EFFECT OF PREOPERATIVE MUSIC THERAPY ON ANAESTHETIC DRUG REQUIREMENT AND PERIOPERATIVE ANXIETY: A PROSPECTIVE RANDOMIZED CONTROLLED TRIAL

Abstract

Perioperative anxiety is the psychological response of patients before and during surgery under general anaesthesia, and can lead to increased sympathetic activity, haemodynamic instability, greater need for anaesthetic drugs, in addition to delayed recovery and subsequent decreased postoperative outcomes. In this study, we assess the effectiveness of music therapy as a non-invasive approach to reduce perioperative state anxiety and improve perioperative comfort. Nevertheless, its effects on the requirement of anaesthetic drugs and haemodynamic stability in patients undergoing elective surgeries with general anaesthesia are poorly defined. This study is a prospective randomised single-blinded controlled study of 60 adult patients with ASA physical status I & II undergoing elective surgeries under general anaesthesia. A total of thirty patients were randomised into either Group M (Music Therapy group) or Group C (Control group). Patients of Group M were made to listen to soft instrumental music using headphones for about 20–30 mins before the induction of anaesthesia, and patients in Group C received routine preoperative care. The primary outcome of the present study was preoperative anxiety as measured using the Amsterdam Preoperative Anxiety and Information Scale (APAIS) and Visual Analogue Scale for Anxiety (VAS-A). Primary outcomes were perioperative anxiety scores and anaesthetic drug requirement. The secondary outcomes included overall intraoperative crude consumption of fentanyl, as well as haemodynamic parameters, the state anxiety score at 1 h after surgery and patient satisfaction. Preoperative music therapy significantly reduces perioperative anxiety in patients scheduled for an elective surgery under general anaesthesia. Post-intervention APAIS and VAS-A scores were significantly lower in the Music Therapy group compared to the Control group (p<0.001). Participants receiving music therapy also required significantly lower propofol induction dose (124.6 ± 15.8 mg vs 146.9 ± 18.3 mg; p<0.001) and lower intraoperative fentanyl consumption (78.4 ± 12.6 µg vs 96.7 ± 15.1 µg; p<0.001). Improved haemodynamic stability and significantly higher postoperative patient satisfaction scores were additionally observed in the Music Therapy group. Preoperative music therapy decreased perioperative anxiety, anaesthetic drug consumption, and resulted in better haemodynamic stability and increased postoperative patient satisfaction. These results endorse the use of music therapy as a safe, cheap and effective supplemental component in perioperative anaesthesia.