Music Listening Among Postoperative Patients in the Intensive Care Unit: A Randomized Controlled Trial with Mixed-Methods Analysis

Abstract

Background:Music listening may reduce the physiological, emotional, and mental effects of distress and anxiety. It is unclear whether music listening may reduce the amount of opioids used for pain management in critical care, postoperative patients or whether music may improve patient experience in the intensive care unit (ICU).Methods:A total of 41 surgical patients were randomized to either music listening or controlled non-music listening groups on ICU admission. Approximately 50-minute music listening interventions were offered 4 times per day (every 4-6 hours) during the 48 hours of patients’ ICU stays. Pain, distress, and anxiety scores were measured immediately before and after music listening or controlled resting periods. Total opioid intake was recorded every 24 hours and during each intervention.Results:There was no significant difference in pain, opioid intake, distress, or anxiety scores between the control and music listening groups during the first 4 time points of the study. However, a mixed modeling analysis examining the pre- and post-intervention scores at the first time point revealed a significant interaction in the Numeric Rating Scale (NRS) for pain between the music and the control groups (P = .037). The Numeric Rating Score decreased in the music group but remained stable in the control group. Following discharge from the ICU, the music group’s interviews were analyzed for themes.Conclusions:Despite the limited sample size, this study identified music listening as an appropriate intervention that improved patients’ post-intervention experience, according to patients’ self-report. Future mixed methods studies are needed to examine both qualitative patient perspectives and methodology to improve music listening in critical care units.

Music Use for Sedation in Critically ill Children (MUSiCC trial): a pilot randomized controlled trial

“…Studies in critically ill children have most often been limited to premature newborns who were neither on mechanical ventilation nor on sedatives [31][32][33]. Patients included in critically ill adult trials were relatively stable and the majority were in a weaning phase from their mechanical ventilation [11,[36][37][38][39][40]. None of the studies evaluated heavily sedated patients in the acute phase of their illness; the included patients were on sedatives for some time, with variability in length of stay at the time of study entry.…”

Progressive muscle relaxation combined with music on pain and stress

“…This study was limited to only patients undergoing hys-terectomy, in another study A. Vaajoki et al (2012); Ames et al (2017), who exhibited that the utilisation of music reduces pain intensity and pain distress in bed rest, during profound breathing and in moving situation after abdominal surgery procedure on the second postoperative day. In a metaanalysis by Kühlmann et al (2018) in the year 2018 who analysed that music interventions signi icantly reduce anxiety and pain in adult surgical patients.…”

Management of Pain in the Intensive Care Unit

“…Regional or neuraxial which includes spinal or epidural modalities may as well be used for post-operative pain relief after a number of surgical procedures [23] .On the other hand, nonpharmacologic interventions are also used for pain management. Examples include music therapy, massage, and relaxation techniques, may benefit as opioid-sparing and analgesiaenhancing.Interestingly, they are low cost, economic, safe, and easy to provide [24] .…”