Live Interactive Music Therapy Across the Perioperative Continuum: A Scoping Review

Music therapy is a nonpharmacologic, patient-centered intervention increasingly used in perioperative settings to improve the surgical experience for patients and their families. Despite growing evidence, music therapy's integration into anesthesia care remains variable, highlighting a need to synthesize the current landscape of music therapy in this clinical context. This scoping review aimed to map the primary characteristics and impacts of live interactive music therapy delivered by a certified music therapist across the perioperative continuum and identify gaps in the literature to guide future research and practice in perioperative settings. Following PRISMA-ScR guidance, database searches were conducted October 2024 to June 2025 using key medical subject headings (MeSH) terms. Inclusion criteria specified (1) live or recorded music therapy delivered by a certified music therapist and (2) intervention timing within 24 hours pre- to 72 hours post-operation. The initial search yielded 2095 articles. After abstract screening, 1049 remained and underwent full-text review. 25 articles met criteria and were included in data extraction. The 25 articles included 1821 patients aged 9-months- to 94-years-old across diverse surgical specialties. Music therapy was delivered preoperatively (n = 17), intraoperatively (n = 8), and postoperatively (n = 15), with inclusion of flexible and protocolized approaches. Pediatric music therapy was more frequently delivered preoperatively, emphasizing play-based, active engagement. Adult music therapy was more evenly distributed across perioperative timepoints, emphasizing introspective, emotion-focused approaches. Selected outcome measures reflected these differences, with pediatric effects captured through behavioral observation (e.g, modified-Yale Perioperative Anxiety Scale [m-YPAS]), whereas adult outcomes relied more heavily on self-reporting (eg, visual analog scale [VAS]). Postoperatively, pediatric and adult music therapy approaches were more aligned across age groups given both used relaxation-based approaches. Perioperative music therapy is a feasible, low-risk adjunct that may complement existing pharmacologic strategies to support anxiety, mood, and pain with minimal interruption to patient care for teams with access to this resource. Limitations including small sample sizes, expectancy effects, inconsistent music therapy intervention reporting, and lack of therapist-contact controls prompt cautious interpretation. Future research should explore intraoperative delivery logistics, dose-response relationships, integration of multimodal outcomes, and anesthesia team perspectives to guide practical integration of music therapy into the anesthesia armamentarium.