Effect of music on vital signs and postoperative pain

AORN Journal, August, 2004 by Eleni Ikonomidou, Anette Rehnstrom, Ole Naesh

Preoperatively, patients in the M group showed a highly significant (P < .01, t = 4.5) reduction in RR after the session compared to patients in the C group (P < .09, t = 1.8). There was a significant difference between the groups (P = .02, t = 2.3). Postoperatively, patients in neither group showed any significant changes in RR.

Heart rate was not significantly affected preoperatively, although a decrease (P = .05, t = 2) was observed in the control group. Postoperatively, patients in both groups showed highly significant postsession decreases, but there was no significant difference between patients in the two groups (P = .6, t = -0.6) for this parameter.

Blood pressure tended toward overall lower values after the sessions both preoperatively and postoperatively. The decrease was significant preoperatively among patients in the C group (P = .05, t = 2.1) (M group P = .07, t = 1.9) and postoperatively among patients in the M group (P = .04, t = 2.2) (C group P = .06, t = 2), but there were no significant differences between patients in either group preoperatively or postoperatively.

Pain scores were significantly lower for patients in both groups after the session, but there was no significant difference between the groups. Postoperative cumulative opioid consumption was, however, significantly lower among patients in the M group (P = .04, t = -2.2).

Preoperatively, well-being was significantly higher among patients in both groups after the session but showed no intergroup difference. Postoperatively, patients in the music group tended toward an improved well-being (P = .07, t = 1.9) as opposed to no detectable change among patients in the control group (P = .7, t = 6.4). There was no difference between the groups preoperatively or postoperatively.

Postoperative nausea was observed in only four patients in M group and in three patients in the C group. Thus, no statistical evaluation of the effect of music was attempted.

DISCUSSION

In this study, the researchers were able to demonstrate a statistically significant effect of pre- and postoperative music therapy. Based on the results, the intervention lowers RR preoperatively and decreases postoperative opioid consumption. It appears from the data, however, that the mere interposing of a period of peaceful, undisturbed rest immediately before surgery alone has a positive effect on patients' feelings of well-being and is appreciated by the majority of patients. Such a period of rest also has a positive influence on postoperative pain and vital signs (ie, decreases in BP and RR), but based on study data, this effect is unrelated to whether the patient actually listens to music.

This is the only study that has been undertaken using headphones in both groups and playing a blank CD for the control group, ensuring comparable isolation. This is of major importance in avoiding any confounding factors in the environment and to achieve the same circumstances in both groups. A study comparing a group with headphones to a group with no headphones or to a group with headphones but no CDs is, in the researchers' opinion, not as valid as the present design. Circumstances were fully comparable because patients in both groups had an intervention and differed only with respect to that intervention being music or no music.