Muziek vermindert angst en pijn rond operaties*

Systematische review en meta-analyse
Onderzoek
13-11-2018
A.Y. Rosalie Kühlmann, Leonard F. Kroese en J. (Hans) Jeekel

Music reduces anxiety and pain perioperatively: a systematic review and meta-analysis

Objective

To investigate the effects of music interventions on anxiety and pain perioperatively. This is a secondary version of a previous publication in The British Journal of Surgery, ( 2018;105:773-83).

Methods

We searched eleven electronic databases for full-text publications of RCTs investigating the effect of music interventions on anxiety and pain during invasive surgery. Articles published between 1 January 1980 and 20 October 2016 were double-screened independently, and when eligible, followed by double-data extraction independently. Random-effects meta-analysis was used to calculate effect sizes as standardized mean differences (SMDs). Heterogeneity was investigated in subgroup analyses and metaregression analyses. The review was registered in the PROSPERO database as CRD42016024921.

Results

Ninety-two RCTs (7385 patients) were included in the systematic review, of which 81 were included in the meta-analysis. Music interventions significantly decreased anxiety (SMD -0.69; 95% CI -0.88 to -0.50) and pain (SMD -0.50; 95% CI -0.66 to -0.34) compared with controls, equivalent to a decrease of 21 mm for anxiety and 10 mm for pain on a 100-mm visual analogue scale. Changes in outcome corrected for baseline were even larger: SMD -1.41 (95% CI -1.89 to -0.94) for anxiety and -0.54 (95% CI -0.93 to -0.15) for pain. Music interventions provided during general anaesthesia significantly decreased pain compared with that in controls (SMD -0.41; 95% CI -0.64 to -0.18). Metaregression analysis found no significant association between the effect of music interventions and age, sex, choice and timing of music, and type of anaesthesia, but there was an effect of preoperative music interventions on postoperative pain. Risk of bias in the studies was moderate to high.

Conclusion

Music interventions significantly reduce anxiety and pain in adult surgical patients.

Conflict of interest and financial support: ICMJE forms provided by the authors are available online along with the full text of this article. This is a secondary version of a publication in British Journal of Surgery , 2018;105:773-83. The authors received permission from BritishJournal of Surgery as well as from Wiley and Sons to publish this secondary version. The primary publication in British Journal of Surgery was funded by Stichting Coolsingel, Rotterdam, and Stichting Swart-van Essen, Rotterdam, The Netherlands.