Music may help relieve perioperative anxiety and acute pain in women undergoing elective cesarean delivery

Avinash Kakde, and team reports that perioperative music listening was associated with reduction in anxiety and pain catastrophizing following cesarean delivery. Researchers aimed to determine whether perioperative music listening reduces anxiety, acute pain, and pain catastrophizing scale (PCS) scores following elective cesarean delivery under spinal anesthesia.

The study is published in BMC Anesthesiology.

Around 25% of parturients are known to experience anxiety during pregnancy, which is associated with increased risk of maternal complications e.g., pre-eclampsia and emergency cesarean delivery. Music listening has emerged as a safe and efficacious treatment modality to reduce perioperative anxiety associated with cesarean delivery.

Researchers did randomization as music listening and control groups, baseline patient characteristics, visual analog scale-anxiety (VAS-A) scores, pain scores, PCS total and sub-scores, and music preferences were collected preoperatively. Before surgery, parturients in the experimental group listened to music of their own choice for 30 min.

Music listening was continued during administration of spinal anesthesia and cesarean delivery, and for 30 min following surgery. Postoperative VAS-A score, acute pain score, PCS scores, music preferences, satisfaction score, and feedback were recorded.

The key findings of the study are

• They analyzed 108 parturients (music: n = 53; control: n = 55). Music listening was associated with reduced postoperative VAS-A (mean difference (MD) -1.43, 95%CI -0.63 to -2.22).

• PCS total score (MD -6.39, 95%CI -2.11 to -10.66), PCS sub-scores on rumination (MD -1.68, 95%CI -0.12 to -3.25), magnification (MD -1.53, 95%CI -0.45 to -2.62), and helplessness (MD -3.17, 95%CI -1.29 to -5.06) sub-scores.

• There was no significant difference in postoperative acute pain scores. The majority (> 95%) of parturients reported “excellent” and “good” satisfaction with music listening, and most provided positive feedback.

The researchers concluded that “Perioperative music listening was associated with reduced postoperative anxiety and lower pain catastrophizing. Based on the good patient satisfaction and positive feedback received, the use of music listening in the obstetric setting is recommended.”

Reference: Kakde, A., Lim, M.J., Shen, H. et al. Effect of music listening on perioperative anxiety, acute pain and pain catastrophizing in women undergoing elective cesarean delivery: a randomized controlled trial. BMC Anesthesiol 23, 109 (2023). https://doi.org/10.1186/s12871-023-02060-w