Music as good as benzodiazepines at reducing pre-op anxiety
Listening to music prior to surgery is just as good as taking benzodiazepines at reducing anxiety, according to a new study.
Short-acting benzodiazepines, for example midazolam, are often administered pre-operatively to reduce patient anxiety but have a host of undesirable side effects that may impact the patient’s breathing, blood flow, and moods. Benzodiazepines also require constant monitoring by doctors.
Music therapy, in contrast, was “virtually harm-free and inexpensive,” said lead investigator Dr Veena Graff and colleagues from the Anaesthesiology & Critical Care, University of Pennsylvania in Philadelphia, US. “It can be offered as an alternative to midazolam prior to peripheral regional anaesthesia.”
Music vs midazolam as pre-op anxiolytic
Graff and team compared the anxiolytic effects of intravenous midazolam vs a preprogrammed musical track, delivered through noise-cancelling headphones, three minutes prior to administration of peripheral nerve block in 157 patients attending an ambulatory surgical center. [Reg Anesth Pain Med 2019;44:796-799]
There were 80 patients in the midazolam group and 77 in the music group.
The change in State Trait Anxiety Inventory-6 (STAI-6) scores from before to after the procedure was similar in the music and midazolam groups (-1.6, SD 10.7 vs -4.2, SD 11; p=0.14); mean difference between groups, -2.5 (p=0.1). Physician satisfaction scores, measured using a 10-point analogue scale (0=worst experience and 10=best experience), were similar in both groups (p=0.07). However, patient satisfaction with their overall experience was higher in the midazolam group (p=0.01).
The researchers said this could be due to patients not being able to select the music they listened to, which was the Marconi Union’s ‘Weightless’ series specifically designed by sound therapists to reduce patient anxiety and vital signs pre-operatively.
What type of music would calm patients?
“We’ve shown that there are drug-free alternatives to help calm patients before certain procedures, like nerve blocks,” said Graff. “We’ve rolled out a new process at our ambulatory surgical centre to provide patients who want to listen to music with access to disposable headphones. Ultimately, our goal is to offer music as an alternative to help patients relax during perioperative period.”
What would make for relaxing tunes are research-selected music that has no lyrics, with consistent tempo and dynamics, stable rhythms, and smooth melodic lines is most effective in reducing anxiety, according to an older study. [South Med J 2012;105:486-490]
The researchers said the findings should be interpreted cautiously within the context of the study limitations, and that more studies are warranted to evaluate whether the type of music, as well as how it is delivered, offers advantages over midazolam.