Music therapy for reducing surgical anxiety - Clinical Innovations

AORN Journal,  Nov, 2003  by Michele Brunges,  Gail Avigne

• E-mail
• Print
• Link

Epinephrine was measured by urine collection, which began during surgery when the indwelling urinary catheter was inserted and continued for 24 hours.

STUDY RESULTS

Epinephrine levels were lower in patients who listened to music than in those who did not (Table 1). These findings concur with those of past research that music decreases physiological response to anxiety and the stress of a surgical intervention.

Patients who listened to music were asked on the questionaire whether they believed that it helped decrease their anxiety. There was no questionnaire for the group who did not listen to music; however, many in that group offered voluntary opinions. Some asked, "Where is my music?" and some expressed disappointment when they learned they were not in the group that would listen to music. All participating patients had positive comments and suggestions regarding the implementation of music therapy and said they felt that the music decreased their anxiety toward their upcoming surgery.

Most significantly, researchers also noted that there was a difference in the length of hospital stay between patients who listened to music and those who did not (Figure 1). Patients who listened to preoperative music experienced shorter lengths of stay. Whether this result was related to the decrease in anxiety preoperatively is unknown. In a hospital that maximizes its average daily census, these results become very important for the strategic plan.

[FIGURE 1 OMITTED]

DISCUSSION

This project demonstrated the importance of providing music for surgical patients who want it. Music therapy had positive effects on this group, and patients perceived they had received a higher quality of care. The use of music preoperatively for some patients appears to be an excellent noninvasive technique that can offer patients additional comfort in a stressful situation. Music therapy contributes to reduced anxiety, blood pressure, and heart rate and to relaxed muscle tension. This project demonstrates that many opportunities may exist for additional controlled investigations during surgical experiences to improve patient outcomes.

TABLE 1
Epinephrine Secretion Results

        Reference   Music results   Nonmusic results

Range   0-20 mcg      5-10 mcg          8-32 mcg

Epinephrine secretion was lower in total joint-replacement
patients who listened to music preoperatively.

Editor's note: The authors thank Kimberly-Clark Corp for their funding support and the anesthesia nurses for their help in providing music for patients awaiting surgery.

NOTES

(1.) E Mok, K Y Wong, "Effects of music on patient anxiety," AORN Journal 77 (February 2003) 396-410.

(2.) V M Steelman, "Intraoperative music therapy: Effects on anxiety, blood pressure," AORN Journal 52 (November 1990) 1026-1034.

(3.) K L Kwckkeboom, "Music versus distraction for procedural pain and anxiety in patients with cancer," Oncology Nursing Forum Online 30 (May-June 2003) 433-40.

(4.) S Khalfa et al, "Event-related skin conductance responses to musical emotions in humans," Neuroscience 9 (August 2002).