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Jones HG, Rizzo RRN, Pulling BW, Braithwaite FA, Grant AR, McAuley JH, Jensen MP, Moseley GL, Rees A, Stanton TR. Adjunctive use of hypnosis for clinical pain: a systematic review and meta-analysis. Pain Rep 2024; 9:e1185. [PMID: 39263007 PMCID: PMC11390056 DOI: 10.1097/pr9.0000000000001185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 06/17/2024] [Accepted: 07/12/2024] [Indexed: 09/13/2024] Open
Abstract
Systematic reviews suggest that stand-alone hypnotic suggestions may improve pain outcomes compared with no treatment, waitlist, or usual care. However, in clinical practice, hypnosis is often provided adjunctively with other interventions, which might have different effects than those reported in previous reviews. This systematic review aimed to summarize the analgesic effects of adjunctive hypnosis in adults with clinical pain. Seven databases (MEDLINE, Embase, PsycINFO, Emcare, SCOPUS, CENTRAL, Cochrane) were searched up to January 2024. Randomised controlled trials comparing the analgesic effects of adjunctive hypnosis (hypnosis + primary intervention) with those of the primary intervention alone were included. Meta-analyses (random-effects model) calculated mean differences (MD, [95% confidence intervals]) for pain intensity (0-100). Seventy studies were pooled in meta-analyses (n = 6078). Hypnosis adjunctive to usual care had a small additional analgesic effect (chronic pain: -8.2 [-11.8, -1.9]; medical procedures/surgical pain: -6.9 [-10.4, -3.3]; burn wound care: -8.8 [-13.8, -3.9]). Hypnosis adjunctive to education had a medium additional analgesic effect for chronic pain (-11.5 [-19.7, 3.3]) but not postsurgery pain (-2.0 [-7.8, 3.7]). When paired with psychological interventions, hypnosis slightly increased analgesia in chronic pain only at the three-month follow-up (-2 [-3.7, -0.3]). Hypnosis adjunctive to medicines had a medium additional analgesic effect for chronic pain (-13.2, [-22.5, -3.8]). The overall evidence certainty is very low; therefore, there is still uncertainty about the analgesic effects of adjunctive hypnosis. However, hypnosis adjunct to education may reduce pain intensity for chronic pain. Clarification of proposed therapeutic targets of adjunctive hypnosis to evaluate underlying mechanisms is warranted.
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Affiliation(s)
- Hannah G Jones
- IIMPACT in Health, University of South Australia, Adelaide, South Australia, Australia
- Department of Psychological Medicine, Kings College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom
| | - Rodrigo R N Rizzo
- Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, New South Wales, Australia
- School of Health Sciences, University of New South Wales, Sydney, New South Wales, Australia
| | - Brian W Pulling
- IIMPACT in Health, University of South Australia, Adelaide, South Australia, Australia
- Persistent Pain Research Group, South Australian Health and Medical Research Institute (SAHMRI), Lifelong Health Theme, Hopwood Centre for Neurobiology, Adelaide, South Australia, Australia
| | - Felicity A Braithwaite
- IIMPACT in Health, University of South Australia, Adelaide, South Australia, Australia
- Persistent Pain Research Group, South Australian Health and Medical Research Institute (SAHMRI), Lifelong Health Theme, Hopwood Centre for Neurobiology, Adelaide, South Australia, Australia
| | - Ashley R Grant
- IIMPACT in Health, University of South Australia, Adelaide, South Australia, Australia
| | - James H McAuley
- Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, New South Wales, Australia
- School of Health Sciences, University of New South Wales, Sydney, New South Wales, Australia
| | - Mark P Jensen
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
| | - G Lorimer Moseley
- IIMPACT in Health, University of South Australia, Adelaide, South Australia, Australia
| | - Amy Rees
- IIMPACT in Health, University of South Australia, Adelaide, South Australia, Australia
| | - Tasha R Stanton
- IIMPACT in Health, University of South Australia, Adelaide, South Australia, Australia
- Persistent Pain Research Group, South Australian Health and Medical Research Institute (SAHMRI), Lifelong Health Theme, Hopwood Centre for Neurobiology, Adelaide, South Australia, Australia
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Akelma FK, Altınsoy S, Nalbant B, Özkan D, Ergil J. Comparison of classical and patient-preferred music on anxiety and recovery after ınguinal hernia repair: a prospective randomized controlled study. Perioper Med (Lond) 2024; 13:89. [PMID: 39143577 PMCID: PMC11325758 DOI: 10.1186/s13741-024-00434-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Accepted: 07/03/2024] [Indexed: 08/16/2024] Open
Abstract
BACKGROUND We aimed to evaluate the effects of preoperative listening to patient-preferred music and classical music on postoperative anxiety and recovery. METHODS A prospective, randomized controlled, single-blind study included 255 patients who were scheduled for elective inguinal hernia operation under general anesthesia. Spielberger state State-Trait Anxiety Inventory form 1,2 (STAI-I, STAI-II), Quality of Recovery Score-40 (QoR-40) were applied in the preoperatively. In the preoperative period, the preferential music group (group P) patients listened to their favorite music, while patients in the classical music group (group C) listened to classical music, music was not played in the control group (group N). STAI-I, QoR-40 questionnaire, pain status, and patient satisfaction in the postoperative period were recorded by a blinded investigator. RESULTS A total of 217 patients participated in the study analysis. Postoperative STAI-1 score was lower in group P than in group N (p = 0.025) and was similar among other groups. The postoperative QoR-40 score was significantly higher in group P than in group N (p = 0.003), and it was similar between the other groups. While SBP, DBP and HR premusic and post-music changes were significant, there was no difference in other groups. There was no difference between the groups in the NRS score. The patient satisfaction score was significantly higher in group P. CONCLUSIONS Preoperative patient-preferred music application reduces postoperative anxiety and improves recovery quality compared to classical music. In addition, regulation of hemodynamic data and patient satisfaction increase in a preferential music application, but pain scores do not change. TRIAL REGISTRATION NCT04277559| https://www. CLINICALTRIALS gov/.
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Affiliation(s)
- Fatma Kavak Akelma
- Department of Anesthesiology and Reanimation, Faculty of Medicine, Ankara Yıldırım Beyazıt University, Ankara, Turkey.
- Department of Anesthesiology and Reanimation, Ankara Bilkent City Hospital, Ankara, Turkey.
| | - Savaş Altınsoy
- Department of Anesthesiology and Reanimation, Faculty of Medicine, University of Health Sciences,, Ankara, Turkey
- Department of Anesthesiology and Reanimation, Ankara Etlik City Hospital, Ankara, Turkey
| | - Burak Nalbant
- Department of Anesthesiology and Reanimation, Faculty of Medicine, Ankara Yıldırım Beyazıt University, Ankara, Turkey
- Department of Anesthesiology and Reanimation, Ankara Bilkent City Hospital, Ankara, Turkey
| | - Derya Özkan
- Department of Anesthesiology and Reanimation, Faculty of Medicine, University of Health Sciences,, Ankara, Turkey
- Department of Anesthesiology and Reanimation, Ankara Etlik City Hospital, Ankara, Turkey
| | - Jülide Ergil
- Department of Anesthesiology and Reanimation, Faculty of Medicine, University of Health Sciences,, Ankara, Turkey
- Department of Anesthesiology and Reanimation, Ankara Etlik City Hospital, Ankara, Turkey
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Jiang F, Wang T, Hu L, Chen S, Chen L, Liu X, Lu Y, Gu E, Ulloa L. Personal versus therapist perioperative music intervention: a randomized controlled trial. Int J Surg 2024; 110:4176-4184. [PMID: 38537084 PMCID: PMC11254264 DOI: 10.1097/js9.0000000000001383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 03/11/2024] [Indexed: 07/19/2024]
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% CI:121-127.7; T 20min : 117.6±10.4, 95% CI:115-120.1; T 30min : 116.9±10.6, 95% CI:114.3-119.4), 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% CI:35.0-37.9; 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.
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Affiliation(s)
- Fan Jiang
- Center for Perioperative Organ Protection, Department of Anesthesiology, Duke University Medical Center
- Department of Anesthesiology, First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Tingting Wang
- Department of Anesthesiology, First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Liqiong Hu
- Department of Anesthesiology, First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Shangui Chen
- Department of Anesthesiology, First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Lijian Chen
- Department of Anesthesiology, First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Xuesheng Liu
- Department of Anesthesiology, First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Yao Lu
- Department of Anesthesiology, First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Erwei Gu
- Department of Anesthesiology, First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Luis Ulloa
- Center for Perioperative Organ Protection, Department of Anesthesiology, Duke University Medical Center
- Center of Neuromodulation, Duke University Medical Center, Durham, NC, USA
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Hansen E. Touching the unconscious in the unconscious - hypnotic communication with unconscious patients. Front Psychol 2024; 15:1389449. [PMID: 38966734 PMCID: PMC11223660 DOI: 10.3389/fpsyg.2024.1389449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 05/30/2024] [Indexed: 07/06/2024] Open
Abstract
If hypnosis means contact to the unconscious to modulate psychological and physiological functions by means of suggestions, and if this is facilitated by attenuation of the critical mind, then the question arises as to whether suggestions also have an effect when waking consciousness is otherwise eliminated, namely by coma or anesthesia. A prerequisite would be perception, which actually is evidenced by reports of patients after traumatic brain injury, artificial coma, resuscitation or general anesthesia. Moreover, posttraumatic stress disorder (PTSD) frequently observed after these medical situations is hardly explainable without some sort of awareness under such conditions. Even advanced neurophysiological diagnostic cannot yet rule out consciousness or sensory processing. Especially reference to perception during unconsciousness is given by the results of a recent multicenter study on the effects of hypnotic communication with patients under controlled adequate deep general anesthesia. The observed reductions in incidence and severity of postoperative pain, opioid use, nausea and vomiting cannot be explained by the reaction of a few but only by a considerable proportion of patients. This leads to a strong plea for a more careful treatment of unconscious patients in the emergency room, operating theater or intensive care unit, for the abandonment of the restriction of therapeutic communication to awake patients, and for new aspects of communication and hypnosis research. Obviously, loss of consciousness does not protect against psychological injury, and continuation of communication is needed. But how and what to talk to unconscious patients? Generally addressing the unconscious mind with suggestions that generally exert their effects unconsciously, hypnotic communication appears to be the adequate language. Especially addressing meaningful topics, as derived from the basic psychological needs and known stressors, appears essential. With respect to negative effects by negative or missing communication or to the proposed protective and supporting effects of therapeutic communication with patients clinically rated as unconscious, the role of consciousness is secondary. For the effects of perceived signals and suggestions it does not matter whether consciousness is absent, or partial, or unrecognized present.
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Affiliation(s)
- Ernil Hansen
- Department of Anesthesiology, University Hospital Regensburg, Regensburg, Germany
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Maskal SM, Gentle CK, Ellis RC, Tu C, Rosen MJ, Petro CC, Miller BT, Beffa LRA, Chang JH, Messer N, Melland-Smith M, Jeekel J, Prabhu AS. Does selective intraoperative music reduce pain following abdominal wall reconstruction? A double-blind randomized controlled trial. Hernia 2024:10.1007/s10029-024-03092-y. [PMID: 38890182 DOI: 10.1007/s10029-024-03092-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Accepted: 06/09/2024] [Indexed: 06/20/2024]
Abstract
PURPOSE Although intraoperative music is purported to mitigate postoperative pain after some procedures, its application has never been explored in abdominal wall reconstruction (AWR). We sought to determine whether intraoperative music would decrease early postoperative pain following AWR. METHODS We conducted a placebo-controlled, patient-, surgeon-, and assessor-blinded, randomized controlled trial at a single center between June 2022 and July 2023 including 321 adult patients undergoing open AWR with retromuscular mesh. Patients received noise-canceling headphones and were randomized 1:1 to patient-selected music or silence after induction, stratified by preoperative chronic opioid use. All patients received multimodal pain control. The primary outcome was pain (NRS-11) at 24 ± 3 h. The primary outcome was analyzed by linear regression with pre-specified covariates (chronic opioid use, hernia width, operative time, myofascial release, anxiety disorder diagnosis, and preoperative STAI-6 score). RESULTS 178 patients were randomized to music, 164 of which were analyzed. 177 were randomized to silence, 157 of which were analyzed. At 24 ± 3 h postoperatively, there was no difference in the primary outcome of NRS-11 scores (5.18 ± 2.62 vs 5.27 ± 2.46, p = 0.75). After adjusting for prespecified covariates, the difference of NRS-11 scores at 24 ± 3 h between the music and silence groups remained insignificant (p = 0.83). There was no difference in NRS-11 or STAI-6 scores at 48 ± 3 and 72 ± 3 h, intraoperative sedation, or postoperative narcotic usage. CONCLUSION For patients undergoing AWR, there was no benefit of intraoperative music over routine multimodal pain control for early postoperative pain reduction. TRIAL REGISTRATION ClinicalTrials.gov: NCT05374096.
