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The effect of music and music in combination with therapeutic suggestions on postoperative recovery
Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
2003 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The aim of this thesis was to test the effect of music with or without therapeutic suggestions performed intra- or postoperatively on patients' postoperative recovery. A total of 422 patients were included in four studies with a mean age of 53 years. Of these patients 75 were included in two studies. The surgical procedures were hysterectomy, hernia repair surgery and varicectomy. The anaesthesia and postoperative analgesia were standardized.

All patients were allocated random into one of three groups; two intervention groups and one control group. The intervention groups were exposed to; music or music and therapeutic suggestions intraoperatively in one study and postoperatively in another study. In the third and fourth study the role of music intraoperatively versus music postoperatively was evaluated.

To evaluate the effect on postoperative recovery of these interventions pain, nausea, anxiety, fatigue, sleep, well-being, urinary problems, headache, mobilization, bowel function, hospital stay, blood pressure, oxygen saturation, heart rate, serum-cortisol and blood-glucose and plasma immunoglobulin A were assessed.

The results showed that patients that were exposed to intraoperative music rated less postoperative pain after 1 and 2 hours at the postoperative care unit (PACU) and the first day after surgery, required less morphine for the first hour at the PACU, were less fatigued at discharge and had an earlier mobilization compared to the control group. Patients exposed to intraoperative music in combination with therapeutic suggestions rated less mean pain intensity for the first 2 hours at the PACU, required less ketobemidone the day of surgery and were less fatigued at discharge compared to the control group. Patients listening to postoperative music rated less postoperative pain after 1 and 2 hours and less mean pain intensity for the first 2 hours after surgery, required less morphine for the first hour at the PACU, rated less postoperative anxiety after 1 hour, had less marked increase in glucose levels and greater reduction in cortisol levels after 2 hours and had an increased oxygen saturation after 1 hour at the PACU compared to the control patients. The patients listening to postoperative music in combination with therapeutic suggestions rated less mean pain for the first 2 hours at the PACU compared to the control group. However, in general the analgesic effects of the interventions were modest and of relatively short duration.

Music or music in combination with therapeutic suggestions during surgery and postoperative recovery can be used as an adjunct in multimodal regimes to improve patient recovery process. These interventions are simple, inexpensive and non invasive tools that can be applied in intra- and postoperative care.

Place, publisher, year, edition, pages
Linköping: Linköpings universitet , 2003. , 61 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-27528Local ID: 12184ISBN: 91-7373-500-0 (print)OAI: oai:DiVA.org:liu-27528DiVA: diva2:248080
Public defence
2003-10-10, Wilandersalen, Universitetssjukhuset, Örebro, 13:00 (Swedish)
Opponent
Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2012-11-06
List of papers
1. Improved recovery after music and therapeutic suggestions during general anaesthesia: a double-blind randomised controlled trial
Open this publication in new window or tab >>Improved recovery after music and therapeutic suggestions during general anaesthesia: a double-blind randomised controlled trial
Show others...
2001 (English)In: Acta Anaesthesiologica Scandinavica, ISSN 0001-5172, E-ISSN 1399-6576, Vol. 45, no 7, 812-817 p.Article in journal (Refereed) Published
Abstract [en]

Purpose: This study was designed to determine whether music or music in combination with therapeutic suggestions in the intra-operative period under general anaesthesia could improve the recovery of hysterectomy patients.

Methods: In a double-blind randomised clinical investigation, 90 patients who underwent hysterectomy under general anaesthesia were intra-operatively exposed to music, music in combination with therapeutic suggestion or operation room sounds. The anaesthesia was standardised. Postoperative analgesia was provided by a patient-controlled analgesia (PCA). The pain scores were recorded by means of a visual analogue scale. Nausea, emesis, bowel function, fatigue, well-being and duration of hospital stay were studied as outcome variables.

Results: On the day of surgery, patients exposed to music in combination with therapeutic suggestions required less rescue analgesic compared with the controls. Patients in the music group experienced more effective analgesia the first day after surgery and could be mobilised earlier after the operation. At discharge from the hospital patients in the music and music combined with therapeutic suggestion group were less fatigued compared to the controls. No differences were noted in nausea, emesis, bowel function, well-being or length of hospital stay between the groups.

Conclusion: This double-blind study has demonstrated that intra-operative music and music in combination with therapeutic suggestions may have some beneficial effects on postoperative recovery after hysterectomy. Further controlled studies are necessary to confirm our results.

Keyword
Fatigue, General anesthesia, Hysterectomy, Intra-operative, Mobilisation, Music, Pain, Therapeutic suggestions, Well-being
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-27053 (URN)10.1034/j.1399-6576.2001.045007812.x (DOI)11699 (Local ID)11699 (Archive number)11699 (OAI)
Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13
2. Analgesia following music and therapeutic suggestions in the PACU in ambulatory surgery: a randomized controlled trial
Open this publication in new window or tab >>Analgesia following music and therapeutic suggestions in the PACU in ambulatory surgery: a randomized controlled trial
2003 (English)In: Acta Anaesthesiologica Scandinavica, ISSN 0001-5172, E-ISSN 1399-6576, Vol. 47, no 3, 278-283 p.Article in journal (Refereed) Published
Abstract [en]

Background: This study was designed to determine whether music (M), or music in combination with therapeutic suggestions (M/TS) could improve the postoperative recovery in the immediate postoperative in daycare surgery.

