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How music reduces pain after major heart surgery

Tuesday January 26th 2021

Listening to music following major heart surgery can significantly reduce anxiety and pain, according to an analysis published today.

Dutch researchers reviewed the results of 20 studies involving 1169 patients, published in English up to October 2019, and pooled the data from 16 that consisted of 987 patients.

Writing in Open Heart, they say heart surgery patients are often anxious before their procedure, and often experience severe pain afterwards.

Patients are also exposed to stressors that increase anxiety and pain, such as noise, sleeplessness, and mechanical ventilation, if they are transferred to intensive care. These can, in turn, increase length of hospital stay and the need for additional medication.

Out of the 16 studies reviewed, the researchers found that 90% of the procedures were for coronary artery bypass grafts and/or valve replacement, and four validated scales and scoring systems were used to measure anxiety and pain: State Trait Anxiety Inventory; Visual Analogue Scale; Numeric Rating Scale; and the Hospital Anxiety and Depression Scale.

40% of patients chose their preferred music from either pre-selected lists, while 35% chose lists selected by the researcher. 15% had their own playlists and the music sessions were either repeated several times on one day or over several days, or once daily over several days.

In 14 studies, the music was provided only after surgery, while in five, patients listened to the music before, during, and after the procedure.

The pooled data analysis showed that the first postoperative music session was associated with the equivalent reduction of four points on the State Trait Anxiety Inventory and of 1.05 points on the Visual Analogue Scale/Numeric Rating Scale for anxiety. It was also associated with a reduction of 1.26 points on the Visual Analogue Scale/Numeric Rating Scale for pain.

Several days of listening to music reduced anxiety for up to eight days after surgery, but the researchers did not find any effect on pain when they pooled the data from studies providing music before surgery only, or those offering a mixture of time periods.

Listening to music was not associated with any significant effects on the use of opioids; length of hospital stay; time spent on mechanical ventilation; blood pressure; heart rate; or breathing rate.

Because this was an observational study, the researchers say that further studies are needed before any definitive conclusions can be made, but they say that listening to music is a “promising” option for major heart surgery patients.

The researchers, led by Ellaha Kakar, from Erasmus Medical Centre, Rotterdam, The Netherlands, say: “Since music intervention has neither risks nor known side effects, but may have a positive effect on patients’ health outcomes, healthcare professionals should consider providing perioperative music for patients undergoing cardiac surgery.”

Kakar E, Billar RJ, van Rosmalen J et al. Music intervention to relieve anxiety and pain in adults undergoing cardiac surgery: a systematic review and metanalysis. Open Heart 26 January 2021; doi 10.1136/openhrt-2020-001474

[abstract]

Tags: Europe | Heart Health | Pain Relief

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