Relief of Procedural Pain in Critically Ill Patients by Music Therapy: A Randomized Controlled Trial

Abstract

Background: This study aimed to determine the effectiveness of music listening for procedural pain relief using two different observational pain tools during endotracheal suctioning. Materials and Methods: This study was a randomized controlled trial. The sample of the study included 98 patients with mechanical ventilation support who met the selection criteria. The patients were randomly assigned to control and music therapy groups. Patients in the control group were routinely suctioned as usual. Patients in the music group received music therapy 20 min before, during, and 20 min after endotracheal suctioning. The primary outcome was the pain relief during suctioning. Results: Forty patients in each arm completed the study. Pain scores in the Critical Care Pain Observation Tool and Behavioral Pain Scale were lower in the music group than in the control group during endotracheal suctioning (group: F = 14.85, p = 0.000; F = 9.04, p = 0.000, respectively). It was also found to be a significant interaction effect between the groups and time (group × time: F = 17.35, p = 0.000; F = 18.00, p = 0.000, respectively). Conclusion: The Critical Care Pain Observation Tool and Behavioral Pain Scale in the current study generally demonstrated similar pain scores during the painful procedure. Our findings support that music therapy may act as a nonpharmacological therapy to relieve procedural pain in patients on mechanical ventilation.

Inter-Professional-Compassionate pain management during endotracheal suctioning: a valuable lesson from a Chinese surgical intensive care unit

“…These results extend the efficacy of previous studies utilizing music therapy and a catheter size of 12 in reducing pain intensity and agitation. 2,5,11,25,27,28 This study also supports the efficacy of the application of 3-phase procedural pain management in relieving the painful procedures employed in previous studies. 3,8,10,[17][18][19]29 These results illustrate the benefit of using a systematic EBP process and translating the current best available evidence into nursing practice to provide high-quality care and positive outcomes for patients.…”

Effect of Music Therapy in Relieving the Symptom Experiences and Improving Outcomes of Critical Care Patients: A Systematic Review

“…Based on the search and the feasibility test, 19 RCTs were related to music therapy in critical care units (Table 4) [14], [15], [16], [17], [18], [19], [20], [21], [22], [23], [24], [25], [26], [27], [28], [29], [30], [31], [32]. The various types of music used in this study were classical music and instrumental music produced from various musical instruments (piano, harp, guitar, flute, and others), natural sound-based music, religious music to traditional music in their respective countries.…”

“…From a review of various studies, it shows that in principle, music that can be used as therapy was music with a relaxing rhythm, soft tones, and slow rhythms. Nine (9/19) RCT states that music tempo ranges from 60 to 80 beats/min [14], [15], [16], [17], [20], [21], [22], [24], [25]. Each study used a different volume, starting from 30 to 40 dB [20], 50-60 dB [18], or determined by a nurse [31], and others reported that the music volume was adjusted to the participant's preference or set at an adequate level for each participant.…”

“…The majority (16/19) of studies conducted music therapy on participants using headphones/ earphones, except for the study conducted by Karabulut. (2019 &, which used pillow music media and study conducted by Hansen et al, [26] which used loudspeaker.…”

“…There were eight (8/19) RCTs exploring the effects of music therapy on pain intensity in critical care units [14], [17], [18], [22], [23], [24], [27], [31]. The majority (7/8) of the studies reported significant differences in pain scores between the music group and the control group; however, one study by Khan et al (2020) reported no difference.…”