The Effects of Perioperative Music Interventions in Pediatric Surgery: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Marianne J E van der Heijden, Sadaf Oliai Araghi, Monique van Dijk, Johannes Jeekel, M G Myriam Hunink, Marianne J E van der Heijden, Sadaf Oliai Araghi, Monique van Dijk, Johannes Jeekel, M G Myriam Hunink

Abstract

Objective: Music interventions are widely used, but have not yet gained a place in guidelines for pediatric surgery or pediatric anesthesia. In this systematic review and meta-analysis we examined the effects of music interventions on pain, anxiety and distress in children undergoing invasive surgery.

Data sources: We searched 25 electronic databases from their first available date until October 2014.

Study selection: Included were all randomized controlled trials with a parallel group, crossover or cluster design that included pediatric patients from 1 month to 18 years old undergoing minimally invasive or invasive surgical procedures, and receiving either live music therapy or recorded music.

Data extraction and synthesis: 4846 records were retrieved from the searches, 26 full text reports were evaluated and data was extracted by two independent investigators.

Main outcome measures: Pain was measured with the Visual Analogue Scale, the Coloured Analogue Scale and the Facial Pain Scale. Anxiety and distress were measured with an emotional index scale (not validated), the Spielberger short State Trait Anxiety Inventory and a Facial Affective Scale.

Results: Three RCTs were eligible for inclusion encompassing 196 orthopedic, cardiac and day surgery patients (age of 1 day to 18 years) receiving either live music therapy or recorded music. Overall a statistically significant positive effect was demonstrated on postoperative pain (SMD -1.07; 95%CI-2.08; -0.07) and on anxiety and distress (SMD -0.34 95% CI -0.66; -0.01 and SMD -0.50; 95% CI -0.84; - 0.16.

Conclusions and relevance: This systematic review and meta-analysis indicates that music interventions may have a statistically significant effect in reducing post-operative pain, anxiety and distress in children undergoing a surgical procedure. Evidence from this review and other reviews suggests music therapy may be considered for clinical use.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1. Pain change score (music vs.…
Fig 1. Pain change score (music vs. no music) before and after the intervention by CAS and FAS
Fig 2. Anxiety/distress change score (music vs.…
Fig 2. Anxiety/distress change score (music vs. no music) before and after the intervention measured by Short-STAI and bipolar descriptors.
Fig 3. Anxiety/distress change score (music vs.…
Fig 3. Anxiety/distress change score (music vs. no music) before and after the intervention measured by FAS and bipolar descriptors.

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