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Interactive music therapy as a treatment for preoperative anxiety in children: a randomized controlled trial
Zeev N Kain1, Alison A Caldwell-Andrews, Dawn M Krivutza
1Department of Anesthesiology, Yale University School of Medicine, New Haven, Connecticut 06510, USA. kain@biomed.med.yale.edu
Insights
Interactive music therapy did not reduce preinduction anxiety in children undergoing surgery. Midazolam was more effective than music therapy or placebo in reducing anxiety during anesthesia induction.
Area of Science:
- Pediatric Anesthesiology
- Child Psychology
- Complementary Therapies
Background:
- Preinduction anxiety is common in children undergoing surgery.
- Effective anxiety management strategies are crucial for pediatric patients.
- Interactive music therapy is explored as a non-pharmacological intervention.
Purpose of the Study:
- To evaluate the effectiveness of interactive music therapy in reducing preinduction anxiety in children.
- To compare music therapy with midazolam and a control group for perioperative anxiety.
Main Methods:
- Randomized controlled trial involving children undergoing outpatient surgery.
- Three groups: interactive music therapy (n=51), oral midazolam (n=34), and control (n=38).
- Primary outcome: children's perioperative anxiety, assessed during anesthesia induction, separation, and entrance to the operating room.
Main Results:
- Midazolam significantly reduced anxiety during anesthesia induction compared to music therapy and control groups.
- No significant difference in anxiety during anesthesia induction between music therapy and control groups.
- A therapist effect was noted, with some therapists showing reduced anxiety during separation and OR entrance, but midazolam remained superior.
Conclusions:
- Interactive music therapy may offer benefits for anxiety during separation and OR entrance, contingent on the therapist.
- Music therapy was not effective in reducing anxiety during the critical phase of anesthesia induction.
- Midazolam demonstrated superior anxiolytic effects compared to music therapy in this pediatric surgical population.
Unlabelled:
In this study, we examined whether interactive music therapy is an effective treatment for preinduction anxiety. Children undergoing outpatient surgery were randomized to 3 groups: interactive music therapy (n = 51), oral midazolam (n = 34), or control (n = 38). The primary outcome of the study was children's perioperative anxiety. We found that children who received midazolam were significantly less anxious during the induction of anesthesia than children in the music therapy and control groups (P = 0.015 and P = 0.005, respectively). We found no difference in anxiety during the induction of anesthesia between children in the music therapy group and children in the control group. An analysis controlling for therapist revealed a significant therapist effect; i.e., children treated by one of the therapists were significantly less anxious than children in the other therapist group and the control group on separation to the operating room (OR) (P < 0.05) and on entrance to the OR (P < 0.05), but not on the introduction of the anesthesia mask (P = not significant). Children in the midazolam group were the least anxious even after controlling for therapist effect (P < 0.05). We conclude that music therapy may be helpful on separation and entrance to the OR, depending on the therapist. However, music therapy does not appear to relieve anxiety during the induction of anesthesia.
Implications:
Depending on the music therapist, interactive music therapy may relieve anxiety on separation and entrance to the operating room but appears less effective during the induction of anesthesia.