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Affiliation(s)
- Sara M Maskal
- Cleveland Clinic Foundation, Crile Building, A100, 2049 E 100th Street, Cleveland, OH, 44195, USA.
| | - Corey K Gentle
- Cleveland Clinic Foundation, Crile Building, A100, 2049 E 100th Street, Cleveland, OH, 44195, USA
| | - Ryan C Ellis
- Cleveland Clinic Foundation, Crile Building, A100, 2049 E 100th Street, Cleveland, OH, 44195, USA
| | - Chao Tu
- Cleveland Clinic Foundation, Crile Building, A100, 2049 E 100th Street, Cleveland, OH, 44195, USA
| | - Michael J Rosen
- Cleveland Clinic Foundation, Crile Building, A100, 2049 E 100th Street, Cleveland, OH, 44195, USA
| | - Clayton C Petro
- Cleveland Clinic Foundation, Crile Building, A100, 2049 E 100th Street, Cleveland, OH, 44195, USA
| | - Benjamin T Miller
- Cleveland Clinic Foundation, Crile Building, A100, 2049 E 100th Street, Cleveland, OH, 44195, USA
| | - Lucas R A Beffa
- Cleveland Clinic Foundation, Crile Building, A100, 2049 E 100th Street, Cleveland, OH, 44195, USA
| | - Jenny H Chang
- Cleveland Clinic Foundation, Crile Building, A100, 2049 E 100th Street, Cleveland, OH, 44195, USA
| | - Nir Messer
- Cleveland Clinic Foundation, Crile Building, A100, 2049 E 100th Street, Cleveland, OH, 44195, USA
| | - Megan Melland-Smith
- Cleveland Clinic Foundation, Crile Building, A100, 2049 E 100th Street, Cleveland, OH, 44195, USA
| | - Johannes Jeekel
- Erasmus Medical Center, Erasmus University, Rotterdam, Netherlands
| | - Ajita S Prabhu
- Cleveland Clinic Foundation, Crile Building, A100, 2049 E 100th Street, Cleveland, OH, 44195, USA
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Fu VX, Lagarde SM, Favoccia CT, Heisterkamp J, van Oers AE, Coene PPLO, Koopman JSHA, van den Berg SAA, Dik WA, Jeekel J, Wijnhoven BPL. Intraoperative Music to Promote Patient Outcome (IMPROMPTU): A Double-Blind Randomized Controlled Trial. J Surg Res 2024; 296:291-301. [PMID: 38306934 DOI: 10.1016/j.jss.2024.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 12/03/2023] [Accepted: 01/02/2024] [Indexed: 02/04/2024]
Abstract
INTRODUCTION Perioperative music can have beneficial effects on postoperative pain, anxiety, opioid requirement, and the physiological stress response to surgery. The aim was to assess the effects of intraoperative music during general anesthesia in patients undergoing surgery for esophagogastric cancer. MATERIALS AND METHODS The IMPROMPTU study was a double-blind, placebo-controlled, randomized multicenter trial. Adult patients undergoing surgery for stage II-III esophagogastric cancer were eligible. Exclusion criteria were a hearing impairment, insufficient Dutch language knowledge, corticosteroids use, or objection to hearing unknown music. Patients wore active noise-cancelling headphones intraoperatively with preselected instrumental classical music (intervention) or no music (control). Computerized randomization with centralized allocation, stratified according to surgical procedure using variable block sizes, was employed. Primary endpoint was postoperative pain on the first postoperative day. Secondary endpoints were postoperative pain during the first postoperative week, postoperative opioid requirement, intraoperative medication requirement, the stress response to surgery, postoperative complication rate, length of stay, and mortality, with follow-up lasting 30 d. RESULTS From November 2018 to September 2020, 145 patients were assessed and 83 randomized. Seventy patients (music n = 31, control n = 39) were analyzed. Median age was 70 [IQR 63-70], and 48 patients (69%) were male. Music did not reduce postoperative pain (numeric rating scale 1.8 (SD0.94) versus 2.0 (1.0), mean difference -0.28 [95% CI -0.76-0.19], P = 0.236). No statistically significant differences were seen in medication requirement, stress response, complication rate, or length of stay. CONCLUSIONS Intraoperative, preselected, classical music during esophagogastric cancer surgery did not significantly improve postoperative outcome and recovery when compared to no music using noise-cancelling headphones.
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Affiliation(s)
- Victor X Fu
- Department of Surgery, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
| | - Sjoerd M Lagarde
- Department of Surgery, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Christian T Favoccia
- Department of Anesthesiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Joos Heisterkamp
- Department of Surgery, Elisabeth-Tweesteden Hospital, Tilburg, The Netherlands
| | - Annemarie E van Oers
- Department of Anesthesiology, Elisabeth-Tweesteden Hospital, Tilburg, The Netherlands
| | | | | | - Sjoerd A A van den Berg
- Department of Clinical Chemistry, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Willem A Dik
- Department of Immunology, Laboratory Medical Immunology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Johannes Jeekel
- Department of Neuroscience, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Bas P L Wijnhoven
- Department of Surgery, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
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Kaufmann C, Zech N, Brandt F, Hilker M, Debl K, Creutzenberg M, Zeman F, Graf BM, Sinner B. Intraoperative suggestions to prevent postoperative delirium in patients undergoing transaortic valvular replacement: a randomized placebo-controlled trial. Aging Clin Exp Res 2023; 35:1865-1872. [PMID: 37392348 PMCID: PMC10460361 DOI: 10.1007/s40520-023-02476-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 06/06/2023] [Indexed: 07/03/2023]
Abstract
BACKGROUND Postoperative delirium (POD) is a serious complication following anaesthesia and surgery and significantly influences postoperative outcome especially in the elderly population. Intraoperative music and positive suggestions influence postoperative outcomes by attenuating analgesic demand and increasing patient satisfaction. AIMS Here, we examined the effect of intraoperative music and positive suggestions on the development of POD in aged patients undergoing transcatheter aortic valve replacement (TAVR) procedure under general anaesthesia. METHODS For this randomized placebo-controlled study, eligible patients without cognitive deficit, indicated by a MMSE < 10 points, were anesthetized using remifentanil and sevoflurane. Anaesthetic depth was guide with bispectral index. An audiotape with positive suggestions was applied from a MP3 player via headphones. POD, pain and PONV was assessed. CAM-ICU and Nu-DESC were done twice daily for the first 5 days. RESULTS Of 140 patients 118 patients could be analysed (57 male, 80.6 ± 5.1 years). POD was diagnosed in 16 patients (12.7%). POD was significantly more often observed in male (12, 21.1%) than in female (4, 6.6%, p = 0.02) and in patients with a low MMSE (23.6 ± 4.5 vs. 26.8 ± 2.8, p = 0.001). Anaesthetic depth did not influence the incidence of POD. Intraoperative music and suggestions did not affect the rate of POD, pain, analgesic requirement or PONV. DISCUSSION In patients undergoing TAVR male sex and low MMSE scoring are associated with an increase in POD. CONCLUSIONS Intraoperative music and positive suggestions do not influence the incidence of POD in this patient group. STUDY REGISTRATION DRKS: 00024444, start of registration: 4.02.202, final registration: 17.09.2021.
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Affiliation(s)
- Christina Kaufmann
- Department of Anesthesiology, University Hospital Regensburg, Regensburg, Germany
| | - Nina Zech
- Department of Anesthesiology, University Hospital Regensburg, Regensburg, Germany
| | - Florian Brandt
- Department of Anesthesiology, University Hospital Regensburg, Regensburg, Germany
| | - Michael Hilker
- Department of Cardiothoracic Surgery, University Hospital Regensburg, Regensburg, Germany
| | - Kurt Debl
- Department of Cardiology, University Hospital Regensburg, Regensburg, Germany
| | - Marcus Creutzenberg
- Department of Anesthesiology, University Hospital Regensburg, Regensburg, Germany
| | - Florian Zeman
- Department of Medical Biostatistics, University Hospital Regensburg, Regensburg, Germany
| | - Bernhard M Graf
- Department of Anesthesiology, University Hospital Regensburg, Regensburg, Germany
| | - Barbara Sinner
- Department of Anesthesiology, University Hospital Regensburg, Regensburg, Germany.
- Department of Anesthesia and Intensive Care, Medical University Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria.
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Thevi T, Abas AL, Vossmerbaeumer U. Effects of Music on Pain and Autonomic Functions of Heart Rate, Blood Pressure, Nausea and Vomiting After Major Surgery—Meta-analysis. Indian J Surg 2022. [DOI: 10.1007/s12262-021-03032-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Effectiveness of Music Intervention on Postoperative Nausea and Vomiting: A Systematic Review and Meta-analysis. J Perianesth Nurs 2022; 37:717-727. [DOI: 10.1016/j.jopan.2021.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 11/17/2021] [Accepted: 11/21/2021] [Indexed: 11/20/2022]
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Hekimoglu Sahin S, Duran R, Basaran UN, Sut N, Colak A, Duran S. Is music the food of the anesthesia in children? WORLD JOURNAL OF PEDIATRIC SURGERY 2022; 5:e000328. [DOI: 10.1136/wjps-2021-000328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 01/29/2022] [Indexed: 11/04/2022] Open
Abstract
BackgroundThe noise in an operating room may have a detrimental effect on human cognitive functions, and it may cause perioperative anxiety with prolonged exposure. The aim of this study was to investigate the effects of music therapy and use of earplugs and normal noise level in the operating room under general anesthesia of pediatric patients on hemodynamic parameters and postoperative emergence delirium.MethodsOne hundred and five pediatric patients were involved in this study. The patients were randomly divided into three groups. Group N was exposed to the ambient operating room noise, group S received earplugs from an independent anesthesiologist, and group M used a CD player. The preoperative anxiety levels of children were evaluated with the Modified Yale Preoperative Anxiety Scale (M-YPAS). Mean arterial pressure (MAP) and heart rate were recorded at 30-minute periods until the completion of surgery, end of surgery and postoperatively. During each measurement, noise level recordings were performed using sonometer. Pediatric Anesthesia Emergency Delirium (PAED) score was evaluated after postoperative extubation.ResultsM-YPAS was similar between groups. The MAP at 30 and 60 min intraoperatively, at end of surgery, and at 5, 10, and 15 min postoperatively was significantly lower in group S than in group N. There were no differences in heart rate among the groups. Postoperative PAED score was not significantly different among the groups.ConclusionsThe music therapy was not more effective than silence and operating noise room in reducing PAED score postoperatively in pediatric patients.Trial registration numberClinicalTrials.gov Registry (NCT03544502).
