Music for Postoperative Pain
By David Kiefer, MD
Clinical Assistant Professor, Department of Family Medicine, University of Wisconsin; Clinical Assistant Professor of Medicine, Arizona Center for Integrative Medicine, University of Arizona, Tucson
Dr. Kiefer reports he is a consultant for WebMD.
Synopsis: Music, irrespective of type and timing, improves recovery from surgical procedures based on this meta-analysis.
Source: Hoyle J. Music as an aid for postoperative recovery in adults: A systematic review and meta-analysis. Lancet 2015; August 13. [Epub ahead of print].
Summary Point
- Music improves postoperative pain, analgesic use, and anxiety.
This report may have come to your attention from a recent National Public Radio audio segment,1 or it’s a confirmation of personal experience with the soothing effects of music. Either way, the results are compelling and may positively shape follow-up from one of allopathic medicine’s most drastic, and effective, interventions: surgery. In this systematic review, the authors included 73 randomized, controlled trials relevant to the effect of music on recovery from surgical procedures. Inclusion criteria included any form of music before, after, or during a surgical procedure (excluding head/neck, because of potential effect on hearing). With respect to intervention groups, there was a variety of music and delivery used, the latter included such devices as headphones, musical pillows, and background sound systems. The timing and length of treatment also varied between the studies. Control groups included no music, bed rest free from disturbance, and white noise. Table 1 shows the results found; music therapy led to improvements in most categories, including less postoperative pain, anxiety, and analgesic use. These comparisons used a “standard mean difference” due to the fact that many studies used different scales, though the postoperative pain measurement only incorporated studies that used the Visual Analog Scale (VAS), while the anxiety score was based on studies that used the State-Trait Anxiety Inventory (STAI). The increase in patient satisfaction was not statistically significant, nor was the length of stay in the hospital. The type of music used did not affect the findings, nor did the timing of the music “treatment” (one must ask whether it is correct to call listening to music a treatment). Interestingly, music was effective even when patients were under anesthesia. Provided that the extra sound music contributes to an already busy surgical suite doesn’t compromise the ability of staff to hear each other during a procedure, the researchers were quick to point out the safety of music, an intervention apparently free of side effects. How will this change our clinical practice? For those of us involved in surgical procedures, we will be hard pressed not to involve some music, any music, during the pre-operative, operative, and postoperative period. The exact type and duration of music does not seem to matter, but given the appearance of other patient-oriented initiatives in the medical system and the connection to improved patient outcomes, perhaps the first step should be “What would you like to listen to today?”
Table 1: Effect of Music on Recovery from Surgical Procedures |
|
|
Outcome |
Standard mean difference compared to control groups |
|
Postoperative pain (VAS) |
-0.77 (-0.99-0.56) |
|
Anxiety (STAI) |
-0.68 (-0.95-0.41) |
|
Analgesic use |
-0.37 (-0.54-0.20) |
|
Patient satisfaction (varied scales) |
1.09 (0.51-1.68) |
|
Length of stay |
-0.11 (-0.35-0.12) |
REFERENCE
- Harris R. Sutures With A Soundtrack: Music Can Ease Pain, Anxiety Of Surgery. National Public Radio. August 13, 2015. Available at: www.npr.org/sections/health-shots/2015/08/13/431695242/sutures-with-a-soundtrack-music-can-ease-pain-anxiety-of-surgery. Accessed August 14, 2015
Music, irrespective of type and timing, improves recovery from surgical procedures based on this meta-analysis.
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