Effects of Music Listening on Cortisol Levels and Propofol Consumption during Spinal Anesthesia

Stefan Koelsch, Julian Fuermetz, Ulrich Sack, Katrin Bauer, Maximilian Hohenadel, Martin Wiegel, Udo X Kaisers, Wolfgang Heinke, Stefan Koelsch, Julian Fuermetz, Ulrich Sack, Katrin Bauer, Maximilian Hohenadel, Martin Wiegel, Udo X Kaisers, Wolfgang Heinke

Abstract

Background: This study explores effects of instrumental music on the hormonal system (as indicated by serum cortisol and adrenocorticotropic hormone), the immune system (as indicated by immunoglobulin A) and sedative drug requirements during surgery (elective total hip joint replacement under spinal anesthesia with light sedation). This is the first study investigating this issue with a double-blind design using instrumental music.

Methodology/principal findings: Patients (n = 40) were randomly assigned either to a music group (listening to instrumental music), or to a control group (listening to a non-musical placebo stimulus). Both groups listened to the auditory stimulus about 2 h before, and during the entire intra-operative period (during the intra-operative light sedation, subjects were able to respond lethargically to verbal commands). Results indicate that, during surgery, patients of the music group had a lower propofol consumption, and lower cortisol levels, compared to the control group.

Conclusion/significance: Our data show that listening to music during surgery under regional anesthesia has effects on cortisol levels (reflecting stress-reducing effects) and reduces sedative requirements to reach light sedation.

Keywords: ACTH; IgA; anesthesia; cortisol; emotion; hormones; immunology; music.

Figures

Figure 1
Figure 1
Illustration of the six different time points (vertical lines) at which serum samples were obtained [the average time in the bottom row indicates the time of the day, averaged across all subjects; SEM was less than 25 min for each of the time points (TP)]. The auditory stimulation commenced at TP 1; TP 2 was immediately before applying spinal anesthesia, and TP 3 directly after skin incision. TP 4 was before skin closure; TP 5 was 3 h, and TP 6 was 24 h, after the end of surgery.
Figure 2
Figure 2
Average propofol consumption (left panel), target propofol concentration (middle panel), and propofol concentration relative to the BIS-value (100–BIS-value/concentration, right panel), separately for the two groups (control group, music group). Particularly in relation to the BIS-values, propofol requirement was significantly lower in the music compared to the control group. Error bars indicate SEM.
Figure 3
Figure 3
Cortisol, ACTH, and IgA values, separately for both groups (music group, control group) and the six different time points. Gray-shaded are indicate the intra-operative period. None of the parameters differed between groups at time point 1. During the intra-operative period, cortisol levels were lower in the music than in the control group. ACTH and IgA levels differed between time points, but not between groups. Error bars indicate SEM.

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