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Prakash R, Singh P, Arya A, Singh M, Khan M. Effect of spiritual music on old-age patients undergoing lower limb surgery under spinal anesthesia. Anesth Essays Res 2022; 16:208-212. [DOI: 10.4103/aer.aer_25_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 07/11/2022] [Accepted: 07/18/2022] [Indexed: 11/04/2022] Open
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Fu VX, Sleurink KJ, Janssen JC, Wijnhoven BPL, Jeekel J, Klimek M. Perception of auditory stimuli during general anesthesia and its effects on patient outcomes: a systematic review and meta-analysis. Can J Anaesth 2021; 68:1231-1253. [PMID: 34013463 PMCID: PMC8282577 DOI: 10.1007/s12630-021-02015-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 03/06/2021] [Accepted: 03/29/2021] [Indexed: 12/03/2022] Open
Abstract
PURPOSE Interest in implicit memory formation and unconscious auditory stimulus perception during general anesthesia has resurfaced as perioperative music has been reported to produce beneficial effects. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) evaluating explicit and implicit memory formation during general anesthesia and its effects on postoperative patient outcomes and recovery. SOURCE We performed a systematic literature search of Embase, Ovid Medline, and Cochrane Central from inception date until 15 October 2020. Eligible for inclusion were RCTs investigating intraoperative auditory stimulation in adult surgical patients under general anesthesia in which patients, healthcare staff, and outcome assessors were all blinded. We used random effects models for meta-analyses. This study adhered to the PRISMA guidelines and was registered in PROSPERO (CRD42020178087). PRINCIPAL FINDINGS Fifty-three (4,200 patients) of 5,859 identified articles were included. There was evidence of implicit memory formation in seven out of 17 studies (41%) when assessed using perceptual priming tasks. Mixed results were observed on postoperative behavioural and motor response after intraoperative suggestions. Intraoperative music significantly reduced postoperative pain (standardized mean difference [SMD], -0.84; 95% confidence interval [CI], -1.1 to -0.57; P < 0.001; I2 = 0; n = 226) and opioid requirements (SMD, -0.29; 95% CI, -0.57 to -0.015; P = 0.039; I2 = 36; n = 336), while positive therapeutic suggestions did not. CONCLUSION The results of this systematic review and meta-analysis show that intraoperative auditory stimuli can be perceived and processed during clinically adequate, general anesthesia irrespective of surgical procedure severity, leading to implicit memory formation without explicit awareness. Intraoperative music can exert significant beneficial effects on postoperative pain and opioid requirements. Whether the employed intraoperative anesthesia regimen is of influence is not yet clear.
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Affiliation(s)
- Victor X Fu
- Department of Surgery, Erasmus MC, University Medical Centre Rotterdam, Doctor Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands.
- Department of Neuroscience, Erasmus MC, University Medical Centre Rotterdam, Doctor Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands.
| | - Karel J Sleurink
- Department of Surgery, Erasmus MC, University Medical Centre Rotterdam, Doctor Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands
- Department of Neuroscience, Erasmus MC, University Medical Centre Rotterdam, Doctor Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands
| | - Joséphine C Janssen
- Department of Surgery, Erasmus MC, University Medical Centre Rotterdam, Doctor Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands
- Department of Neuroscience, Erasmus MC, University Medical Centre Rotterdam, Doctor Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands
| | - Bas P L Wijnhoven
- Department of Surgery, Erasmus MC, University Medical Centre Rotterdam, Doctor Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands
| | - Johannes Jeekel
- Department of Neuroscience, Erasmus MC, University Medical Centre Rotterdam, Doctor Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands
| | - Markus Klimek
- Department of Anesthesiology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
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Dale VH. The impact of perioperative music on abdominal surgery patients' experience of postoperative pain: A systematic review and meta-analysis. J Perioper Pract 2021; 31:31-43. [PMID: 32894995 DOI: 10.1177/1750458920943375] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Music interventions have been analysed for their use in many surgical specialties, but they have not yet been reviewed in relation to abdominal surgery. This systematic review and meta-analysis examines the effect that listening to music perioperatively has on the postoperative pain of abdominal surgery patients. METHODS A systematic search of PubMed, Cochrane Library and Scopus was undertaken to identify randomised controlled trials comparing a music intervention with standard care, where self-reported postoperative pain was included as an outcome. Study quality was then assessed by the author in conjunction with Robot Reviewer software based on the Cochrane bias methodology, and a meta-analysis was performed using standard mean difference and a random-effects model. RESULTS Twelve studies met the inclusion criteria for review, and eight studies (2217 subjects) had appropriate data reporting to be included in the meta-analysis. Half of the reviewed studies concluded a significant positive impact on postoperative pain and the meta-analysis reinforced this hypothesis (p < 0.001). There was minimal difference in impact between intra and postoperative interventions, or between patient or researcher selected music. CONCLUSIONS This review supports the use of music in the perioperative period for abdominal surgery patients as a low cost adjunct to pharmaceutical pain relief.
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Abstract
Objective: To assess and quantify the effect of perioperative music on medication requirement, length of stay and costs in adult surgical patients. Summary Background Data: There is an increasing interest in nonpharmacological interventions to decrease opioid analgesics use, as they have significant adverse effects and opioid prescription rates have reached epidemic proportions. Previous studies have reported beneficial outcomes of perioperative music. Methods: A systematic literature search of 8 databases was performed from inception date to January 7, 2019. Randomized controlled trials investigating the effect of perioperative music on medication requirement, length of stay or costs in adult surgical patients were eligible. Meta-analysis was performed using random effect models, pooled standardized mean differences (SMD) were calculated with 95% confidence intervals (CI). This study was registered with PROSPERO (CRD42018093140) and adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines. Results: The literature search yielded 2414 articles, 55 studies (N = 4968 patients) were included. Perioperative music significantly reduced postoperative opioid requirement (pooled SMD −0.31 [95% CI −0.45 to −0.16], P < 0.001, I2 = 44.3, N = 1398). Perioperative music also significantly reduced intraoperative propofol (pooled SMD −0.72 [95% CI −1.01 to −0.43], P < 0.00001, I2 = 61.1, N = 554) and midazolam requirement (pooled SMD −1.07 [95% CI −1.70 to −0.44], P < 0.001, I2 = 73.1, N = 184), while achieving the same sedation level. No significant reduction in length of stay (pooled SMD −0.18 [95% CI −0.43 to 0.067], P = 0.15, I2 = 56.0, N = 600) was observed. Conclusions: Perioperative music can reduce opioid and sedative medication requirement, potentially improving patient outcome and reducing medical costs as higher opioid dosage is associated with an increased risk of adverse events and chronic opioid abuse.
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15
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Nowak H, Zech N, Asmussen S, Rahmel T, Tryba M, Oprea G, Grause L, Schork K, Moeller M, Loeser J, Gyarmati K, Mittler C, Saller T, Zagler A, Lutz K, Adamzik M, Hansen E. Effect of therapeutic suggestions during general anaesthesia on postoperative pain and opioid use: multicentre randomised controlled trial. BMJ 2020; 371:m4284. [PMID: 33303476 PMCID: PMC7726311 DOI: 10.1136/bmj.m4284] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/06/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To investigate the effect of therapeutic suggestions played to patients through earphones during surgery on postoperative pain and opioid use. DESIGN Blinded randomised controlled study. SETTING Five tertiary care hospitals in Germany. PARTICIPANTS 385 of 400 patients consecutively recruited from January to December 2018 who were to undergo surgery for 1-3 hours under general anaesthesia. In the per protocol analysis 191 patients were included in the intervention group and 194 patients in the control group. INTERVENTION The intervention comprised an audiotape of background music and positive suggestions based on hypnotherapeutic principles, which was played repeatedly for 20 minutes followed by 10 minutes of silence to patients through earphones during general anaesthesia. Patients in the control group were assigned to a blank tape. MAIN OUTCOME MEASURES The main outcome was dose of opioid administered by patient controlled analgesia or nurse controlled analgesia within the first postoperative 24 hours, based on regular evaluation of pain intensity on a numerical rating scale (range 0-10, with higher scores representing more severe pain). RESULTS Compared with the control group, the intervention group required a significantly (P=0.002) lower opioid dose within 24 hours after surgery, with a median of 4.0 mg (interquartile range 0-8) morphine equivalents versus 5.3 (2-12), and an effect size (Cohen's d) of 0.36 (95% confidence interval 0.16 to 0.56). The number of patients who needed opioids postoperatively was significantly (P=0.001) reduced in the intervention group: 121 of 191 (63%, 95% confidence interval 45% to 70%) patients in the intervention group versus 155 of 194 (80%, 74% to 85%) in the control group. The number needed to treat to avoid postoperative opioids was 6. Pain scores were consistently and significantly lower in the intervention group within 24 hours after surgery, with an average reduction of 25%. No adverse events were reported. CONCLUSIONS Therapeutic suggestions played through earphones during general anaesthesia could provide a safe, feasible, inexpensive, and non-drug technique to reduce postoperative pain and opioid use, with the potential for more general use. Based on the finding of intraoperative perception by a considerable number of patients, surgeons and anaesthetists should be careful about background noise and conversations during surgery. TRIAL REGISTRATION German Clinical Trial Register DRKS00013800.
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Affiliation(s)
- Hartmuth Nowak
- Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Knappschaftskrankenhaus, Ruhr University Bochum, Bochum, Germany
- Contributed equally
| | - Nina Zech
- Department of Anesthesiology, University Hospital Regensburg, University of Regensburg, Regensburg, Germany
- Contributed equally
| | - Sven Asmussen
- Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Knappschaftskrankenhaus, Ruhr University Bochum, Bochum, Germany
| | - Tim Rahmel
- Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Knappschaftskrankenhaus, Ruhr University Bochum, Bochum, Germany
| | - Michael Tryba
- Clinic for Anesthesiology, Intensive Care Medicine, Emergency Medicine and Pain Therapy, Kassel Hospital, Kassel, Germany
- Kassel School of Medicine, Kassel, Germany
| | - Guenther Oprea
- Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Knappschaftskrankenhaus, Ruhr University Bochum, Bochum, Germany
| | - Lisa Grause
- Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Knappschaftskrankenhaus, Ruhr University Bochum, Bochum, Germany
| | - Karin Schork
- Medizinisches Proteom-Center, Ruhr University Bochum, Bochum, Germany
| | | | - Johannes Loeser
- Department of Anesthesiology and Intensive Care Medicine, University Hospital, University of Cologne, Cologne, Germany
| | - Katharina Gyarmati
- Department of Anesthesiology and Intensive Care Medicine, University Hospital, University of Cologne, Cologne, Germany
| | - Corinna Mittler
- Department of Anesthesiology and Intensive Care Medicine, University Hospital, University of Cologne, Cologne, Germany
| | - Thomas Saller
- Department of Anaesthesiology, University Hospital, LMU Munich, Munich, Germany
| | - Alexandra Zagler
- Department of Anaesthesiology, University Hospital, LMU Munich, Munich, Germany
| | - Katrin Lutz
- Department of Anesthesiology, University Hospital Regensburg, University of Regensburg, Regensburg, Germany
| | - Michael Adamzik
- Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Knappschaftskrankenhaus, Ruhr University Bochum, Bochum, Germany
| | - Ernil Hansen
- Department of Anaesthesiology, University Hospital Regensburg, Franz-Josef-Strauss-Allee 11, 93042 Regensburg, Germany
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Elvir-Lazo OL, White PF, Yumul R, Cruz Eng H. Management strategies for the treatment and prevention of postoperative/postdischarge nausea and vomiting: an updated review. F1000Res 2020; 9. [PMID: 32913634 PMCID: PMC7429924 DOI: 10.12688/f1000research.21832.1] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/04/2020] [Indexed: 01/10/2023] Open
Abstract
Postoperative nausea and vomiting (PONV) and postdischarge nausea and vomiting (PDNV) remain common and distressing complications following surgery. The routine use of opioid analgesics for perioperative pain management is a major contributing factor to both PONV and PDNV after surgery. PONV and PDNV can delay discharge from the hospital or surgicenter, delay the return to normal activities of daily living after discharge home, and increase medical costs. The high incidence of PONV and PDNV has persisted despite the introduction of many new antiemetic drugs (and more aggressive use of antiemetic prophylaxis) over the last two decades as a result of growth in minimally invasive ambulatory surgery and the increased emphasis on earlier mobilization and discharge after both minor and major surgical procedures (e.g. enhanced recovery protocols). Pharmacologic management of PONV should be tailored to the patient’s risk level using the validated PONV and PDNV risk-scoring systems to encourage cost-effective practices and minimize the potential for adverse side effects due to drug interactions in the perioperative period. A combination of prophylactic antiemetic drugs with different mechanisms of action should be administered to patients with moderate to high risk of developing PONV. In addition to utilizing prophylactic antiemetic drugs, the management of perioperative pain using opioid-sparing multimodal analgesic techniques is critically important for achieving an enhanced recovery after surgery. In conclusion, the utilization of strategies to reduce the baseline risk of PONV (e.g. adequate hydration and the use of nonpharmacologic antiemetic and opioid-sparing analgesic techniques) and implementing multimodal antiemetic and analgesic regimens will reduce the likelihood of patients developing PONV and PDNV after surgery.
