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Listening to music after major heart surgery could lower anxiety, pain

Open Heart
Reuters Health - 28/01/2021 -Listening to music is linked with lower anxiety and pain after heart surgery, which could be a great option for doctors to offer to their patients, according to a team of surgeons and pain researchers.

In addition, listening to music has no risks or known side effects, unlike pain medications, so it may be a good option to calm patients' nerves and reduce their pain, the team writes in the journal Open Heart.

"Patients undergoing cardiac surgery often experience preoperative anxiety, which is associated with higher postoperative pain, and this requires higher amounts of opioids in order to control the pain," said lead author Dr. Ellaha Kakar of Erasmus University Medical Center in Rotterdam, the Netherlands.

"Benzodiazepines are often administered to reduce anxiety, but their efficacy remains unclear and they do have the risk of side effects, along with the side effects of opioids for pain," she told Reuters Health by email. "It is of great importance to reduce the administration of these medications and explore non-pharmacological interventions, such as music."

Dr. Kakar and colleagues reviewed and analyzed 20 studies that tested postoperative music sessions and changes in pain and anxiety scores. Most of the heart surgeries were for a coronary-artery bypass graft or valve replacement. The music, often offered through headphones, was described as calming and light and didn't have strong rhythms or percussion.

Across more than 1,000 patients, anxiety and pain scores both dropped significantly (by about 0.5 standardized mean difference for both). On a numeric rating scale from 0 to 10, anxiety fell by 1.05 and pain by 1.26.

Listening to music across multiple sessions appeared to reduce anxiety even more, up to eight days after an operation. The research team didn't find any statistically significant effects on a patient's length of stay in the hospital, time on mechanical ventilation, blood pressure, heart rate or opioid use.

Patients reported the greatest reduction in anxiety when they were able to choose the music, the authors write.

"Music is an important part of human life and scientifically proven in various patient populations," Dr. Kakar said. "Its introduction to the healthcare system should be seriously considered."

Future research should focus on different surgeries and hospital settings, as well as the type of music, duration and frequency for best results, she and her colleagues write.

Other non-pharmacological interventions, such as massage and reciting religious texts, have also shown positive results in terms of reducing anxiety levels and increasing pain tolerance, said Dr. Amer Harky of the Liverpool Heart and Chest Hospital in the U.K. Dr. Harky, who wasn't involved in the study, has written about music therapy and the effects on pain and anxiety after heart surgery.

"Although the studies seem to be of an average sample size and there is a need for larger-scale trials, those types of interventions should be encouraged, as they come with positive outcomes, possibly lower costs and almost no adverse side effects," he told Reuters Health by email.

Dr. Melissa Richard-Lalonde of McGill University in Montreal, Canada, who also wasn't involved in the research, has studied music and pain in adult intensive-care units.

"I would recommend anyone who enjoys listening to music and who is preparing to undergo cardiac surgery to consider bringing music of their choice for their postoperative recovery stay at the hospital," she told Reuters Health by email. "Health professionals working in postoperative care should facilitate patients' access to music as part of the recovery process."

SOURCE: https://bit.ly/3qWSJBY Open Heart, online January 25, 2021.

By Carolyn Crist

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