Children Listening to Music or Watching Cartoons During ER Procedures: A RCT

Abstract

Objective This study aims to determine if listening to music and watching cartoons are effective to distract children from pain and distress during procedures in the emergency room (ER). Methods This study is a single-center, 3-armed, superiority randomized controlled trial comparing listening to music, watching cartoons, and standard care during ER procedures in children aged 3–13 years. The primary outcome was pain measured from video footage with the Alder Hey Triage Pain Score (AHTPS). Children older than 4 years self-reported pain with the Faces Pain Scale-Revised (FPS-R). The secondary outcome was distress measured with the Observational Scale of Behavioral Distress-revised (OSBD-r). Another indicator of distress was heart rate. Results Data of 191 participants were analyzed for the 3 groups: music (n = 75), cartoon (n = 62), and control (n = 54). The median age was 7.3 years (4.9–9.7). In multivariable analysis, pain assessed with the AHTPS was significantly lower (B = −1.173, 95% confidence interval −1.953, −0.394, p = .003) in the music group than in the control groups. Across the 3 groups, 108 children self-reported pain with the FPS-R after the procedure. The scores were lowest in the music group, but the differences between groups were not significant (p = .077). OSBD-r distress scores assigned during the procedures were not significantly different between the 3 groups (p = .55). Heart rate directly after the procedure was not statistically significantly different between the 3 groups (p = .83). Conclusions Listening to recorded music is a beneficial distraction for children experiencing pain during ER procedures, whereas watching cartoons did not seem to reduce pain or distress.

Music Intervention for Pain Control in the Pediatric Population: A Systematic Review and Meta-Analysis

“…A total of 5601 participants in 38 articles, published between 2006 and 2022, were included (Table 1). Among all articles, eight articles were conducted in America [31][32][33][34][35][36][37], 14 in Europe [38][39][40][41][42][43][44][45][46][47][48][49][50][51], 13 in Asia [52][53][54][55][56][57][58][59][60][61][62][63][64][65], and three in Africa [11,66,67]. Most studies (n = 33) had a parallel randomized controlled design, and five studies [39,45,48,53,62] had a cross-over randomized controlled design.…”

“…The mean age of the participants ranged from a few days of birth to teenage years. To be specific, two articles included adolescents [43,52], 12 newborns [31,39,41,48,49,53,56,[60][61][62]64,65], and 24 infants and children [11,[32][33][34][35][36][37][38]42,[44][45][46][47]50,51,54,55,[57][58][59]63,66,67]. On the other hand, 29 studies were conducted in the hospital setting [11,[32][33][34]36,[38][39][40][41][44][45][46][47]…”

“…On the other hand, 29 studies were conducted in the hospital setting [11,[32][33][34]36,[38][39][40][41][44][45][46][47][48][49][50][51][53][54][55][56][58][59][60][61][62][64][65][66][67], and 9 in the clinic setting [31,35,37,42,43,51,52,57,63]. As for the type of pain, 18 articles examined participants with prick pain (heel lance, intravenous (IV) insertion, immunization, acupuncture, and lumbar puncture) [33,35,37,39,41,43,48,51,53,54,56,…”

“…Music intervention (MI), including music therapy and music treatment [7,8], refers to a non-invasive systematic interventional process in which music is delivered by therapist or medical personnel to improve patients' health outcomes [9][10][11]. MI facilitates a sense of control in patients [12] and provides mental distraction [8,13], emotional smoothness, and relaxation, which have been found to have pain relief effects.…”

Lineamientos de manejo materno-infantil en el consultorio odontológico en tiempos de COVID-19

“…La música también puede ser usada para bebés y niños mayores de 3 años que requieren intervenciones dentales con el objetivo de reducir cualquier angustia generada con el procedimiento. 73,74 Considerando que puede haber mayor cansancio para respirar del odontólogo con el uso de las máscaras y pantalla facial de forma continua y que además durante la pandemia se debe reducir el contacto y exceso de conversación en el ambiente clínico para reducir la contaminación, se sugiere que la música sea pasiva, es decir grabada con el uso de algún dispositivo de audio.…”