Effects of Music Therapy During Total Knee Arthroplasty Under Spinal Anesthesia: A Prospective Randomized Controlled Study.

Promil Kukreja,Hari Kalagara,Elie Ghanem,Katherine Talbott,William A Potter,Alexander Woods,Lisa Macbeth,Adam B Sturdivant

doi:10.7759/cureus.7396

Abstract

PurposeMusic therapy is an effective non-pharmacologic intervention that is cost-effective, easy to implement, and customize. It has been shown to significantly alleviate anxiety and improve patient satisfaction. In this study, we aimed to compare music therapy to a control (no music) group with respect to sedation requirements, anxiety levels, and patient satisfaction for patients undergoing total knee arthroplasty under spinal anesthesia.MethodsIn this randomized controlled study, we compared the effect of music therapy in patients ≥ 18 years old. Patients undergoing total knee arthroplasty were screened for the study to rule out any contraindications for spinal anesthesia. Patients were randomized in a 1:1 ratio for either the "music" or "control" group. Both groups were compared for sedation requirements, preoperative and postoperative anxiety levels, and patient satisfaction.ResultsSubjects in the music group had a statistically significant lower than average State-Trait Anxiety Inventory (STAI)-State baseline score as compared to the control group (music group 31.00 (standard deviation (SD) 1.44), control group 38.04 (SD 2.35); p = 0.01). Postoperative STAI-State-Trait Anxiety Inventory (STAI)-State scores for the music group were lower for the music group than the control group (music group 28.34 (SD 1.64), control group 32.21 (SD 1.56), p= 0.09). STAI-Trait scores were similar pre-operatively, but significantly less post-operatively in the music group (28.14 SD 1.0) as compared to the control group (34.71 SD 2.31); p = 0.01. Propofol dose per kilogram per surgical minute was similar between the two groups (music group 0.05, control group 0.06; p= 0.264). Patient satisfaction scores with their perioperative experience were higher in the music group (p= 0.009).ConclusionsMusic therapy may be offered as an alternative to traditional anxiolytics intra-operatively. However further studies are warranted to evaluate whether or not music therapy can decrease sedation and anxiolytic medications during surgery. The type and mode of delivery of music also need to be studied to better understand the impact of music therapy.Clinical trial registry: Clinicaltrials.gov # NCT03569397

Highlights

Spinal anesthesia is being used more frequently for patients having knee arthroplasty because it is associated with better pain control, more stable vital signs, faster postoperative recovery, and fewer risks than general anesthesia [1]
Postoperative STAI-State-Trait Anxiety Inventory (STAI)-State scores for the music group were lower for the music group than the control group (music group 28.34 (SD 1.64), control group 32.21 (SD 1.56), p= 0.09)
Patient satisfaction scores with their perioperative experience were higher in the music group (p= 0.009)

Summary

Introduction

Spinal anesthesia is being used more frequently for patients having knee arthroplasty because it is associated with better pain control, more stable vital signs, faster postoperative recovery, and fewer risks than general anesthesia [1]. The operating room environment, especially for orthopedic procedures, and for joint replacement surgery, can be loud since hammers and drills are often used. The sound of an orthopedic oscillating saw can reach up to 105 decibels (db) which may cause some degree of noise-induced hearing loss [2]. How to cite this article Kukreja P, Talbott K, Macbeth L, et al (March 24, 2020) Effects of Music Therapy During Total Knee Arthroplasty Under Spinal Anesthesia: A Prospective Randomized Controlled Study.

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