Personal versus therapist perioperative music intervention: a randomized controlled trial.

ABSTRACT

INTRODUCTION: Music interventions can alleviate patient anxiety and improve post-surgical satisfaction. However, it remains uncertain whether personal music preferences affect efficacy. The authors tested whether personal music intervention with patient-selected songs played ad libitum is more effective than standard therapist-designed treatment with classical music. METHODS: A prospective, parallel-group, single-blinded, randomized controlled trial with 229 participants (aged 18-60 years) previously scheduled for elective surgery. Data analyses followed a modified intention-to-treat principle. The patients were randomized into three groups Standard care without music (Control), therapist-designed classic music treatment (TT), or personal music intervention with patient-selected songs played ad libitum by the patient (PI). All patients received standard post-anaesthesia care, and music intervention was started upon arrival at the post-anaesthesia care unit. Primary outcomes were anxiety and overall satisfaction at discharge. In contrast, secondary outcomes were systolic blood pressure during music intervention, the sleep quality of the night after surgery, and the occurrence of postoperative nausea and vomiting within the first 24 h after surgery. RESULTS: Compared with therapist-designed music treatment, personal intervention decreased systolic blood pressure (T 0 124.3±13.7, 95% CI121-127.7; T 20min 117.6±10.4, 95% CI115-120.1; T 30min 116.9±10.6, 95% CI114.3-119.4), prevented postoperative nausea and vomiting (Control 55.9%, TT 64.6%, PI 77.6%), including severe postoperative nausea (VAS score>4; Control 44.1%; TT 33.8%; PI 20.9%) and severe emesis (Frequency≥3, Control 13.2%; TT 7.7%; PI 4.5%). None of the treatments affected sleep quality at night after surgery (Median, Q1-Q3, Control 3, 1-3; TT 3, 1-4; PI 3, 1-3.5). Personal, but not therapist, music intervention significantly prevented anxiety (Control 36.4±5.9, 95% CI35.0-37.9; TT 36.2±7.1, 95% CI 34.4-37.9; PI 33.8±5.6, 95% CI 32.4-35.2) and emesis (Control 23.9%; TT 23.4%; PI 13.2%) and improved patient satisfaction (Median, Q1-Q3, C 8, 6-8; TT 8, 7-9; PI 8, 7-9). CONCLUSIONS: Personal music intervention improved postoperative systolic blood pressure, anxiety, nausea, emesis, and overall satisfaction, but not sleep quality, as compared to therapist-designed classic intervention.