Anxiolytic Effects of Intraoperative Music Therapy in Adults Undergoing Local Anaesthetic Interventions.

BACKGROUND: Intra-operative anxiety is a commonly experienced feeling amongst patients undergoing surgery. Moreover, conscious patients are exposed to the multiple environmental factors triggering this emotion. Apprehension and fear are common emotions interlinked with associated intra-operative anxiety. Several concerning complications are associated with this emotion during surgery, many of which include severe cardiac related events, such as heart failure and acute myocardial infarction, extreme postoperative pain, increased requirement of analgesic, sedation and anaesthetic demand, extended hospital stay, and reduced patient satisfaction. In this review, the effect of intra-operative music therapy to alleviate anxiety in adults undergoing surgery will be studied in order to establish whether intra-operative music alleviates anxiety in adults undergoing local anaesthetic surgical interventions.

METHODS: The Population studied was adults aged 18-80 years old undergoing local anaesthetic interventions. The Intervention observed was the exposure of intra-operative music therapy. The Comparison was against patients undergoing surgery without being subject to music therapy. The desired Outcome was the alleviation of intra-operative anxiety. The intention was to develop a systematic review of the available data. In orderto develop the literature search, Key elements of the question were identified and utilized to generate alternative terms. Subsequently, Boolean Operators were used to combine these terms. Search results were narrowed down by means of limiters and selected databases; EBSCO, PubMed and ScienceDirect were used to execute the search. The PRISMA 2009 framework was used as a guideline in excluding irrelevant studies. Assessment of study eligibility was done byapplying inclusion/exclusion criteria. Appraisal of literature was done by using The Critical Appraisal Skills Programme (CASP) tool as a framework.

RESULTS: A total of five studies were identified. These included randomised control trials. Two of these studies demonstrated statistical significance whilst the remaining three failed to do so. The overall result of these studies was inconclusive and inconsistent in attempting to determine whether intra-operative music therapy alleviates anxiety in patients undergoing local anaesthetic interventions.

CONCLUSION: The presentation of a definite conclusion is not possible. However, evidence is promising and pointing towards the likelihood of beneficial outcomes resulting from the intervention of interest. However, further research is required.

IMPLICATIONS AND RECOMMENDATIONS: It is recommended that the patients be offered the choice of selecting their preferred music if they give consent to undergo surgery while being exposed to music therapy. Various cost-effective audio devices could be installed in operating theatres. The general public and healthcare professionals should be educated about the benefits of intra-operative music therapy. Future studies should use larger sample sizes, and attrition rate should be reduced through better communication with patients and thorough taking into account the demographic characteristics of the patients.