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Affiliation(s)
| | - Paul F White
- Department of Anesthesiology, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA.,The White Mountain Institute, The Sea Ranch, Sonoma, CA, 95497, USA.,Instituto Ortopedico Rizzoli, University of Bologna, Bologna, Italy
| | - Roya Yumul
- Department of Anesthesiology, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA.,David Geffen School of Medicine-UCLA, Charles R. Drew University of Medicine and Science, Los Angeles, CA, 90095, USA
| | - Hillenn Cruz Eng
- Department of Anesthesiology, PennState Hershey Medical Center, Hershey, PA, 17033, USA
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17
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Gökçek E, Kaydu A. The effects of music therapy in patients undergoing septorhinoplasty surgery under general anesthesia. Braz J Otorhinolaryngol 2020; 86:419-426. [PMID: 31523022 PMCID: PMC9422617 DOI: 10.1016/j.bjorl.2019.01.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 12/06/2018] [Accepted: 01/10/2019] [Indexed: 02/08/2023] Open
Abstract
Introduction Music has been used for several years as a relaxation method to reduce stress and anxiety. It is a painless, safe, inexpensive and practical nonpharmacologic therapeutic modality, widely used all over the world. Objectives We aimed to evaluate the effect of music therapy on intraoperative awareness, patient satisfaction, awakening pain and waking quality in patients undergoing elective septorhinoplasty under general anesthesia. Methods This randomized, controlled, prospective study was conducted with 120 patients undergoing septorhinoplasty within a 2 months period. The patients were randomly selected and divided into two groups: group music (music during surgery) and control group (without music during surgery). All patients underwent standard general anesthesia. Patients aged 18–70 years who would undergo a planned surgery under general anesthesia were included. Patients who had emergency surgery, hearing or cognitive impairment, were excluded from the study. Results A total of 120 patients were enrolled, and separated into two groups. There were no statistically significant differences between the groups in terms of demographic characteristics, anesthesia and surgery durations (p > 0.05). In the music group, sedation agitation scores were lower than those in the control group at the postoperative period (3.76 ± 1.64 vs. 5.11 ± 2.13; p < 0.001). In addition; in patients of the music group, the pain level (2.73 ± 1.28 vs. 3.61 ± 1.40) was lower (p < 0.001), requiring less analgesic drugs intake. Conclusion Music therapy, which is a nonpharmacologic intervention, is an effective method, without side effects, leading to positive effects in the awakening, hemodynamic parameters and analgesic requirements in the postoperative period. It is also effective in reducing the anxiety and intraoperative awareness episodes of surgical patients.
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18
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Abstract
Pain is a significant public healthcare challenge. There is growing support for the use of music and suggestive techniques as adjuvant pain treatments. The purpose of this study was to (1) examine the effects of music listening combined with relaxation suggestions compared to music alone and silence on experimental pain, and (2) to explore the potential mechanisms of music-induced analgesia. Sixty-six healthy females were randomized to receive either (1) music plus relaxation suggestions, (2) music alone, or (3) silence. Pain and psychological constructs were assessed following two cold-pressor trials. Between-group comparisons indicated that music and suggestions for relaxation are not superior to music alone for pain. More research is needed to explore the effect of analgesic suggestions in combination with music to further investigate music's potential in clinical pain management.
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Affiliation(s)
- Alisa J Johnson
- Pain Research & Intervention Center of Excellence, Department of Community Dentistry & Behavioral Sciences, Institute of Aging, University of Florida, Gainesville, USA.,Department of Psychology & Neuroscience, Baylor University, Waco, Texas, USA
| | - Gary R Elkins
- Department of Psychology & Neuroscience, Baylor University, Waco, Texas, USA
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19
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Garland EL, Brintz CE, Hanley AW, Roseen EJ, Atchley RM, Gaylord SA, Faurot KR, Yaffe J, Fiander M, Keefe FJ. Mind-Body Therapies for Opioid-Treated Pain: A Systematic Review and Meta-analysis. JAMA Intern Med 2020; 180:91-105. [PMID: 31682676 PMCID: PMC6830441 DOI: 10.1001/jamainternmed.2019.4917] [Citation(s) in RCA: 83] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 08/29/2019] [Indexed: 12/15/2022]
Abstract
Importance Mind-body therapies (MBTs) are emerging as potential tools for addressing the opioid crisis. Knowing whether mind-body therapies may benefit patients treated with opioids for acute, procedural, and chronic pain conditions may be useful for prescribers, payers, policy makers, and patients. Objective To evaluate the association of MBTs with pain and opioid dose reduction in a diverse adult population with clinical pain. Data Sources For this systematic review and meta-analysis, the MEDLINE, Embase, Emcare, CINAHL, PsycINFO, and Cochrane Library databases were searched for English-language randomized clinical trials and systematic reviews from date of inception to March 2018. Search logic included (pain OR analgesia OR opioids) AND mind-body therapies. The gray literature, ClinicalTrials.gov, and relevant bibliographies were also searched. Study Selection Randomized clinical trials that evaluated the use of MBTs for symptom management in adults also prescribed opioids for clinical pain. Data Extraction and Synthesis Independent reviewers screened citations, extracted data, and assessed risk of bias. Meta-analyses were conducted using standardized mean differences in pain and opioid dose to obtain aggregate estimates of effect size with 95% CIs. Main Outcomes and Measures The primary outcome was pain intensity. The secondary outcomes were opioid dose, opioid misuse, opioid craving, disability, or function. Results Of 4212 citations reviewed, 60 reports with 6404 participants were included in the meta-analysis. Overall, MBTs were associated with pain reduction (Cohen d = -0.51; 95% CI, -0.76 to -0.26) and reduced opioid dose (Cohen d = -0.26; 95% CI, -0.44 to -0.08). Studies tested meditation (n = 5), hypnosis (n = 25), relaxation (n = 14), guided imagery (n = 7), therapeutic suggestion (n = 6), and cognitive behavioral therapy (n = 7) interventions. Moderate to large effect size improvements in pain outcomes were found for meditation (Cohen d = -0.70), hypnosis (Cohen d = -0.54), suggestion (Cohen d = -0.68), and cognitive behavioral therapy (Cohen d = -0.43) but not for other MBTs. Although most meditation (n = 4 [80%]), cognitive-behavioral therapy (n = 4 [57%]), and hypnosis (n = 12 [63%]) studies found improved opioid-related outcomes, fewer studies of suggestion, guided imagery, and relaxation reported such improvements. Most MBT studies used active or placebo controls and were judged to be at low risk of bias. Conclusions and Relevance The findings suggest that MBTs are associated with moderate improvements in pain and small reductions in opioid dose and may be associated with therapeutic benefits for opioid-related problems, such as opioid craving and misuse. Future studies should carefully quantify opioid dosing variables to determine the association of mind-body therapies with opioid-related outcomes.
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Affiliation(s)
- Eric L. Garland
- Center on Mindfulness and Integrative Health Intervention Development, University of Utah, Salt Lake City
- College of Social Work, University of Utah, Salt Lake City
| | - Carrie E. Brintz
- Program on Integrative Medicine, Physical Medicine and Rehabilitation, University of North Carolina at Chapel Hill, Chapel Hill
| | - Adam W. Hanley
- Center on Mindfulness and Integrative Health Intervention Development, University of Utah, Salt Lake City
- College of Social Work, University of Utah, Salt Lake City
| | - Eric J. Roseen
- Department of Family Medicine, Boston University and Boston University School of Medicine, Boston, Massachusetts
- Department of Rehabilitation Science, Massachusetts General Hospital Institute of Health Professions, Boston, Massachusetts
| | - Rachel M. Atchley
- Department of Anesthesiology, Brigham and Women’s Hospital, Harvard University, Boston, Massachusetts
| | - Susan A. Gaylord
- Program on Integrative Medicine, Physical Medicine and Rehabilitation, University of North Carolina at Chapel Hill, Chapel Hill
| | - Keturah R. Faurot
- Program on Integrative Medicine, Physical Medicine and Rehabilitation, University of North Carolina at Chapel Hill, Chapel Hill
| | - Joanne Yaffe
- College of Social Work, University of Utah, Salt Lake City
| | | | - Francis J. Keefe
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina
- Department of Anesthesiology, Duke University, Durham, North Carolina
- Department of Medicine, Duke University, Durham, North Carolina
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20
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Lin HH, Chang YC, Chou HH, Chang CP, Huang MY, Liu SJ, Tsai CH, Lei WT, Yeh TL. Effect of music interventions on anxiety during labor: a systematic review and meta-analysis of randomized controlled trials. PeerJ 2019; 7:e6945. [PMID: 31143552 PMCID: PMC6525590 DOI: 10.7717/peerj.6945] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Accepted: 04/11/2019] [Indexed: 12/26/2022] Open
Abstract
Background Anxiety is commonly experienced during the delivery process and has shown to have adverse effects on maternal and infant health outcomes. Music interventions tend to reduce the effects of anxiety in diverse populations, are low cost, are easily accessible, and have high acceptability. The aim of this review and meta-analysis was to assess the effectiveness of music interventions in reducing anxiety levels among women during labor. Methods Seven databases from inception to the end of December, 2018, without any language or time restriction including Embase, PubMed, the Cochrane Library, the Cumulative Index to Nursing and Allied Health, PsycINFO, Airiti Library, and PerioPath: Index to Taiwan Periodical Literature were searched using key terms related to pregnancy, anxiety, and music. Randomized controlled trials that assessed the effect of music during labor and measured anxiety levels as an outcome were included. Meta-analyses were conducted to assess anxiety reduction following a music intervention compared to that after placebo treatment. Results A total of 14 studies that investigated a total of 1,310 participants were included in this review. The meta-analyses indicated that those in the intervention group had a significant decrease in anxiety scores (standardized mean difference = −2.40, 95% confidence interval (CI) [−3.29 to −1.52], p < 0.001; I2 = 97.66%), heart rate (HR) (difference in means = −3.04 beats/min, 95% CI [−4.79 to −1.29] beats/min, p = 0.001; I2 = 0.00%), systolic blood pressure (SBP) (difference in means = −3.71 mmHg, 95% CI [−7.07 to −0.35] mmHg, p = 0.031; I2 = 58.47%), and diastolic blood pressure (DBP) (difference in means = −3.54 mmHg, 95% CI [−5.27 to −1.81] mmHg, p < 0.001; I2 = 0.00%) as compared to the women in the control group. Conclusions Music interventions may decrease anxiety scores and physiological indexes related to anxiety (HR, SBP, and DBP). Music interventions may be a good non-pharmacological approach for decreasing anxiety levels during labor.
