How is Intraoperative Music Therapy Beneficial to Adult Patients Undergoing General Anesthesia? A Systematic Review

  • Donté A. Flanagan, MSN, CRNA, DNPc Columbia University
  • Athena Kerin, MS, CRNA SUNY Downstate Medical Center

Abstract

Today’s expanding role of technology and the internet-of-things has become an integral aspect of the treatment modalities of health care providers throughout health care systems. With the advent of new devices and online music services, every genre of music is merely a finger touch away for each and every patient. Music therapy has been accepted as a beneficial tool used for the treatment of anxiety and pain relief for the conscious patient. Research has also been conducted to examine the analgesic benefits of music therapy on the patient undergoing general anesthesia. This systematic review focused on answering the aforementioned question regarding the added effects of music therapy. After thorough examination of the literature, it was concluded that the incorporation of volume-protective headphones and patient-chosen music therapy can be an effective and inexpensive intervention during general anesthesia with statistically significant results for decreased pain, decreased opioid needs, and increased patient satisfaction.


 


INTRODUCTION


The use of music for the treatment of disease processes and ailments can be traced back for millennia. Light et al1 found evidence of the use of music for medical treatment as far back as 2500 BC. For centuries, the benefits were observational at best, but music remained as an acceptable adjunct therapy for patients in the health care arena. In English hospitals in the 19th century, musicians were hired to play for sick patients.1 Physicians and scientists began to study the effects on physiology and the benefits of music at the turn of the 20th century. It was then that physicians across the world began to record the changes caused by music on vital signs. Farr1 pioneered the idea of music in operation suites as early as 1929. In the late 1940s, Pickrell and his research team spent 6 years studying the effects of music therapy on preoperative, intraoperative, and postoperative surgical patients.2 Their research findings suggest that patients experience decreased fear and apprehension when music is an added element of the surgical experience. Pickrell et al2 also noted the use of headphones to be beneficial, not only for delivering the intervention but also as a tool for blocking out nonreassuring noise and conversation inside the surgical arena. Theses surgeries were exclusively performed on sedated patients receiving local, spinal, or regional anesthesia. Systematic reviews to date have included regional anesthesia (ie, epidural, spinal, and local anesthesia), monitored anesthesia care, and general anesthesia3; however, the present systematic review focused only on those interventions done under general anesthesia.

Author Biographies

Donté A. Flanagan, MSN, CRNA, DNPc, Columbia University
Doctoral Candidate at Columbia University in New York, New York. Graduate of Samford University Masters of Science in Nursing with an Anesthesia concentration in 2010. Staff CRNA at New York Eye and Ear Infirmary in Manhattan, NY specializing in the field of ENT. Graduated Emory University School of Nursing in 2006 with a Bachelor of Science of Nursing. Born and raised in Chattanooga, TN and now a resident of Brooklyn, NY.
Athena Kerin, MS, CRNA, SUNY Downstate Medical Center

Athena Kerin, MS, CRNA. Associate Program Director, Nurse Anesthesia, College of Nursing, SUNY Downstate Medical Center. Resident of New York, NY. 

