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Grand Rounds

RCT Results: Does Music Therapy Reduce Perioperative Anxiety in Women Undergoing Total Laparoscopic Hysterectomy?

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BACKGROUND AND PURPOSE:

  • Casarin et al. (JMIG, 2021) assessed the superiority of a music therapy intervention vs usual care in reducing the preoperative anxiety of patients undergoing total laparoscopic hysterectomy (TLH) for benign indications

METHODS:

  • Randomized controlled study
  • Participants
    • Patients undergoing TLH for benign disease
  • Interventions
    • 1 hour of music therapy with a music therapist prior to anesthesia
    • Usual care
  • Study design
    • Participants were randomized 1:2 to music and control groups, respectively
    • Anxiety was evaluated with the State-Trait Anxiety Inventory Y Form (STAI-Y)
      • Pathologic anxiety was defined as STAI-Y state >45
    • Postoperative pain was registered using the visual analog scale
  • Primary outcome
    • Anxiety levels at baseline and during preoperative, early postoperative, and late postoperative periods
    • Postoperative pain

RESULTS:

  • Music group: 30 patients | Control group: 70 patients

Anxiety Level

  • Women in the Music arm experienced lower anxiety levels during the preoperative period (P=0.002)
    • Music group: median STAI-Y scores 38.0
    • Control group: 41.0
  • STAI-Y scores did not vary significantly at each subsequent time point

Pathologic Anxiety

  • There was a significant difference in the proportion of women with pathologic anxiety during the
    • Preoperative period (P=0.04)
      • Music group: 16.7%
      • Control group: 37.2%
    • Early postoperative period (P=0.04)
      • Music group: 0%
      • Control group: 12.9%
  • No significant differences between groups during the
    • Late postoperative period (P=0.93)
      • Music group: 6.6%
      • Control group: 7.1%

Pain Intensity

  • Postoperative pain intensity did not significantly differ between the groups at 1, 3, and 6 hours after surgery

CONCLUSION:

  • Music therapy may reduce the amount of perioperative anxiety patients experience during total laparoscopic hysterectomy for benign indications
  • The authors state

Music therapy seems a viable complementary modality to usual surgical care in the gynecologic setting for its ability to significantly decrease preoperative anxiety

Women undergoing hysterectomy are a distinct patient group at higher risk of preprocedural anxiety and its detrimental effects and would most benefit from anxiety-reduction interventions

Learn More – Primary Sources:

Music Therapy for Preoperative Anxiety Reduction in Women Undergoing Total Laparoscopic Hysterectomy: A Randomized Controlled Trial

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Related ObG Topics:

Can Music Help Reduce Pain and Stress During Oocyte Retrieval?
Can Epidural be an Alternative to General Anesthesia for Laparoscopic Hysterectomies?
The Opioid Crisis: Can Using A Decision Aid Decrease Opioid Prescribing Following Hysterectomy?

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