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Stress and immune response in patients exposed to intra- or postoperative music: a randomised controlled trial
Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
Department of Clinical Medicine, Division of Anaesthesiology, Örebro University Hospital, Sweden.
(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 [en]
Music, general anaesthesia, intraoperative, postoperative, cortisol, glucose, IgA, anxiety, pain
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-85128OAI: oai:DiVA.org:liu-85128DiVA: diva2:565066
Available from: 2012-11-06 Created: 2012-11-06 Last updated: 2012-11-06
In thesis
1. The effect of music and music in combination with therapeutic suggestions on postoperative recovery
Open this publication in new window or tab >>The effect of music and music in combination with therapeutic suggestions on postoperative recovery
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:nbn:se:liu:diva-27528 (URN)12184 (Local ID)91-7373-500-0 (ISBN)12184 (Archive number)12184 (OAI)
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

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Nilsson, UlricaUnosson, Mitra

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