Methods: One-hundred and eighty-two unpremedicated patients who underwent varicose vein or open inguinal hernia repair surgery under general anaesthesia were randomly assigned to (a) listening to music (b) music in combination with therapeutic suggestions or (c) blank tape in the immediate postoperative period. The surgical technique, anaesthesia and postoperative analgesia were standardized. Analgesia, the total requirement of morphine, nausea, fatigue, well-being, anxiety, headache, urinary problems, heart rate and oxygen saturation were studied as outcome variables.

Results: Pain intensity (VAS) was significantly lower (P = 0.002) in the M (2.1), and the M/TS (1.9) group compared with the control group (2.9) and a higher oxygen saturation in M (99.2%) and M/TS (99.2%) group compared with the control (98.0%), P < 0.001, were found. No differences were noted in the other outcome variables.

Conclusion: This controlled study has demonstrated that music with or without therapeutic suggestions in the early postoperative period has a beneficial effect on patients' experience of analgesia. Although statistically significant, the improvement in analgesia is modest in this group of patients with low overall pain levels.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-27054 (URN)10.1034/j.1399-6576.2003.00064.x (DOI)11700 (Local ID)11700 (Archive number)11700 (OAI)
Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13
3. Stress and immune response in patients exposed to intra- or postoperative music: a randomised controlled trial
Open this publication in new window or tab >>Stress and immune response in patients exposed to intra- or postoperative music: a randomised controlled trial
(English)Manuscript (preprint) (Other academic)
Abstract [en]

This randomised controlled trial was designed to evaluate whether intra- or postoperative music could influence stress and immune response during and after general anaesthesia and also if there was a different response between patients exposed to music intraoperatively or postoperatively. Seventy-five patients undergoing open hernia repair as day care surgery were randomly allocated to three groups: intraoperative music (IM), postoperative music (PM) and silence i.e. control group. The anaesthesia and postoperative analgesia were standardised and the same surgeon performed all the operations. Stress response was assessed during and after surgery by determining the plasma cortisol and blood glucose levels. Immune function was evaluated by studying immuuoglobulin A (IgA) levels. Patients' postoperative pain, anxiety, blood pressure, heart rate and oxygen saturation were also studied as stress markers. The results showed that there were significant differences between the PM group and the control group with regard to more marked decreased levels of cortisol and less marked increased glucose levels after 2 hours in the postanaesthesia care unit (PACU). The PM group also rated less anxiety and the IM and PM group rated less pain after 1 hour in the PACU compared with the control group. There was no difference in IgA, blood pressure, heart rate and oxygen saturation between the groups. This study indicating that postoperative music decreases patients' stress response with regard to s-cortisol, b-glucose and anxiety. Music therapy also has an influence intra- or postoperatively on postoperative pain intensity, but not on immune function as assessed by IgA.

Keyword
Music, general anaesthesia, intraoperative, postoperative, cortisol, glucose, IgA, anxiety, pain
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-85128 (URN)
Available from: 2012-11-06 Created: 2012-11-06 Last updated: 2012-11-06
4. A comparison of intra-operative or postoperative exposure to music: a controlled trial of the effects on postoperative pain
Open this publication in new window or tab >>A comparison of intra-operative or postoperative exposure to music: a controlled trial of the effects on postoperative pain
2003 (English)In: Anaesthesia, ISSN 0003-2409, E-ISSN 1365-2044, Vol. 58, no 7, 699-703 p.Article in journal (Refereed) Published
Abstract [en]

The effect of intra-operative compared to postoperative music on postoperative pain was evaluated in a controlled trial. In all, 151 patients undergoing day case surgery for inguinal hernia repair or varicose vein surgery under general anaesthesia were randomly allocated to three groups: group 1 listened to music intra-operatively, group 2 listened to music postoperatively and group 3, the control group, listened to ‘white noise’. The anaesthetic and postoperative analgesic techniques were standardised. Pain was assessed using a numeric rating scale (0–10) and patients requirements for postoperative morphine, paracetamol and ibuprofen was recorded. The effect of music on nausea, fatigue and anxiety was also investigated. The results showed that patients exposed to music intra-operatively or postoperatively reported significantly lower pain intensity at 1 and 2 h postoperatively and patients in the postoperative music group required less morphine at 1 h compared to the control group. No differences were noted in the other variables. This study demonstrates that there is a short-term pain-reducing effect of music therapy however, the beneficial effects do not differ if the patient is exposed to music intra-operatively or postoperatively.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-27055 (URN)10.1046/j.1365-2044.2003.03189_4.x (DOI)11701 (Local ID)11701 (Archive number)11701 (OAI)
Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13

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