Binaural Beats for Postoperative Pain and Anxiety Reduction

April 29, 2026 updated by: Victor Hugo Hernandez, University of Miami

Binaural Beats vs Music of Choice for Early Postoperative Pain After Ambulatory Total Knee and Total Hip Arthroplasty: A Randomized Controlled Trial

To deliver a 30-minute binaural beats audio intervention in PACU and collect pain and anxiety outcomes immediately following surgery, and 4 hours following surgery completion in adults undergoing ambulatory total knee arthroplasty and total hip arthroplasty (TKA and THA).

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Estimated)

50

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

  • United States
    • Florida
      • Miami, Florida, United States, 33132
        • Recruiting
        • Univeristy of Miami Health System
        • Principal Investigator:
          • Victor H Hernandez, MD
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • American Society of Anesthesiologists Physical Status Classification System (ASA) 1-3
  • Spinal anesthesia
  • Patients receiving nerve-block in Post-Anesthesia Care Unit (PACU)
  • Primary total hip or total knee arthroplasty

Exclusion Criteria:

  • Moderate-severe hearing impairment or use of hearing aids
  • History of significant tinnitus, active delirium, chronic high-dose opioid therapy (>60 MME/day baseline)
  • Major psychiatric pathology
  • General anesthesia

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Binaural Beats (BB)
Participants assigned to this arm will listen to a 30-minute binaural beats audio session at a comfortable volume through standardized over-ear headphones while in the post-anesthesia care unit (PACU). The audio will use a primary target frequency of 10 Hz (alpha range), created using soft sine-wave carriers in the 200-600 Hz range that generate a 10 Hz interaural difference (e.g., 400 Hz left ear / 410 Hz right ear). Volume will be set at a comfortable conversational level (~55-65 dBA) and may be adjusted by the participant. The session will begin within 15 minutes of PACU arrival. Participants may stop the audio at any time.
Other: Binaural Beats Audio Intervention
30-minute binaural beats audio session targeting 400 and 410 hertz (Hz) alpha 400 hertz (Hz) in one ear 410 hertz (Hz) in other ear frequency delivered through standardized headphones in the PACU.
Active Comparator: Music of Choice (MOC)
Participants in this arm will receive usual postoperative care in the post-anesthesia care unit (PACU) and may listen to music of their choice using standardized headphones. They will select their preferred music and listen for 30 minutes at a comfortable volume (~55-65 dBA), which they may adjust as needed. No binaural beat frequencies will be used. Music listening is optional and may be stopped at any time.
Other: Music of Choice
Usual postoperative care in addition to patient-selected music using standardized headphones

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in Pain Score Numeric Pain Rating Scale (NPRS)
Time Frame: Baseline (pre-operative) to 4 hours post-operation.
Pain intensity will be measured using the Numeric Pain Rating Scale (NPRS), a validated 0-10 scale where 0 = no pain and 10 = worst imaginable pain. Change will be calculated as the difference between the pre-operative NPRS score and the NPRS score obtained 4 hours after surgery. Higher scores indicate greater pain intensity.
Baseline (pre-operative) to 4 hours post-operation.
Change in Anxiety Score State-Trait Anxiety Inventory (STAI-S)
Time Frame: Baseline (pre-operative) to 4 hours post-operation.
Anxiety will be measured using the State-Trait Anxiety Inventory - State Subscale (STAI-S). The STAI-S consists of 20 items scored from 1 to 4, producing a total score range of 20-80, with higher scores indicating greater state anxiety. Change will be calculated as the difference between the pre-operative STAI-S score and the STAI-S score obtained 4 hours after surgery.
Baseline (pre-operative) to 4 hours post-operation.

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Total Opioid Consumption in the Post-Anesthesia Care Unit (PACU) (MME)
Time Frame: From PACU arrival (time 0) until PACU discharge (typically 1-4 hours post-operation)
Total opioid use administered during the post-anesthesia care unit (PACU) stay will be recorded, including all intravenous and oral opioid medications. All doses will be converted to morphine milligram equivalents (MME) using standard Centers for Disease Control and Prevention (CDC) conversion factors. Unit of Measure: Morphine milligram equivalents (MME)
From PACU arrival (time 0) until PACU discharge (typically 1-4 hours post-operation)
Postoperative Vital Signs Heart Rate
Time Frame: Every 30 minutes from PACU arrival until PACU discharge (approximately 1-4 hours post-operation).
Heart rate (beats per minute) recorded at fixed 30-minute intervals during PACU recovery. Values will be abstracted from the electronic medical record.
Every 30 minutes from PACU arrival until PACU discharge (approximately 1-4 hours post-operation).
Patient Satisfaction Score
Time Frame: Measured once during the PACU stay, at the earliest feasible time point up to 4 hours post-operation
Patient satisfaction with the postoperative experience will be measured using a 5-point Likert scale, where 1 = very dissatisfied and 5 = very satisfied. Unit of Measure: Likert score (1-5)
Measured once during the PACU stay, at the earliest feasible time point up to 4 hours post-operation
Postoperative Vital Signs Blood Pressure
Time Frame: Every 30 minutes from PACU arrival until PACU discharge (approximately 1-4 hours post-operation).
Systolic and diastolic blood pressure (millimeters of mercury) recorded at fixed 30-minute intervals during PACU recovery. Values will be abstracted from the electronic medical record.
Every 30 minutes from PACU arrival until PACU discharge (approximately 1-4 hours post-operation).
Postoperative Vital Signs Respiratory Rate
Time Frame: Every 30 minutes from PACU arrival until PACU discharge (approximately 1-4 hours post-operation).
Respiratory rate (breaths per minute) recorded at fixed 30-minute intervals during PACU recovery. Values will be abstracted from the electronic medical record.
Every 30 minutes from PACU arrival until PACU discharge (approximately 1-4 hours post-operation).

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

University of Miami

Investigators

  • Principal Investigator: Victor H Hernandez, MD, MSc, University of Miami

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

March 9, 2026

Primary Completion (Estimated)

August 30, 2026

Study Completion (Estimated)

August 30, 2026

Study Registration Dates

First Submitted

February 18, 2026

First Submitted That Met QC Criteria

February 23, 2026

First Posted (Actual)

February 27, 2026

Study Record Updates

Last Update Posted (Actual)

April 30, 2026

Last Update Submitted That Met QC Criteria

April 29, 2026

Last Verified

April 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 20251389

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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