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Affiliation(s)
- Hsin-Hui Lin
- Department of Family Medicine, MacKay Memorial Hospital, Taipei, Taiwan
| | - Yu-Chen Chang
- Department of Family Medicine, MacKay Memorial Hospital, Taipei, Taiwan
| | - Hsiao-Hui Chou
- Department of Family Medicine, MacKay Memorial Hospital, Taipei, Taiwan
| | - Chih-Po Chang
- Department of Family Medicine, MacKay Memorial Hospital, Taipei, Taiwan
| | - Ming-Yuan Huang
- Department of Hospice and Palliative Care, MacKay Memorial Hospital, Tamsui Branch, New Taipei City, Taiwan
| | - Shu-Jung Liu
- Department of Medical Library, MacKay Memorial Hospital, Tamsui Branch, New Taipei City, Taiwan
| | - Chin-Han Tsai
- Department of Gynecology and Obstetrics, Hsinchu MacKay Memorial Hospital, Hsinchu, Taiwan
| | - Wei-Te Lei
- Department of Pediatrics, Hsinchu MacKay Memorial Hospital, Hsinchu, Taiwan.,Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan City, Taiwan
| | - Tzu-Lin Yeh
- Department of Family Medicine, Hsinchu MacKay Memorial Hospital, Hsinchu, Taiwan.,Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan
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21
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Çetinkaya F. The effects of listening to music on the postoperative nausea and vomiting. Complement Ther Clin Pract 2019; 35:278-283. [PMID: 31003670 DOI: 10.1016/j.ctcp.2019.03.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 02/01/2019] [Accepted: 03/04/2019] [Indexed: 01/10/2023]
Abstract
AIM To determine the effect of music on the severity of postoperative nausea and vomiting after the laparoscopic cholecystectomy. METHODS This study was a randomized, controlled clinical study. The subjects were randomly divided into two groups (intervention group and control group). The numerical scale of nausea was used in rating the nausea complaints of the patients and the vomiting incidence assessment form in determining the incidence of vomiting. RESULTS There were statistically significant difference between the groups in terms of the severity of nausea complaint (W = 110.826 p < 0.001). When compared to the control group, the vomiting incidence of the patients was statistically significantly lower in intervention group. CONCLUSIONS This study demonstrated that listening to music decreased the severity nausea and the incidence of vomiting in the postoperative period.
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Affiliation(s)
- Funda Çetinkaya
- Aksaray University, Faculty of Health Sciences, Department of Surgical Nursing, Aksaray, Turkey.
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22
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Kahloul M, Mhamdi S, Nakhli MS, Sfeyhi AN, Azzaza M, Chaouch A, Naija W. Effects of music therapy under general anesthesia in patients undergoing abdominal surgery. Libyan J Med 2018; 12:1260886. [PMID: 28452603 PMCID: PMC5328375 DOI: 10.1080/19932820.2017.1260886] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND Music therapy, an innovative approach that has proven effectiveness in many medical conditions, seems beneficial also in managing surgical patients. The aim of this study is to evaluate its effects, under general anesthesia, on perioperative patient satisfaction, stress, pain, and awareness. METHODS This is a prospective, randomized, double-blind study conducted in the operating theatre of visceral surgery at Sahloul Teaching Hospital over a period of 4 months. Patients aged more than 18 undergoing a scheduled surgery under general anesthesia were included. Patients undergoing urgent surgery or presenting hearing or cognitive disorders were excluded. Before induction, patients wore headphones linked to an MP3 player. They were randomly allocated into 2 groups: Group M (with music during surgery) and group C (without music). Hemodynamic parameters, quality of arousal, pain experienced, patient's satisfaction, and awareness incidence during anesthesia were recorded. RESULTS One hundred and forty patients were included and allocated into 2 groups that were comparable in demographic characteristics, surgical intervention type and anesthesia duration. Comparison of these two groups regarding the hemodynamic profile found more stability in group M for systolic arterial blood pressure. A calm recovery was more often noted in group M (77.1% versus 44%, p < 10-3). The average Visual Analog Scale (VAS) score was lower in the intervention group (33.8 ± 13.63 versus 45.1 ± 16.2; p < 10-3). The satisfaction rate was significantly higher among the experimental group (81.4% versus 51.4%; p < 10-3). The incidence of intraoperative awareness was higher in group C (8 cases versus 3 cases) but the difference was not statistically significant. CONCLUSION Music therapy is a non-pharmacological, inexpensive, and non-invasive technique that can significantly enhance patient satisfaction and decrease patients' embarrassing experiences related to perioperative stress, pain, and awareness.
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Affiliation(s)
- Mohamed Kahloul
- a Department of Anesthesia and Intensive Care, Teaching Hospital of Sahloul , University of Medicine Ibn Jazzar , Sousse , Tunisia
| | - Salah Mhamdi
- a Department of Anesthesia and Intensive Care, Teaching Hospital of Sahloul , University of Medicine Ibn Jazzar , Sousse , Tunisia
| | - Mohamed Said Nakhli
- a Department of Anesthesia and Intensive Care, Teaching Hospital of Sahloul , University of Medicine Ibn Jazzar , Sousse , Tunisia
| | - Ahmed Nadhir Sfeyhi
- a Department of Anesthesia and Intensive Care, Teaching Hospital of Sahloul , University of Medicine Ibn Jazzar , Sousse , Tunisia
| | - Mohamed Azzaza
- b Department of Abdominal Surgery, Teaching Hospital of Sahloul , University of Medicine Ibn Jazzar , Sousse , Tunisia
| | - Ajmi Chaouch
- a Department of Anesthesia and Intensive Care, Teaching Hospital of Sahloul , University of Medicine Ibn Jazzar , Sousse , Tunisia
| | - Walid Naija
- a Department of Anesthesia and Intensive Care, Teaching Hospital of Sahloul , University of Medicine Ibn Jazzar , Sousse , Tunisia
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Kühlmann AYR, de Rooij A, Kroese LF, van Dijk M, Hunink MGM, Jeekel J. Meta-analysis evaluating music interventions for anxiety and pain in surgery. Br J Surg 2018; 105:773-783. [PMID: 29665028 PMCID: PMC6175460 DOI: 10.1002/bjs.10853] [Citation(s) in RCA: 162] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Revised: 12/08/2017] [Accepted: 02/09/2018] [Indexed: 01/01/2023]
Abstract
BACKGROUND This study aimed to evaluate anxiety and pain following perioperative music interventions compared with control conditions in adult patients. METHODS Eleven electronic databases were searched for full-text publications of RCTs investigating the effect of music interventions on anxiety and pain during invasive surgery published between 1 January 1980 and 20 October 2016. Results and data were double-screened and extracted independently. Random-effects meta-analysis was used to calculate effect sizes as standardized mean differences (MDs). Heterogeneity was investigated in subgroup analyses and metaregression analyses. The review was registered in the PROSPERO database as CRD42016024921. RESULTS Ninety-two RCTs (7385 patients) were included in the systematic review, of which 81 were included in the meta-analysis. Music interventions significantly decreased anxiety (MD -0·69, 95 per cent c.i. -0·88 to -0·50; P < 0·001) and pain (MD -0·50, -0·66 to -0·34; P < 0·001) compared with controls, equivalent to a decrease of 21 mm for anxiety and 10 mm for pain on a 100-mm visual analogue scale. Changes in outcome corrected for baseline were even larger: MD -1·41 (-1·89 to -0·94; P < 0·001) for anxiety and -0·54 (-0·93 to -0·15; P = 0·006) for pain. Music interventions provided during general anaesthesia significantly decreased pain compared with that in controls (MD -0·41, -0·64 to -0·18; P < 0·001). Metaregression analysis found no significant association between the effect of music interventions and age, sex, choice and timing of music, and type of anaesthesia. Risk of bias in the studies was moderate to high. CONCLUSION Music interventions significantly reduce anxiety and pain in adult surgical patients.
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Affiliation(s)
- A Y R Kühlmann
- Department of Paediatric Surgery, Erasmus Medical Centre-Sophia Children's Hospital, Rotterdam, The Netherlands
| | - A de Rooij
- Department of Neuroscience, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - L F Kroese
- Department of Surgery, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - M van Dijk
- Department of Paediatric Surgery, Erasmus Medical Centre-Sophia Children's Hospital, Rotterdam, The Netherlands.,Department of Internal Medicine, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - M G M Hunink
- Department of Epidemiology, Erasmus Medical Centre, Rotterdam, The Netherlands.,Department of Radiology, Erasmus Medical Centre, Rotterdam, The Netherlands.,Department of Health Policy and Management, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - J Jeekel
- Department of Neuroscience, Erasmus Medical Centre, Rotterdam, The Netherlands
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Supnet C, Crow A, Stutzman S, Olson D. Music as Medicine: The Therapeutic Potential of Music for Acute Stroke Patients. Crit Care Nurse 2018; 36:e1-7. [PMID: 27037347 DOI: 10.4037/ccn2016413] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Nurses caring for patients with acute stroke are likely to administer both music and medication with therapeutic intent. The administration of medication is based on accumulated scientific evidence and tailored to the needs of each patient. However, the therapeutic use of music is generally based on good intentions and anecdotal evidence. This review summarizes and examines the current literature regarding the effectiveness of music in the treatment of critically ill patients and the use of music in neurologically injured patients. The rationale for hypothesis-driven research to explore therapeutic music intervention in acute stroke is compelling.
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Affiliation(s)
- Charlene Supnet
- Charlene Supnet is an experienced basic/clinical neuroscience researcher and writer for the Department of Neurology and Neurotherapeutics and the Neuroscience Nursing Research Center, University of Texas Southwestern Medical Center, Dallas, Texas.April Crow is a nurse in the inpatient rehabilitation unit of Zale Lipshy University Hospital, Dallas, Texas.Sonja Stutzman is the clinical research manager for the Neuroscience Nursing Research Center, University of Texas Southwestern Medical Center. Additionally, she coordinates several acute studies in the neuroscience intensive care unit.DaiWai Olson is an associate professor and director of the Neuroscience Nursing Research Center at University of Texas Southwestern
| | - April Crow
- Charlene Supnet is an experienced basic/clinical neuroscience researcher and writer for the Department of Neurology and Neurotherapeutics and the Neuroscience Nursing Research Center, University of Texas Southwestern Medical Center, Dallas, Texas.April Crow is a nurse in the inpatient rehabilitation unit of Zale Lipshy University Hospital, Dallas, Texas.Sonja Stutzman is the clinical research manager for the Neuroscience Nursing Research Center, University of Texas Southwestern Medical Center. Additionally, she coordinates several acute studies in the neuroscience intensive care unit.DaiWai Olson is an associate professor and director of the Neuroscience Nursing Research Center at University of Texas Southwestern
| | - Sonja Stutzman
- Charlene Supnet is an experienced basic/clinical neuroscience researcher and writer for the Department of Neurology and Neurotherapeutics and the Neuroscience Nursing Research Center, University of Texas Southwestern Medical Center, Dallas, Texas.April Crow is a nurse in the inpatient rehabilitation unit of Zale Lipshy University Hospital, Dallas, Texas.Sonja Stutzman is the clinical research manager for the Neuroscience Nursing Research Center, University of Texas Southwestern Medical Center. Additionally, she coordinates several acute studies in the neuroscience intensive care unit.DaiWai Olson is an associate professor and director of the Neuroscience Nursing Research Center at University of Texas Southwestern
| | - DaiWai Olson
- Charlene Supnet is an experienced basic/clinical neuroscience researcher and writer for the Department of Neurology and Neurotherapeutics and the Neuroscience Nursing Research Center, University of Texas Southwestern Medical Center, Dallas, Texas.April Crow is a nurse in the inpatient rehabilitation unit of Zale Lipshy University Hospital, Dallas, Texas.Sonja Stutzman is the clinical research manager for the Neuroscience Nursing Research Center, University of Texas Southwestern Medical Center. Additionally, she coordinates several acute studies in the neuroscience intensive care unit.DaiWai Olson is an associate professor and director of the Neuroscience Nursing Research Center at University of Texas Southwestern.
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25
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Lawes EG. Auditory stimulation and levels of anaesthesia. Anaesthesia 2017; 72:1043-1044. [DOI: 10.1111/anae.13945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
Purpose To determine the effects of intra-operative Korean traditional music on pain experienced by Korean patients undergoing sequential bilateral cataract surgery. Methods This was a two-sequence, two-period, and two-treatment crossover study. Fifty-two patients with cataracts were divided into two groups by block randomization, and bilateral cataract surgery was performed. In group 1, patients listened to Korean traditional music (KTM) during their first but not second cataract surgery. This sequence was reversed for patients in group 2. After each surgery, patients scored their pain intensity (PI) using a visual analog scale (VAS) ranging from 0 to 10, where 0 was ‘no pain’ and 10 was ‘unbearable pain.’ Result There was a statistically significant reduction in the mean VAS score with KTM (3.1 ± 2.0) compared to that without KTM (4.1 ± 2.2; p = 0.013). However, there were no statistically significant differences in blood pressure or pulse rates. Conclusion KTM had a significant effect on reducing pain experienced by patients during cataract surgery. This may be useful in the context of other surgical procedures to reduce pain in Korean patients.
