The 95% Effective Duration of Music for Anxiolysis Before Elective Cesarean Delivery

Music can be used in the perioperative period as a nonpharmacological intervention to reduce anxiety, but how long it should be played to be effective is unknown. The goal of this study was to determine the 95% effective duration (ED95) of music of different subtypes for anxiolysis in parturients awaiting elective cesarean delivery. It was hypothesized that the overall ED95 would be <15 minutes and similar between music groups.

A prospective, randomized, biased coin study was conducted at a major academic institution. Consented parturients undergoing elective cesarean delivery were randomly assigned to one of 2 music groups: preselected Mozart sonatas or patient preference. Music duration began at 4 minutes and was subsequently increased, decreased, or kept the same based on the previous subject's response. Anxiety on a verbal scale of 0 to 10 and vital signs were compared pre-and postmusic. Successful intervention was defined as a decrease in anxiety by at least 1 point. Primary ED95 estimates with centered isotonic regressions (CIRs) were compared utilizing 83% confidence intervals (CI), while turning-point and simple means were compared with Student's t tests for sensitivity analysis.

A total of 57 pregnant women were approached and 40 agreed to participate. The mean age was 33 (standard deviation [SD] 5.1). Primary ED95 estimates by CIR were 6.8 (83% CI, 5.9-8.4) minutes and 6.7 (83% CI, 5.9-8.3) minutes for Mozart and personal preference music, respectively. Mean ED95 by CIR for any music type was 6.8 minutes. Mean immediate postintervention anxiety reduction with Mozart music was 1.7 (SD 1.4) and personal preference was 2.6 (SD 2.0). There were no significant changes in heart rate or blood pressure immediately after music.

Playing music for <7 minutes is a versatile, effective, and low-risk method for anxiolysis in women awaiting elective cesarean delivery.