The effect of Mozart music on patient satisfaction during caesarean delivery: a randomised controlled trial.

BACKGROUND: Music is a low-cost intervention that can improve patient satisfaction. METHODS: This was a prospective, randomised, controlled trial conducted at an urban tertiary care academic medical centre in the United States. Nulliparous women 18-50 years old with a healthy singleton pregnancy at ≥ 37 weeks gestational age undergoing elective caesarean delivery under neuraxial anaesthesia were randomised to the music group (Mozart sonatas) or control group (no music). Mozart sonatas were broadcast to the music group immediately prior to patient entry and maintained throughout the procedure. The primary outcome was patient satisfaction using the Maternal Satisfaction Scale for Caesarean Section (MSSCS). Secondary outcomes were changes in anxiety pre- and post-operatively and post-operative mean arterial pressure (MAP). Student's t-test, the Wilcoxon rank sum test, and the c2 test were used where appropriate for statistical analyses. RESULTS: 27 parturients were evaluated for participation between 2018 and 2019, and 22 enrolled. The final study subject number was 20 due to two withdrawals. There were no clinically meaningful differences in baseline demographics, vital signs, and anxiety. The mean (SD) total patient satisfaction for music vs. control was 116 (16) vs. 120 (22), mean difference 4 (95% CI: -14.0 to 22.0), P = 0.645. The mean (SD) change in anxiety with music vs. control was 2.7 (2.7) vs. 2.5 (2.6), mean difference -0.4 (95% CI: -4.0 to 3.2), P = 0.827. The median (IQR) post-operative MAP with music vs. control was 77.7 (73.7-85.3) vs. 77.3 (72.0-87.3), P = 0.678. CONCLUSIONS: The use of Mozart sonatas did not result in improvements in patient satis-faction, anxiety or MAP in parturients undergoing elective caesarean delivery.

The association of sex with pain scores and perioperative opioid administration following laparoscopic sleeve gastrectomy.

Aim: We investigated whether sex is associated with pain scores and opioid administration after laparoscopic sleeve gastrectomy. Materials & methods: We performed a single-center, retrospective analysis of laparoscopic sleeve gastrectomy patients from December 2016-July 2018. Multivariable linear regressions were performed to investigate the association of sex with pain scores and opioid administration. Results: Baseline pain scores were similar between women and men (n = 266; 78% women). Men reported lower pain scores in all phases of care and received more opioids during their hospitalization (ß = 25.48; 95% CI: 5.77-45.20; p = 0.01), compared with women. Conclusion: Our data suggest that women self-report greater postoperative pain scores, while men received more opioids during their hospitalization. Further studies are needed to understand the reasons for such differences in postoperative pain management.

Men are at higher risk for long-term opioid use compared with women, but it remains unclear whether perioperative management is a sentinel event for such outcomes. Since patients who receive higher amounts of postoperative opioids are more likely to remain on long term narcotics, we investigated whether sex is associated with pain scores and opioid administration after bariatric surgery. We demonstrate that men self-report lower pain scores in the postanesthesia care unit, surgical floor and at discharge, compared with women. We also show that while men and women received comparable doses of opioids in the operating room and postanesthesia care unit, men received more opioids on the surgical floor. Our findings suggest that strategies to reduce opioid administration after bariatric surgery should largely focus on care after the immediate postoperative period.