. J Rehab Med 2001; 33: 279–283.Google Scholar
Wang SM, Kulkarni L, Dolev J, Kain ZN. Music and preoperative anxiety: a randomized, controlled study. Anesth Analg 2002; 94: 1489–1494.Google Scholar
Charnetski CJ, Strand G, Olexa ML, Turoczi LJ, Rinehart JM. The effect of music modality on immunoglobulin A (IgA). J Pennsylvania Acad Sci 1989; 63: 73–76.Google Scholar
Burns SJ, Harbuz MS, Hucklebridge F, Bunt L. A pilot study into therapeutic effects of music therapy at cancer help center. Altern Ther Health Med 2001; 7: 48–56.Google Scholar
Pavlin DJ, Chen C, Penaloza DA, Polissar NL, Buckley FP. Pain as a factor complicating recovery and discharge after ambulatory surgery. Anesth Analg 2002; 95: 627–634.Google Scholar
Fernandez E, Turk DC. The utility of cognitive coping strategies for altering pain perception: a meta-analysis. Pain 1989; 38: 123–135.Google Scholar
Tsuchiya M, Asada A, Ryo K, et al. Relaxing intraoperative natural sounds blunts haemodynamic change at the emergence from propofol general anaesthesia and increases the acceptability of anaesthesia to the patient. Acta Anaesth Scand 2003; 47: 939–943.Google Scholar
O'Neill. The efficacy of music therapy on patient recovery in the post-anaesthetic care unit. J Adv Periop Care 2002; 1: 19–26.Google Scholar
Marwick C. Music therapists chime in with data on medical results. JAMA 2002; 283: 731–733.Google Scholar