P1328effectiveness of Music for Alleviating Pain During Haemodialysis Access Cannulation: A Multi-Facility, Single-Blind, Randomised Controlled Trial

Abstract

Background and Aims Repeated needle pain during haemodialysis (HD) access cannulations is a serious problem for HD patients. Although the efficacy of music for alleviating pain and anxiety is well established, there is insufficient scientific evidence related to its effectiveness in alleviating pain during access cannulations during HD. This study aimed to investigate the effects of music on reducing pain during access cannulating in HD patients. Method A prospective, multi-facility, single-blind, crossover, randomised controlled trial was conducted. The intervention included listening to Mozart and a white-noise control condition. Patients were randomly allocated to either an ‘Early-group’ or a ‘Later-group’. All patients who underwent cannulation wore headphones without sound in the first and third weeks (No-sound period). The Early-group received cannulation while listening to Mozart’s Sonata for Two Pianos in D major (K.448) during the second week (Music period), and white noise during the fourth week (White noise period). The Later-group received cannulation while listening to white noise first, followed by Mozart in the fourth week. During each period, the music or no-music protocol started 8 minutes prior to the cannulation, and participants finished listening after HD began. The Visual Analogue Scale (VAS) was used to measure pain and anxiety during cannulation and the VAS scores for pain and anxiety were compared for the music and no-music settings. We evaluated the ratio of outcome measures between the music and white noise periods with the repeated measure mixed effect regression. We analysed the effects according to the intention-to-treat principle. Two-sided-significance-level was set at 0.05. Results In total, one hundred and twenty-one patients were enrolled in this study, across four facilities. The median age was 64 years, and there were 84 males (69.4%). Sixty-five patients (53.7%) used analgesics for alleviating pain. The median VAS pain score was 28 and VAS anxiety score was 19 in No-sound period. The Mozart music setting had a 12.2% (95% confidence interval (CI): 2.3 to 21.1, p=0.017) lower VAS score than the white noise setting. On the other hand, there was no significant difference in the VAS anxiety score between the two groups, that is the Mozart music setting had a 7.96% (95% CI: -4.70 to 18.4, p=0.172) reduction compared to the white noise setting. Conclusion We examined the effects of Mozart’s music on alleviating pain using scientific methods. The music appears to reduce pain of access cannulation in HD patients. Although the trial assessed the effects of music using a single musical composition, the study did not clarify the effects of music on the physical, emotional, and cognitive status of patients. Further studies in this direction are required.

Acoustic stimulation for relieving pain during venipuncture: a systematic review and network meta-analysis

“…Only three studies, Ikenoue et al , 40 Momenabadi et al 47 and Kishida et al 61 reported treatment costs ( online supplemental table 5 ). Ikenoue et al 40 compared music medicine (researcher selected) versus sounds without linguistic meaning, whereas Kishida et al 61 compared music medicine (researcher selected) versus sounds with linguistic meaning. Both studies used free online music; only tablet computers and headphones/earphones purchased for research purposes were used for sound reproduction.…”

“…29 Thus, we obtained 101 full texts and identified 38 eligible full texts reporting on 27 RCTs. 22 23 30-63 We denote each study by the author's name and year of publication: Aydin 2017, 30 Tapar 2017, 31 Aghbolagh 2020, 22 Arts 1994, 23 Balan 2009, 32 Çelikol 2019, 33 Schaal 2021, 34 35 Jacobson 1999, 36 37 Hsieh 2017, 38 Karaca 2022, 39 Ikenoue 2020, [40][41][42] Shabandokht-Zarmi 2017, 43 44 Hoseini 2019, 45 46 Momenabadi 2021, 47 Raghibi 2018, 48 Mou 2020, 49 Hartling 2013, 50 51 Jacquier 2022 (52-54)(44, 50, 59), Gerçeker 2019, 55 Nouira 2020, 56 Sahiner 2016, 57 Shahabi 2007, 58 Press 2013, 59 Zengin 2013, 60 Kishida 2019, 61 Fleckenstein 2022 62 and Alemdar 2023. 63 The detailed characteristics of the studies included in this review are presented in online supplemental tables 5 and 6.…”