Controversy in music listening/stress reduction research

Normalization of hypertensive responses during ambulatory surgical stress by perioperative music

OBJECTIVE

The purpose of this study was to determine whether cognitive appraisals of stress level and hypertensive responses to ambulatory ophthalmic surgery can be ameliorated by patient-selected music.

METHODS

We studied 40 elderly individuals requiring ophthalmic surgery, 20 in an experimental group (mean age, 74 years) and 20 in a control group (mean age, 77 years). All patients had an established resting blood pressure <140/90 mm Hg. In the experimental group self-selected music was provided by headphones throughout the preoperative, surgical, and postoperative periods. In the control group patients had neither headphones nor music. All patients received similar (weight-determined) doses of alfentanil and midazolam during surgery. Heart rate, blood pressure, and patient-reported stress and coping levels were the dependent variables.

RESULTS

In both groups, blood pressure values were normal (approximately 129/82 mm Hg) during screening examinations 1 week before surgery. On the day of surgery both groups displayed increased preoperative blood pressures (approximately 159/92 mm Hg) associated with increases in heart rate (by approximately 17 beats/min). Intraoperative blood pressures in the experimental group returned quickly to screening baseline values, whereas the control group experienced persistent elevations in intraoperative blood pressure similar to preoperative levels. Over the course of the surgical experience, patients with music reported significant reductions in perceived stress and increases in coping abilities (p < .001), whereas those without music did not.

CONCLUSIONS

The perceived stress of ambulatory surgery in geriatric patients is associated with a clinical hypertensive response that is ameliorated by self-selected perioperative music, which also decreases perceived stress and increases patients' sense of personal control and well-being.

Use of music in therapeutic care

Nursing is currently examining issues that relate to quality of care. One way in which nurses can provide higher standards is by improving the environment and patient care with the use of piped, background music.

Integrating music in breathing training and relaxation: I. Background, rationale, and relevant elements

Quasiformal reports of widespread use of music in counterarousal techniques abound despite little evidence of its psychophysiological effects. Some known effects are presented here, and they suggest, among other things, an influence on hemispheric dominance, changes in autonomic nervous system activity, and relaxation by paradoxical arousal patterns contrary to those in cognitive function and anxiety. Hypothetical subcortical reflexes are postulated as mediators. Different types of music and their effect are described. Of particular relevance is that some forms of music have been reliably shown to have a profound beneficial effect on breathing.