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Affiliation(s)
- Suvin Choi
- Da Vinci College of General Education, Chung-Ang University, Seoul, Republic of Korea
| | - Sang-Gue Park
- Department of Applied Statistics, Chung-Ang University, Seoul, Republic of Korea
| | - Lorne Bellan
- Department of Ophthalmology, Misericordia Health Centre, Winnipeg, Canada
| | - Hyung-Hwan Lee
- School of Korean Music, Chung-Ang University, Anseong, Republic of Korea
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Gasenzer ER, Leischik R. [Music, pulse, heart and sport]. Herz 2017; 43:43-52. [PMID: 28116463 DOI: 10.1007/s00059-016-4520-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Revised: 10/15/2016] [Accepted: 11/26/2016] [Indexed: 10/20/2022]
Abstract
Music, with its various elements, such as rhythm, sound and melody had the unique ability even in prehistoric, ancient and medieval times to have a special fascination for humans. Nowadays, it is impossible to eliminate music from our daily lives. We are accompanied by music in shopping arcades, on the radio, during sport or leisure time activities and in wellness therapy. Ritualized drumming was used in the medical sense to drive away evil spirits or to undergo holy enlightenment. Today we experience the varied effects of music on all sensory organs and we utilize its impact on cardiovascular and neurological rehabilitation, during invasive cardiovascular procedures or during physical activities, such as training or work. The results of recent studies showed positive effects of music on heart rate and in therapeutic treatment (e. g. music therapy). This article pursues the impact of music on the body and the heart and takes sports medical aspects from the past and the present into consideration; however, not all forms of music and not all types of musical activity are equally suitable and are dependent on the type of intervention, the sports activity or form of movement and also on the underlying disease. This article discusses the influence of music on the body, pulse, on the heart and soul in the past and the present day.
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Affiliation(s)
- E R Gasenzer
- Fakultät für Medizin, Universität Witten/Herdecke, 58448, Witten, Deutschland. .,Lehrstuhl für Chirurgische Forschung, Institut für Forschung in der Operativen Medizin, Universität Witten/Herdecke, Ostmerheimer Str. 200, 51109, Köln, Deutschland.
| | - R Leischik
- Fakultät für Medizin, Universität Witten/Herdecke, 58448, Witten, Deutschland. .,Senior Lecturer Prevention, Health Promotion and Sports Medicine, Lehrauftrag für Prävention, Sportmedizin, Gesundheitsförderung, Universität Witten-Herdecke, Elberfelder Str.1, 58095, Hagen, Deutschland.
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Rosendahl J, Koranyi S, Jacob D, Zech N, Hansen E. Efficacy of therapeutic suggestions under general anesthesia: a systematic review and meta-analysis of randomized controlled trials. BMC Anesthesiol 2016; 16:125. [PMID: 28007033 PMCID: PMC5178078 DOI: 10.1186/s12871-016-0292-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 12/13/2016] [Indexed: 01/20/2023] Open
Abstract
Background General anesthesia does not block central nervous processing of auditive information. Therefore, positive suggestions even given during surgery might have the potential to encourage well-being and recovery of patients. Aim of this review was to summarize the evidence on the efficacy of therapeutic suggestions under general anesthesia in adults undergoing surgery compared to an attention control (i.e. white noise). Methods We included randomized controlled trials that investigated therapeutic suggestions presented during general anesthesia to adult patients undergoing surgery or medical procedures. Outcomes on pain intensity, mental distress, recovery, use of medication, measured postoperatively within hospitalization were considered. Electronic searches were carried out in the following databases (last search February 23, 2015): MEDLINE, CENTRAL, Web of Science, PsycINFO, ProQuest Dissertations and Theses. Results Thirty-two eligible randomized controlled trials were included, comprising a total of 2102 patients. All studies used taped suggestions. Random effects meta-analyses revealed no effects on pain intensity (Hedges’ g = 0.04, CI 95% [−0.04; 0.12], number needed to treat [NNT] = 44.3) and mental distress (g = 0.03, CI 95% [−0.11; 0.16], NNT = 68.2). In contrast, we found small but significant positive effects on use of medication (g = 0.19, CI 95% [0.09; 0.29], NNT = 9.2) and on recovery (g = 0.14, CI 95% [0.03; 0.25], NNT = 13.0). All effects were homogeneous and robust. Conclusions Even though effects were small, our results provide indications that intraoperative suggestions can have the potential to reduce the need for medication and enhance recovery. Further high quality trials are needed to strengthen the promising evidence on the efficacy of therapeutic suggestions under general anesthesia for patients undergoing surgery. Electronic supplementary material The online version of this article (doi:10.1186/s12871-016-0292-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jenny Rosendahl
- Institute of Psychosocial Medicine and Psychotherapy, Jena University Hospital, Friedrich-Schiller University, Stoystr. 3, 07743, Jena, Germany.
| | - Susan Koranyi
- Department of Medical Psychology and Medical Sociology, University Hospital Leipzig, Philipp-Rosenthal-Str. 55, 04103, Leipzig, Germany
| | - Davina Jacob
- Institute of Psychosocial Medicine and Psychotherapy, Jena University Hospital, Friedrich-Schiller University, Stoystr. 3, 07743, Jena, Germany
| | - Nina Zech
- Department of Anaesthesiology, University Hospital Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany
| | - Ernil Hansen
- Department of Anaesthesiology, University Hospital Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany
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Management of Postoperative Pain: A Clinical Practice Guideline From the American Pain Society, the American Society of Regional Anesthesia and Pain Medicine, and the American Society of Anesthesiologists' Committee on Regional Anesthesia, Executive Committee, and Administrative Council. THE JOURNAL OF PAIN 2016; 17:131-57. [PMID: 26827847 DOI: 10.1016/j.jpain.2015.12.008] [Citation(s) in RCA: 1594] [Impact Index Per Article: 199.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Revised: 12/11/2015] [Accepted: 12/14/2015] [Indexed: 12/11/2022]
Abstract
UNLABELLED Most patients who undergo surgical procedures experience acute postoperative pain, but evidence suggests that less than half report adequate postoperative pain relief. Many preoperative, intraoperative, and postoperative interventions and management strategies are available for reducing and managing postoperative pain. The American Pain Society, with input from the American Society of Anesthesiologists, commissioned an interdisciplinary expert panel to develop a clinical practice guideline to promote evidence-based, effective, and safer postoperative pain management in children and adults. The guideline was subsequently approved by the American Society for Regional Anesthesia. As part of the guideline development process, a systematic review was commissioned on various aspects related to various interventions and management strategies for postoperative pain. After a review of the evidence, the expert panel formulated recommendations that addressed various aspects of postoperative pain management, including preoperative education, perioperative pain management planning, use of different pharmacological and nonpharmacological modalities, organizational policies, and transition to outpatient care. The recommendations are based on the underlying premise that optimal management begins in the preoperative period with an assessment of the patient and development of a plan of care tailored to the individual and the surgical procedure involved. The panel found that evidence supports the use of multimodal regimens in many situations, although the exact components of effective multimodal care will vary depending on the patient, setting, and surgical procedure. Although these guidelines are based on a systematic review of the evidence on management of postoperative pain, the panel identified numerous research gaps. Of 32 recommendations, 4 were assessed as being supported by high-quality evidence, and 11 (in the areas of patient education and perioperative planning, patient assessment, organizational structures and policies, and transitioning to outpatient care) were made on the basis of low-quality evidence. PERSPECTIVE This guideline, on the basis of a systematic review of the evidence on postoperative pain management, provides recommendations developed by a multidisciplinary expert panel. Safe and effective postoperative pain management should be on the basis of a plan of care tailored to the individual and the surgical procedure involved, and multimodal regimens are recommended in many situations.
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Téllez A, Sánchez-Jáuregui T, Juárez-García DM, García-Solís M. Breast Biopsy: The Effects of Hypnosis and Music. Int J Clin Exp Hypn 2016; 64:456-69. [PMID: 27585728 DOI: 10.1080/00207144.2016.1209034] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The authors evaluated the efficacies of audio-recorded hypnosis with background music and music without hypnosis in the reduction of emotional and physical disturbances in patients scheduled for breast biopsy in comparison with a control group. A total of 75 patients were randomly assigned to 3 different groups and evaluated at baseline and before and after breast biopsy using visual analog scales of stress, pain, depression, anxiety, fatigue, optimism, and general well-being. The results showed that, before breast biopsy, the music group presented less stress and anxiety, whereas the hypnosis with music group presented reduced stress, anxiety, and depression and increased optimism and general well-being. After the biopsy, the music group presented less anxiety and pain, whereas the hypnosis group showed less anxiety and increased optimism.
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Affiliation(s)
- Arnoldo Téllez
- a Universidad Autónoma de Nuevo León , Monterrey , México
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Szeverényi C, Csernátony Z, Balogh Á, Simon T, Varga K. Effects of Positive Suggestions on the Need for Red Blood Cell Transfusion in Orthopedic Surgery. Int J Clin Exp Hypn 2016; 64:404-18. [PMID: 27585725 DOI: 10.1080/00207144.2016.1209041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This study examined whether positive suggestions applied without a hypnotic induction in the perioperative period reduces the need for red blood cell transfusions in patients who underwent total hip or knee arthroplasties with spinal anesthesia. No hypnotic assessment was performed. Ninety-five patients were randomly assigned to the suggestion group (n = 45) and to the control group (n = 50). Patients in the suggestion group received verbal suggestions before and audiotaped suggestions during the surgery for reducing blood loss, anxiety, postoperative pain, and fast recovery. Our study showed that using positive suggestions in the perioperative period significantly decreases the necessity for transfusion.
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Affiliation(s)
| | | | | | - Tünde Simon
- a University of Debrecen , Clinical Center , Hungary
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Launay J, Tarr B, Dunbar RIM. Synchrony as an Adaptive Mechanism for Large-Scale Human Social Bonding. Ethology 2016. [DOI: 10.1111/eth.12528] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Affiliation(s)
- Jacques Launay
- Department of Experimental Psychology; University of Oxford; Oxford UK
- Division of Psychology; Brunel University London; Uxbridge UK
| | - Bronwyn Tarr
- Department of Experimental Psychology; University of Oxford; Oxford UK
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Effects of music on sedation depth and sedative use during pediatric dental procedures. J Clin Anesth 2016; 34:647-53. [PMID: 27687464 DOI: 10.1016/j.jclinane.2016.07.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2015] [Revised: 06/16/2016] [Accepted: 07/06/2016] [Indexed: 11/20/2022]
Abstract
STUDY OBJECTIVE The study aimed to investigate the effects of listening to music or providing sound isolation on the depth of sedation and need for sedatives in pediatric dental patients. DESIGN Prospective, randomized, and controlled study. SETTING Tertiary, university hospital. PATIENTS In total, 180 pediatric patients, American Society of Anesthesiologists physical status I and II, who were scheduled for dental procedures of tooth extraction, filling, amputation, and root treatment. INTERVENTIONS Patients were categorized into 3 groups: music, isolation, and control. During the procedures, the patients in the music group listened to Vivaldi's The Four Seasons violin concertos by sound-isolating headphones, whereas the patients in the isolation group wore the headphones but did not listen to music. All patients were sedated by 0.1 mg/kg midazolam and 1 mg/kg propofol. During the procedure, an additional 0.5 mg/kg propofol was administered as required. MEASUREMENTS AND MAIN RESULTS Bispectral index was used for quantifying the depth of sedation, and total dosage of the propofol was used for sedative requirements. The patients' heart rates, oxygen saturations, and Observer's Assessment of Alertness and Sedation Scale and bispectral index scores, which were monitored during the operation, were similar among the groups. In terms of the amount of propofol used, the groups were similar. Prolonged postoperative recovery cases were found to be significantly frequent in the control group, according to the recovery duration measurements (P = .004). CONCLUSIONS Listening to music or providing sound isolation during pediatric dental interventions did not alter the sedation level, amount of medication, and hemodynamic variables significantly. This result might be due to the deep sedation levels reached during the procedures. However, listening to music and providing sound isolation might have contributed in shortening the postoperative recovery duration of the patients.
