Meta-analysis evaluating music interventions for anxiety and pain in surgery

A Y R Kühlmann, A de Rooij, L F Kroese, M van Dijk, M G M Hunink, J Jeekel, A Y R Kühlmann, A de Rooij, L F Kroese, M van Dijk, M G M Hunink, J Jeekel

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.

© 2018 The Authors. BJS published by John Wiley & Sons Ltd on behalf of BJS Society Ltd.

Figures

Figure 1
Figure 1
Flow chart showing selection of studies for review. *Some studies reported both anxiety and pain outcomes. †Some studies reported both final outcome and change in scores
Figure 2
Figure 2
Summary forest plot for anxiety. Mean differences between music intervention and control groups are shown with 95 per cent confidence intervals. The number of studies in each subgroup analysis is indicated
Figure 3
Figure 3
Summary forest plot for pain. Mean differences between music intervention and control groups are shown with 95 per cent confidence intervals. The number of studies in each subgroup analysis is indicated

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