References

1. Light GA, Love DM, Benson D, Morch ET. Music in surgery. Curr Res Anest Anal. 1954;258-264.
2. Pickrell KL, Metzger JT, Wilde NJ, Broadbent TR, Edwards EF. The use and therapeutic value of music in the hospital and operating room. Plast Reconstr Surg. 1950;6(2):142-152. https://doi.org/10.1097/00006534-195008000-00005.
3. Nilsson U. The anxiety- and pain-reducing effects of music interventions: a systematic review. AORN J. 2008;87(4):780-807. https://doi.org/10.1016/j.aorn.2007.09.013.
4. Wakim J, Smith S, Guinn C. The efficacy of music therapy. J Perianesth Nurs. 2010;25(4):226-232. https://doi.org/10.1016/j.jopan.2010.05.009.
5. Hershenson R. Musical family’s contribution to society. The New York Times. http://www.nytimes.com/1994/04/10/nyregion/musical-family-s-contributions-to-society.html. Updated April 10, 1994. Accessed March 15, 2016.
6. Migneault B, Girard F, Albert C, et al. The effect of music on the neurohormonal stress response to surgery under general anesthesia. Anesth Analg. 2004;98:527-532. https://doi.org/10.1213/01.ANE.0000096182.70239.23.
7. Hemi-Sync. http://www.hemi-sync.com. Accessed April 9, 2016.
8. Kliempt P, Ruta D, Ogston S, Landeck A, Martay K. Hemispheric-synchronization during anesthesia: a double-blind randomised trial using audiotapes for intra-operative nociception control. Anaesthesia. 1999;54(8):769-773. https://doi.org/10.1046/j.1365-2044.1999.00958.x.
9. Moher D, Liberati A, Tetzlaff J, Altman DG. PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6(7):e1000097. https://doi.org/10.1371/journal.pmed.1000097.
10. Binns-Turner P, Wilson L, Pryor E, Boyd G, Prickett C. Perioperative music and its effects on anxiety, hemodynamics, and pain in women undergoing mastectomy. AANA J. 2011;79(4):S21-S27.
11. Blankfield RP, Zyzanski SJ, Flocke SA, Alemagno S, Scheurman K. Taped therapeutic suggestions and taped music as adjuncts in the care of coronary-artery-bypass patients. Am J Clin Hypn. 1995;37(3):32-42. https://doi.org/10.1080/00029157.1995.10403137.
12. Graversen M, Sommer T. Perioperative music may reduce pain and fatigue in patients undergoing laparoscopic cholecystectomy. Acta Anaesthesiol Scand. 2013;57(8):1010-1016. https://doi.org/10.1111/aas.12100.
13. Heiser R, Chiles K, Fudge M, Gray S. The use of music during the immediate postoperative period. AORN J. 1997;65(4):777-785. https://doi.org/10.1016/S0001-2092(06)62999-2.
14. Laurion S, Fetzer SJ. The effect of two nursing interventions on the postoperative outcomes of gynecologic laparoscopic patients. J Perianesth Nurs. 2003;18(4):254-261. https://doi.org/10.1016/S1089-9472(03)00131-X.
15. 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 Anaesthesiol Scand. 2001;45(7):812-817. https://doi.org/10.1034/j.1399-6576.2001.045007812.x.
16. Nilsson U, Rawal N, Unosson M. A comparison of intra-operative or postoperative exposure to music—a controlled trial of the effects on postoperative pain. Anaesthesia. 2003;58(7):699-703. https://doi.org/10.1046/j.1365-2044.2003.03189_4.x.
17. Nilsson U, Unosson M, Rawal N. Stress reduction and analgesia in patients exposed to calming music postoperatively: a randomized controlled trial. Eur J Anaesthesiol. 2005;22(2):96-102. https://doi.org/10.1017/S0265021505000189.
18. Occupational Health and Safety Administration. Occupational Noise Exposure. https://www.osha.gov/SLTC/noisehearingconservation/#loud. Accessed May 13, 2016.
19. Schambo L, Umadhay T, Pedoto A. Music in the operating room: is it a safety hazard? AANA J. 2015;83(1):43-48.
20. Grol R. Improving the quality of medical care: building bridges among professional pride, payer profit and patient satisfaction. JAMA. 2001;286(20):2578-2585. https://doi.org/10.1001/jama.286.20.2578. Accessed March 13, 2016.
21. Zusman EE. HCAHPS replaces Press Ganey survey as quality measure for patient hospital experience. Neurosurgery. 2012;71(2):N21-N24. https://doi.org/10.1227/01.neu.0000417536.07871.ed.
22. Center for Medicare and Medicaid Services. HCAHPS: Patients’ Perspectives of Care Survey. https://www.cms.gov/medicare/quality-initiatives-patient-assessment-instruments/hospitalqualityinits/hospitalhcahps.html. Updated September 25, 2014. Accessed May 13, 2016.
23. Vader JP. Randomised controlled trials: A user’s guide. BMJ. 1998;317:1258. https://doi.org/10.1136/bmj.317.7167.1258.
Published
2017-06-19
How to Cite
FLANAGAN, MSN, CRNA, DNPC, Donté A.; KERIN, MS, CRNA, Athena. How is Intraoperative Music Therapy Beneficial to Adult Patients Undergoing General Anesthesia? A Systematic Review. Anesthesia eJournal, [S.l.], v. 5, p. 5-13, june 2017. ISSN 2333-2611. Available at: <https://anesthesiaejournal.com/index.php/aej/article/view/62>. Date accessed: 25 sep. 2017.
Section
Articles

Keywords

Music Therapy; General Anesthesia; Surgery; Intraoperative; Headphones; Patient Satisfaction