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Guétin S, Diego ED, Mohy F, Adolphe C, Hoareau G, Touchon J, Thayer JF, Koenig J. A patient-controlled, smartphone-based music intervention to reduce pain—A multi-center observational study of patients with chronic pain. Eur J Integr Med 2016. [DOI: 10.1016/j.eujim.2016.01.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
OBJECTIVES The aim of the study was to assess the effect of art including ambient features such as music, interior design including visual art, and architectural features on health outcomes in surgical patients. BACKGROUND Healing environments can have a positive influence on many patients, but data focusing on art in surgical patients remain scarce. METHODS We conducted a systematic search following the PRISMA guidelines from January 2000 to October 2014 on art in surgical patients. For music interventions, we pooled controlled studies measuring health outcomes (eg, pain, anxiety, blood pressure, and heart rate) in a meta-analysis. For other art forms (ambient and architectural features and interior design), we did a narrative review, also including nonsurgical patients, and looked for examples covering 3 countries. RESULTS Our search identified 1101 hits with 48 studies focusing on art in surgical patients: 47 studies on musical intervention and 1 on sunlight. The meta-analysis of these studies disclosed significant effects for music on pain after surgery, anxiety, systolic blood pressure, and heart rate, when compared with control groups without music. Effects of music were larger with self-selected music, and lower in surgical interventions performed under general anesthesia. Interior design features such as nature images and more spacious rooms, and architectural features providing more sunlight had positive effects on anxiety and postoperative pain. CONCLUSIONS Self-selected music for surgical patients is an effective and low-cost intervention to enhance well being and possibly faster recovery. Although potentially very important, the impact of environmental features and spacious architecture with wide access to sunlight remains poorly explored in surgery. Further experimental research is needed to better assess the magnitude of the impact and cost effectiveness.
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Cheng TH, Tsai CG. Female Listeners' Autonomic Responses to Dramatic Shifts Between Loud and Soft Music/Sound Passages: A Study of Heavy Metal Songs. Front Psychol 2016; 7:182. [PMID: 26925009 PMCID: PMC4756174 DOI: 10.3389/fpsyg.2016.00182] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Accepted: 01/31/2016] [Indexed: 11/17/2022] Open
Abstract
Although music and the emotion it conveys unfold over time, little is known about how listeners respond to shifts in musical emotions. A special technique in heavy metal music utilizes dramatic shifts between loud and soft passages. Loud passages are penetrated by distorted sounds conveying aggression, whereas soft passages are often characterized by a clean, calm singing voice and light accompaniment. The present study used heavy metal songs and soft sea sounds to examine how female listeners’ respiration rates and heart rates responded to the arousal changes associated with auditory stimuli. The high-frequency power of heart rate variability (HF-HRV) was used to assess cardiac parasympathetic activity. The results showed that the soft passages of heavy metal songs and soft sea sounds expressed lower arousal and induced significantly higher HF-HRVs than the loud passages of heavy metal songs. Listeners’ respiration rate was determined by the arousal level of the present music passage, whereas the heart rate was dependent on both the present and preceding passages. Compared with soft sea sounds, the loud music passage led to greater deceleration of the heart rate at the beginning of the following soft music passage. The sea sounds delayed the heart rate acceleration evoked by the following loud music passage. The data provide evidence that sound-induced parasympathetic activity affects listeners’ heart rate in response to the following music passage. These findings have potential implications for future research on the temporal dynamics of musical emotions.
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Affiliation(s)
- Tzu-Han Cheng
- Department of Psychology, National Taiwan University Taipei, Taiwan
| | - Chen-Gia Tsai
- Graduate Institute of Musicology, National Taiwan UniversityTaipei, Taiwan; Center for Neurobiology and Cognitive Science, National Taiwan UniversityTaipei, Taiwan
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Stoicea N, Gan TJ, Joseph N, Uribe A, Pandya J, Dalal R, Bergese SD. Alternative Therapies for the Prevention of Postoperative Nausea and Vomiting. Front Med (Lausanne) 2015; 2:87. [PMID: 26734609 PMCID: PMC4679858 DOI: 10.3389/fmed.2015.00087] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Accepted: 11/24/2015] [Indexed: 11/13/2022] Open
Abstract
Postoperative nausea and vomiting (PONV) is a complication affecting between 20 and 40% of all surgery patients, with high-risk patients experiencing rates of up to 80%. Recent studies and publications have shed light on the uses of alternative treatment for PONV through their modulation of endogenous opioid neuropeptides and neurokinin ligands. In addition to reducing PONV, hypnosis was reported to be useful in attenuating postoperative pain and anxiety, and contributing to hemodynamic stability. Music therapy has been utilized to deepen the sedation level and decrease patient anxiety, antiemetic and analgesic requirements, hospital length of stay, and fatigue. Isopropyl alcohol and peppermint oil aromatherapy have both been used to reduce postoperative nausea. With correct training in traditional Chinese healing techniques, acupuncture (APu) at the P6 acupoint has also been shown to be useful in preventing early PONV, postdischarge nausea and vomiting, and alleviating of pain. Electro-acupuncture (EAPu), as with APu, provided analgesic and antiemetic effects through release and modulation of opioid neuropeptides. These non-pharmacological modalities of treatment contribute to an overall patient wellbeing, assisting in physical and emotional healing.
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Affiliation(s)
- Nicoleta Stoicea
- Department of Anesthesiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Tong J. Gan
- Department of Anesthesiology, Stony Brook University Medical Center, Stony Brook, NY, USA
| | - Nicholas Joseph
- Department of Anesthesiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
- Department of Neuroscience, The Ohio State University, Columbus, OH, USA
| | - Alberto Uribe
- Department of Anesthesiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Jyoti Pandya
- Department of Anesthesiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Rohan Dalal
- Department of Psychology, The Ohio State University, Columbus, OH, USA
| | - Sergio D. Bergese
- Department of Anesthesiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
- Department of Neurological Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA
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Sin WM, Chow KM. Effect of Music Therapy on Postoperative Pain Management in Gynecological Patients: A Literature Review. Pain Manag Nurs 2015; 16:978-87. [DOI: 10.1016/j.pmn.2015.06.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Revised: 06/24/2015] [Accepted: 06/29/2015] [Indexed: 10/22/2022]
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van der Heijden MJE, Oliai Araghi S, van Dijk M, Jeekel J, Hunink MGM. The Effects of Perioperative Music Interventions in Pediatric Surgery: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. PLoS One 2015; 10:e0133608. [PMID: 26247769 PMCID: PMC4527726 DOI: 10.1371/journal.pone.0133608] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Accepted: 06/29/2015] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Music interventions are widely used, but have not yet gained a place in guidelines for pediatric surgery or pediatric anesthesia. In this systematic review and meta-analysis we examined the effects of music interventions on pain, anxiety and distress in children undergoing invasive surgery. DATA SOURCES We searched 25 electronic databases from their first available date until October 2014. STUDY SELECTION Included were all randomized controlled trials with a parallel group, crossover or cluster design that included pediatric patients from 1 month to 18 years old undergoing minimally invasive or invasive surgical procedures, and receiving either live music therapy or recorded music. DATA EXTRACTION AND SYNTHESIS 4846 records were retrieved from the searches, 26 full text reports were evaluated and data was extracted by two independent investigators. MAIN OUTCOME MEASURES Pain was measured with the Visual Analogue Scale, the Coloured Analogue Scale and the Facial Pain Scale. Anxiety and distress were measured with an emotional index scale (not validated), the Spielberger short State Trait Anxiety Inventory and a Facial Affective Scale. RESULTS Three RCTs were eligible for inclusion encompassing 196 orthopedic, cardiac and day surgery patients (age of 1 day to 18 years) receiving either live music therapy or recorded music. Overall a statistically significant positive effect was demonstrated on postoperative pain (SMD -1.07; 95%CI-2.08; -0.07) and on anxiety and distress (SMD -0.34 95% CI -0.66; -0.01 and SMD -0.50; 95% CI -0.84; - 0.16. CONCLUSIONS AND RELEVANCE This systematic review and meta-analysis indicates that music interventions may have a statistically significant effect in reducing post-operative pain, anxiety and distress in children undergoing a surgical procedure. Evidence from this review and other reviews suggests music therapy may be considered for clinical use.
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Affiliation(s)
| | | | - Monique van Dijk
- Department of Pediatrics, division of Neonatology and Department of Pediatric Surgery, Intensive care Erasmus MC, Rotterdam, the Netherlands
| | - Johannes Jeekel
- Department of Neuroscience, Erasmus MC, Rotterdam, the Netherlands
| | - M. G. Myriam Hunink
- Department of Epidemiology, Erasmus MC, Rotterdam, the Netherlands
- Department of Radiology, Erasmus MC, Rotterdam, the Netherlands
- Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
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Yinger OS, Gooding LF. A Systematic Review of Music-Based Interventions for Procedural Support. J Music Ther 2015; 52:1-77. [DOI: 10.1093/jmt/thv004] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Öbrink E, Jildenstål P, Oddby E, Jakobsson JG. Post-operative nausea and vomiting: Update on predicting the probability and ways to minimize its occurrence, with focus on ambulatory surgery. Int J Surg 2015; 15:100-6. [DOI: 10.1016/j.ijsu.2015.01.024] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2014] [Revised: 01/06/2015] [Accepted: 01/26/2015] [Indexed: 02/08/2023]
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Tarr B, Launay J, Dunbar RIM. Music and social bonding: "self-other" merging and neurohormonal mechanisms. Front Psychol 2014; 5:1096. [PMID: 25324805 PMCID: PMC4179700 DOI: 10.3389/fpsyg.2014.01096] [Citation(s) in RCA: 178] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2014] [Accepted: 09/10/2014] [Indexed: 01/13/2023] Open
Abstract
It has been suggested that a key function of music during its development and spread amongst human populations was its capacity to create and strengthen social bonds amongst interacting group members. However, the mechanisms by which this occurs have not been fully discussed. In this paper we review evidence supporting two thus far independently investigated mechanisms for this social bonding effect: self-other merging as a consequence of inter-personal synchrony, and the release of endorphins during exertive rhythmic activities including musical interaction. In general, self-other merging has been experimentally investigated using dyads, which provide limited insight into large-scale musical activities. Given that music can provide an external rhythmic framework that facilitates synchrony, explanations of social bonding during group musical activities should include reference to endorphins, which are released during synchronized exertive movements. Endorphins (and the endogenous opioid system (EOS) in general) are involved in social bonding across primate species, and are associated with a number of human social behaviors (e.g., laughter, synchronized sports), as well as musical activities (e.g., singing and dancing). Furthermore, passively listening to music engages the EOS, so here we suggest that both self-other merging and the EOS are important in the social bonding effects of music. In order to investigate possible interactions between these two mechanisms, future experiments should recreate ecologically valid examples of musical activities.
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Affiliation(s)
- Bronwyn Tarr
- Social and Evolutionary Neuroscience Research Group, Department of Experimental Psychology, University of OxfordOxford, UK
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Mirbagher Ajorpaz N, Mohammadi A, Najaran H, Khazaei S. Effect of music on postoperative pain in patients under open heart surgery. Nurs Midwifery Stud 2014; 3:e20213. [PMID: 25699280 PMCID: PMC4332992 DOI: 10.17795/nmsjournal20213] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Revised: 07/09/2014] [Accepted: 07/13/2014] [Indexed: 12/16/2022] Open
Abstract
Background: Music, as a non-pharmacological and inexpensive nursing intervention, can be used easily as a complementary technique in reducing pain along with other methods. While some studies have demonstrated pain to decrease after music, others found music to be ineffective on pain. Objectives: The aim of this study was to investigate the effect of music on postoperative pain in patients under open heart surgery. Patients and Methods: A quasi-experimental study was performed on 60 patients under open heart surgery referred to ICU of Shahid Beheshti hospital in Kashan city. Patients were randomly divided into two groups including experimental and control groups. Patients in music group listened to nonverbal music for 30 minutes after surgery by headphones. The control group did not receive any intervention other than routine care. Before and after intervention, pain intensity was measured and recorded by visual analog scale in two groups. Data was analyzed using Chi-Square and t-tests. Results: Before intervention, the mean of pain intensity was 6.32 ± 0.21 and 6.10 ± 0.21 for experimental and control groups, respectively; and the difference was not significant (P = 0.21). After intervention, the mean of pain intensity was 3.11 ± 0.12 and 5.81 ± 0.38 for experimental and control groups, respectively; and the difference was significant (P = 0.04). Conclusions: Listening to the relaxant music can reduce postoperative pain. It is suggested that relaxant music be used as a complementary method in patients in order to reduce prospective pain.
