Siwalai Sucher
Department of Anesthesiology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
Rachata Yubonman
Department of Anesthesiology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
Saranyoo Nonphiaraj
Department of Anesthesiology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
Thitinuch Ruenhunsa
Department of Anesthesiology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
Apinya Kittiponghansa
Department of Anesthesiology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
Pornsuk Chujai
Department of Anesthesiology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
Keywords: Music, Midazolam, Anxiety, Spinal Anesthesia
Abstract
This study aimed to evaluate the anxiety levels and physiological responses between music listening and given intravenous midazolam for perioperative anxiolytics in patients who receiving spinal anesthesia (SA). This prospective, randomized, controlled trial was conducted in adult patients undergoing elective surgery under SA. Participants were randomly assigned to either the music group (Mu group) or the midazolam group (Mi group). The Mu group listened to their preferred music, while the Mi group received an intravenous midazolam. Anxiety levels were assessed using State-Trait Anxiety Inventory (STAI) questionnaire, and physiological parameters were recorded pre- and postoperatively. The primary outcome was the change in STAI score from pre- to postoperative assessment. Secondary outcomes included the changes of physiological parameters, incidence of complications, and patient satisfaction. A total of 72 patients completed the study, 38 patients in Mu group and 34 patients in Mi group. The mean change in STAI score was -2.9 (SD 8.0) in the Mu group and -5.7 (SD 6.6) in the Mi group, with a mean difference of 2.78 (95% CI -0.7 to 6.3, p = 0.114). There were no significant differences in physiological parameters or complication rate between groups. Patient’s satisfaction scores were high in both groups. These finding suggest that music may be a viable alternative to midazolam for intraoperative anxiolysis in patients undergoing SA.
References
Dohlman LE, Kwikiriza A, Ehie O. Benefits and barriers to increasing regional anesthesia in resource-limited settings. Local Reg Anesth. 2020;13:147-158.
Hutton M, Brull R, Macfarlane AJR. Regional anaesthesia and outcomes. BJA Educ. 2018;18(2):52-56.
Brull R, McCartney CJ, Chan VW. Do preoperative anxiety and depression affect quality of recovery and length of stay after hip or knee arthroplasty. J Anaesth. 2002;49(1):10-19.
Varış O, Peker G. Effects of preoperative anxiety level on pain level and joint functions after total knee arthroplasty. Sci Rep. 2023;13(1):20787.
Wu CL, Naqibuddin M, Fleisher LA. Measurement of patient satisfaction as an outcome of regional anesthesia and analgesia: a systematic review. Reg Anesth Pain Med. 2001;26(3):196-208.
Höhener D, Blumenthal S, Borgeat A. Sedation and regional anaesthesia in the adult patient. Br J Anaesth. 2008;100(1):8-16.
Nordt SP, Clark RF. Midazolam: a review of therapeutic uses and toxicity. J Emerg Med. 1997;15(3):357-365.
Aydogan MS, Korkmaz MF, Ozgül U, Erdogan MA, Yucel A, Karaman A, et al. Pain, fentanyl consumption, and delirium in adolescents after scoliosis surgery: dexmedetomidine vs midazolam. Paediatr Anaesth. 2013;23(5):446-452.
Mansouri N, Nasrollahi K, Shetabi H. Prevention of cognitive dysfunction after cataract surgery with intravenous administration of midazolam and dexmedetomidine in elderly patients undergoing cataract surgery. Adv Biomed Res. 2019;8:6-10.
Koelsch S, Fuermetz J, Sack U, Bauer K, Hohenadel M, Wiegel M, et al. Effects of music listening on cortisol levels and propofol consumption during spinal anesthesia. Front Psychol. 2011;2:5-8.
Ilkkaya NK, Ustun FE, Sener EB, Kaya C, Ustun YB, Koksal E, et al. The effects of music, white noise, and ambient noise on sedation and anxiety in patients under spinal anesthesia during surgery. J Perianesth Nurs. 2014;29(5):418-426.
Graff V, Cai L, Badiola I, Elkassabany NM. Music versus midazolam during preoperative nerve block placements: a prospective randomized controlled study. Reg Anesth Pain Med. 2019;208:100251.
Prasad M, Sethi P, Kumari K, Sharma A, Kaur M, Dixit PK, et al. Comparison of binaural tone music vs patient choice music vs midazolam on perioperative anxiety in patients posted for surgery under spinal anaesthesia: A randomized control trial. Cureus. 2023;15(2):e35091.
Spielberger CD. Manual for the state-trait personality inventory (Form Y). Palo Alto, CA: Consulting Psychologists Press; 1983.
Prasert Y. Effect of self-regulation program via line application on anxiety, cooperative brhaviors, and duration of examination in patients undergioing bronchoscopy. Thai J Cardio Thorac Nurs. 2024;34:20-23.
Ready LB, Oden R, Chadwick HS, et al. Development of an anesthesiology-based postoperative pain management service. Anesthesiology. 1988;68:100–106.
Ratanasuwan P, Nonphiaraj S, Pongjanyakul S, Somdee W, Taesiri W, Ruenhunsa T, et al. Efficacy of a combination of ketamine and morphine for intravenous patient-controlled analgesia in upper abdominal Surgery: A prospective, double-blind, randomized controlled trial. J Med Assoc Thai 2021;104(9):1528-1534.
Lee WP, Wu PY, Lee MY, Ho LH, Shih WM. Music listening alleviates anxiety and physiological responses in patients receiving spinal anesthesia. Complement Ther Med. 2017; 31:8-13.
Finn S, Fancourt D. The biological impact of listening to music in clinical and nonclinical settings: A systematic review. Prog Brain Res. 2018;237:173-200.
de Witte M, Spruit A, van Hooren S, Moonen X, Stams GJ. Effects of music interventions on stress-related outcomes: a systematic review and two meta-analyses. Health Psychol Rev. 2020;14(2):294-324.
Giordano F, Giglio M, Sorrentino I, Dell’Olio F, Lorusso P, Massaro M, et al. Effect of preoperative music therapy versus intravenous midazolam on anxiety, sedation and stress in stomatology surgery: A randomized controlled study. J Clin Med. 2023;12(9):3215.
Abdul Hamid MR, Mansor MB, Zainal Abidin MF. Music therapy for reducing anxiety in patients undergoing total knee replacement surgery under subarachnoid anesthesia. J Orthop Surg. 2022;30(2):1-8.
Kukreja P, Talbott K, MacBeth L, Ghanem E, Sturdivant AB, Woods A, et al. Effects of music therapy during total knee arthroplasty under spinal anesthesia: A prospective randomized controlled study. Cureus. 2020;12(3):e7396.
Wang Y, Dong Y, Li Y. Perioperative psychological and music interventions in elderly patients undergoing spinal anesthesia: effect on anxiety, heart rate variability, and postoperative pain. Yonsei Med J. 2014;55(4):1101-1105.
Lee JH. The effects of music on pain: A meta-analysis. J Music Ther. 2016;53(4):430-477.
[26] Koelsch S. Brain correlates of music-evoked emotions. Nat Rev Neurosci. 2014;15(3):170-180.
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