No effect of a musical intervention on stress response to venepuncture in a neonatal population

Abstract

Aim To investigate the effect of a musical intervention on neonatal stress response to venepuncture as measured by salivary cortisol levels and pain profile scores. Methods In a randomised control crossover trial, participants were randomised to both a control arm (sucrose) and intervention arm (sucrose and music) for routine venepuncture procedures. Salivary swabs were collected at baseline, 20 minutes post‐venepuncture and 4 hours post‐venepuncture. Pain levels were assessed using the Premature Infant Pain Profile (PIPP). A total of 16 preterm neonates participated in both arms to complete the study. Results Cortisol values were elevated at all timepoints in the intervention arm (baseline, 20 minutes, and 4 hours post‐procedure) but not significantly so (P = .056, P = .3, and P = .575, respectively). Median change in cortisol values from baseline was +128.48 pg/mL (−47.66 to 517.02) at 20 minutes and +393.52 pg/mL (47.88‐1221.34) at 4 hours post‐procedure in the control arm compared to −69.564 pg/mL (−860.96 to 397.289) and +100.48 pg/mL (−560.46 to 842.99) at 20 minutes and 4 hours post‐procedure in the intervention arm. There was no statistically significant difference observed between groups (P = .311 at 20 minutes, and P = .203 at 4 hours post‐procedure). PIPP scores were not significantly different between study arms. Conclusion Our findings did not support the additional benefit of music intervention on neonatal stress response to venepuncture in preterm infants.

Clinical benefits of music‐based interventions on preterm infants' health: A systematic review of randomised trials

“…Discrepancies were resolved by discussion and consensus. The overall results showed that 27 RCTs had a low (69.2%), 17‐43 7 had a moderate (17.9%) 44‐50 and 5 had a high (12.8%) risk of bias 51‐55 …”

“…Regarding the type of music selected (Table 1 and Table 2), the majority of studies ( n = 26, 66.7%) used lullaby‐style interventions (soothing sounds; repetitive patterns of rhythm; and slower pitch and tempo, with only vocal, musical instruments or both), 17‐22,24,26,30‐33,35,37,39,40,42,43,45,46,50‐55 such as Brahms lullaby ( n = 5, 12.82%) 17,18,22,31,39 and cultural lullabies (specific to the country or language) ( n = 8, 20.51%) 22,26,28,31,32,37,40,51 23,44,47‐49 .…”

“…Thirteen studies (33.3%) reported the analgesic effects of music interventions (Table 1). The Premature Infant Pain Profile (PIPP) was the most frequent tool to assess the PTIs' pain response ( n = 9, 69.2%) 17‐19,21‐24,26,28 . Salivary cortisol concentration, 18 serum cortisol, 19,26 β‐endorphin concentrations, 19 PIPP‐Revised scale, 20 the Neonatal Infant Pain Scale (NIPS), 21 the Neonatal Facial Coding System (NFCS) Scale 25 and the Neonatal Pain, Agitation and Sedation Scale (N‐PASS) were also used to assess this outcome 27…”

“…Kangaroo care, 28 sucrose, 17,20 oral glucose, 21 touch interventions, 19 non‐nutritive sucking, facilitated tucking and holding 22 were some of the most frequently reported therapies combined with music. Only one study that relied on MM interventions failed to report statistically significant results for this outcome 18 …”

“…From the retrieved studies, only 6 (15.4%) had interventions delivered by a music therapist (MT intervention). 24,30,35,36,41,43 The remaining interventions follow under the categorisation of MM , [17][18][19][20][21][22][23][25][26][27][28][29][31][32][33][34][37][38][39][40]42,[44][45][46][47][48][49][50][51][52][53][54][55] and included diverse music genres (such as classical music or western lullabies), pre-recorded and selected by the researcher without consultation from a music therapist.…”