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Affiliation(s)
| | - Abouzar Mohammadi
- Department of Nursing, Kashan University of Medical Sciences, Kashan, IR Iran
| | - Hamed Najaran
- Department of Nursing, Kashan University of Medical Sciences, Kashan, IR Iran
| | - Shala Khazaei
- Department of Nursing, Kashan University of Medical Sciences, Kashan, IR Iran
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Chu-Hui-Lin Chi G, Young A, McFarlane J, Watson M, Coleman RL, Eifel PJ, LoBiondo-Wood G, Bodurka DC, Richardson M. Effects of music relaxation video on pain and anxiety for women with gynaecological cancer receiving intracavitary brachytherapy: a randomised controlled trial. J Res Nurs 2014. [DOI: 10.1177/1744987114529298] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The purpose of this study was to explore the effects of music relaxation video on pain severity, opioid utilisation, and anxiety experienced by women with gynaecological cancer undergoing intracavitary brachytherapy. A two-group randomised controlled trial was conducted in an academic comprehensive cancer centre. Sixty women were randomly assigned to either an experimental group ( n = 31) that watched a 30-minute music relaxation video four times (total 120 minutes) or a control group ( n = 29) that received standard nursing care during the first 44 hours of the intracavitary brachytherapy. Data were collected to evaluate the effects on pain severity, opioid utilisation and anxiety between groups. Pain scores were measured before and after patients watched the 30-minute music relaxation video and anxiety scores were measured following the video. The amount of opioid consumption was recorded during the 44-hour treatment. Data were tested using ANOVA and t-test. Perceived pain reduction was statistically significant in the experimental group ( p = 0.027), but this did not translate into lower total consumption of opioids between the two study groups. Anxiety level reduction was statistically significant in the experimental group ( p = 0.001). Music relaxation videos hold promise to be used in conjunction with standard pharmacologic therapy to reduce perceived pain and anxiety levels during the treatments.
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Affiliation(s)
- Grace Chu-Hui-Lin Chi
- Associate Professor, Department of Nursing, School of Health Professions, Andrews University, USA
| | - Anne Young
- Professor, College of Nursing, Texas Woman’s University, USA
| | | | - Mary Watson
- Professor, Health Sciences, Texas Woman’s University, USA
| | - Robert L Coleman
- Professor, Department of Gynecologic Oncology and Reproductive Medicine, University of Texas, M.D. Anderson Cancer Center, USA
| | - Patricia J Eifel
- Professor, Department of Radiation Oncology, University of Texas, M.D. Anderson Cancer Center, USA
| | - Geri LoBiondo-Wood
- Associate Professor, School of Nursing, University of Texas, Health Science Center at Houston, USA
| | - Diane C Bodurka
- Professor, Department of Gynecologic Oncology, University of Texas, M.D. Anderson Cancer Center, USA
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Bonett E, Pham X, Smith KR, Howard K, Sheppard S, Davidson A. Implicit memory formation using the word stem completion task during anesthesia in children. Paediatr Anaesth 2014; 24:290-6. [PMID: 24219512 DOI: 10.1111/pan.12299] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/26/2013] [Indexed: 10/26/2022]
Abstract
AIMS To determine whether there is evidence of implicit memory formation during pediatric anesthesia using the word stem completion task. BACKGROUND In adults, there is mixed evidence for implicit memory formation during anesthesia; however, there is no evidence in children. Implicit memory in adults has been detected using the word stem completion task. This test has not been used in a pediatric anesthetic setting. METHODS A total of 200 patients aged 7-12 were randomized to hear one of the two lists of 10 words played continuously while anesthetized. Group 1 heard List A and Group 2 heard List B. Postoperatively, 194 completed a word stem completion task where they were required to complete the stems (the first part of words) corresponding to the words on the two word lists combined, with the first word that came to mind. RESULTS Group 1 completed a mean of 2.78 words correctly from List A and a mean of 2.70 words correctly from List B. Group 2 completed a mean of 3.29 words correctly from List A and a mean of 3.66 words correctly from List B. For List A, there was no evidence (P = 0.70) for an association between intraoperative exposure to this list and the odds of successfully completing a stem from this list with the corresponding target word. There was little evidence (P = 0.09) for an association with List B. CONCLUSION This study found no strong evidence that children form implicit memories for auditory words during anesthesia. Given the difference between lists, future research is warranted using carefully chosen word stems.
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Affiliation(s)
- Emily Bonett
- Department of Paediatrics, University of Melbourne, Parkville, Vic., Australia; Department of Anaesthesia, Royal Children's Hospital, Parkville, Vic., Australia
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Schlanger J, Fritúz G, Varga K. Therapeutic suggestion helps to cut back on drug intake for mechanically ventilated patients in intensive care unit. Interv Med Appl Sci 2013; 5:145-52. [PMID: 24381732 DOI: 10.1556/imas.5.2013.4.1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2013] [Revised: 07/23/2013] [Accepted: 10/31/2013] [Indexed: 11/19/2022] Open
Abstract
Research was conducted on ventilated patients treated in an intensive care unit (ICU) under identical circumstances; patients were divided into two groups (subsequently proved statistically identical as to age and Simplified Acute Physiology Score II [SAPS II]). One group was treated with positive suggestions for 15-20 min a day based on a predetermined scheme, but tailored to the individual patient, while the control group received no auxiliary psychological treatment. Our goal was to test the effects of positive communication in this special clinical situation. In this section of the research, the subsequent data collection was aimed to reveal whether any change in drug need could be demonstrated upon the influence of suggestions as compared to the control group. Owing to the strict recruitment criteria, a relatively small sample (suggestion group n = 15, control group n = 10) was available during the approximately nine-month period of research. As an outcome of suggestions, there was a significant drop in benzodiazepine (p < 0.005), opioid (p < 0.001), and the α2-agonist (p < 0.05) intake. All this justifies the presence of therapeutic suggestions among the therapies used in ICUs. However, repeating the trial on a larger sample of patients would be recommended.
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Ghaffaripour S, Mahmoudi H, Sahmeddini MA, Alipour A, Chohedri A. Music can effectively reduce pain perception in women rather than men. Pak J Med Sci 2013; 29:128-31. [PMID: 24353523 PMCID: PMC3809207 DOI: 10.12669/pjms.291.2947] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2012] [Revised: 09/25/2012] [Accepted: 11/15/2012] [Indexed: 12/21/2022] Open
Abstract
Objective: Nowadays music is used to decrease pain and increase relaxation in clinical settings. It is hypothesized that music can affect women more easily than men. We assessed the effect of two types of music (Iranian folkloric and preferred music) on pain tolerance and pain rating in cold pressor test. Methodology: A consecutive sample of 50 healthy Iranian medical students was enrolled. They reported pain tolerance and pain rating in cold pressor test in three different musical conditions served as the outcome measures. The results were analyzed with repeated measurement analysis of variance. Result: Mean tolerance time was significantly higher in preferred music compared to Iranian folkloric music (F (1,48) =25.44, p=0.0001) and no music (F(1,48)=3.51, p=0.0001) conditions. There was a significant interaction when tolerance time in no music condition was compared to preferred music condition, regarding sex; Tolerance time increased more in females (F(1,48)=5.53, p=0.023). The results also indicated that pain ratings, regardless of sex, were different in three musical conditions (F(1.7,81.34)=15.37, p=0.0001). Conclusion: Music distracted attention from pain and Women can be impressed and distracted more easily by music.
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Affiliation(s)
- Sina Ghaffaripour
- Sina Ghaffaripour, MD, Shiraz Anesthesiology and Critical Care Medicine Research Center, Anesthesiology Department
| | - Hilda Mahmoudi
- Hilda Mahmoudi, MD, MPH, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Ali Sahmeddini
- Mohammad Ali Sahmeddini, MD, Shiraz Anesthesiology and Critical Care Medicine Research Center, Anesthesiology Department
| | - Abbas Alipour
- Abbas Alipour, MD, Nutrition and Health School, Epidemiology Department, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Abdolhamid Chohedri
- Abdolhamid Chohedri, MD, Shiraz Anesthesiology and Critical Care Medicine Research Center, Anesthesiology Department, Shiraz University of Medical Sciences, Shiraz, Iran
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Szeverényi C, Csernátony Z, Balogh A, Varga K. Examples of positive suggestions given to patients undergoing orthopaedic surgeries. Interv Med Appl Sci 2013; 5:112-5. [PMID: 24265900 DOI: 10.1556/imas.5.2013.3.3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2013] [Revised: 06/19/2013] [Accepted: 07/03/2013] [Indexed: 11/19/2022] Open
Abstract
In the Department of Orthopaedic Surgery in the University of Debrecen, Debrecen, Hungary, we examined the effectiveness of positive suggestions used in the perioperative period in hip and knee arthroplasties performed under spinal anaesthesia. The goal of the suggestions was to reduce the need for red blood cell transfusion and for analgesics, and to increase the patients' satisfaction. The objective of this article is to present our method with concrete examples of positive suggestions which were given first before the surgery (via personal conversation), then during the operation as well (via audiotaped method). We hope that our article will contribute to the wide-spread awareness of this relatively easy to learn communication method.
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Abstract
2011: this review is being updated by a new author team who are preparing a new protocol. This update is due to be published in 2011. The replacement protocol was published in September 2011 (Bradshaw DH, Brown CJ, Cepeda MS, Pace NL. Music for pain relief (Protocol). Cochrane Database of Systematic Reviews 2011, Issue 9. Art. No.: CD009284. DOI: 10.1002/14651858.CD009284). 2015: at July 2015, the PaPaS Review Group withdrew the 2011 protocol (Bradshaw 2011) as there were significant delays in preparing the full review, which did not meet the expectations of Cochrane and PaPaS editorial processes and timelines. For more information, please contact the PaPaS CRG office. The editorial group responsible for this previously published document have withdrawn it from publication.
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Affiliation(s)
- M Soledad Cepeda
- Johnson & Johnson Pharmaceutical Research and DevelopmentPharmacoepidemiologyPO BOX 200, M/S K304TitussvilleNJUSA08560
| | - Daniel B Carr
- Tufts University School of MedicineDepartment of Public Health and Community Medicine136 Harrison Avenue, Stearns 203CBostonUSA
| | - Joseph Lau
- Brown University Public Health ProgramCenter for Evidence‐based Medicine121 S. Main StreetProvidenceRIUSA02912
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Kekecs Z, Varga K. Positive suggestion techniques in somatic medicine: A review of the empirical studies. Interv Med Appl Sci 2013; 5:101-11. [PMID: 24265899 DOI: 10.1556/imas.5.2013.3.2] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2013] [Revised: 07/07/2013] [Accepted: 07/24/2013] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION THERE IS AN EVER REOCCURRING QUESTION IN MEDICAL PRACTICE: Does the positive attitude and communication of the medical staff make any difference? AIM Our aim is to present a comprehensive overview of the medically relevant effects of positive suggestions by reviewing the recent literature. METHODS We will review the studies measuring the effects of suggestive communication of the past 20 years. In cases of studies presented in more details we quote from the suggestion scripts used in the study, too. RESULTS Some of the reviewed papers report that positive suggestions lead to decreased pain and use of pain medication and positively affect physiological factors like bowel motility, blood pressure and bleeding during surgery as well. However, the literature also contains studies in which only partial or no positive effects were found. CONCLUSIONS We emphasize further, more detailed investigation of positive suggestion techniques and its integration into the education of medical professionals.
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Affiliation(s)
- Zoltán Kekecs
- Department of Affective Psychology, Institute of Psychology, Eötvös Loránd University Budapest Hungary
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