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The Effects of Perioperative Music Interventions in Pediatric Surgery: A Systematic Review and Meta-Analysis of
Marianne J E van der Heijden1, Sadaf Oliai Araghi2, Monique van Dijk3
1Department of Pediatrics, Erasmus MC, Rotterdam, the Netherlands.
Insights
Music interventions significantly reduce pain, anxiety, and distress in children after surgery. This systematic review suggests music therapy can be considered for clinical use in pediatric surgical care.
Area of Science:
- Pediatric Surgery
- Anesthesiology
- Music Therapy
Background:
- Music interventions are commonly used but not yet standard in pediatric surgical guidelines.
- The impact of music on pediatric surgical patients' well-being requires systematic evaluation.
Purpose of the Study:
- To systematically review and meta-analyze the effects of music interventions on pain, anxiety, and distress in children undergoing surgery.
- To assess the potential of music therapy as a clinical tool in pediatric surgical care.
Main Methods:
- Systematic review and meta-analysis of randomized controlled trials (RCTs) published up to October 2014.
- Searched 25 electronic databases for studies involving pediatric patients (1 month to 18 years) undergoing surgery, receiving live or recorded music.
- Included three RCTs with 196 patients, assessing pain and anxiety using validated scales.
Main Results:
- Music interventions demonstrated a statistically significant positive effect on reducing postoperative pain (SMD -1.07).
- Significant reductions were also observed in anxiety and distress levels (SMD -0.34 and -0.50).
- The included studies covered orthopedic, cardiac, and day surgery patients.
Conclusions:
- Music interventions show a statistically significant effect in alleviating postoperative pain, anxiety, and distress in pediatric surgical patients.
- Findings support the consideration of music therapy for clinical application in pediatric surgical settings.
- Further research may solidify music's role in enhancing recovery and patient experience.
Objective:
Music interventions are widely used, but have not yet gained a place in guidelines for pediatric surgery or pediatric anesthesia. In this systematic review and meta-analysis we examined the effects of music interventions on pain, anxiety and distress in children undergoing invasive surgery.
Data Sources:
We searched 25 electronic databases from their first available date until October 2014.
Study Selection:
Included were all randomized controlled trials with a parallel group, crossover or cluster design that included pediatric patients from 1 month to 18 years old undergoing minimally invasive or invasive surgical procedures, and receiving either live music therapy or recorded music.
Data Extraction And Synthesis:
4846 records were retrieved from the searches, 26 full text reports were evaluated and data was extracted by two independent investigators.
Main Outcome Measures:
Pain was measured with the Visual Analogue Scale, the Coloured Analogue Scale and the Facial Pain Scale. Anxiety and distress were measured with an emotional index scale (not validated), the Spielberger short State Trait Anxiety Inventory and a Facial Affective Scale.
Results:
Three RCTs were eligible for inclusion encompassing 196 orthopedic, cardiac and day surgery patients (age of 1 day to 18 years) receiving either live music therapy or recorded music. Overall a statistically significant positive effect was demonstrated on postoperative pain (SMD -1.07; 95%CI-2.08; -0.07) and on anxiety and distress (SMD -0.34 95% CI -0.66; -0.01 and SMD -0.50; 95% CI -0.84; - 0.16.
Conclusions And Relevance:
This systematic review and meta-analysis indicates that music interventions may have a statistically significant effect in reducing post-operative pain, anxiety and distress in children undergoing a surgical procedure. Evidence from this review and other reviews suggests music therapy may be considered for clinical use.
