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AMBULATORY ANESTHESIA

Music and Preoperative Anxiety: A Randomized, Controlled Study

Shu-Ming Wang, MD^*, Lina Kulkarni, MD, Jackqulin Dolev, MD, and Zeev N. Kain, MD

Departments of *Anesthesiology, Pediatrics, and Child Psychiatry, Yale University School of Medicine, New Haven, Connecticut; and Department of Internal Medicine, Stanford University School of Medicine, Palo Alto, California

Address correspondence and reprint requests to Zeev N. Kain, MD, Department of Anesthesiology, Yale School of Medicine, 333 Cedar St., New Haven, CT 06510. Address e-mail to kain{at}biomed med.yale.edu.

Music may decrease the anxiety experienced by patients before surgery. Previous studies of this issue were hindered with multiple methodological problems. In this investigation, we examined this hypothesis while using a rigorous study design and objective outcome measures. Adult patients undergoing anesthesia and surgery were randomly assigned to two study groups. Subjects in Group 1 (n = 48) listened to a 30-min patient-selected music session, and subjects in Group 2 (n = 45) received no intervention. By using self-report validated behavioral (State-Trait Anxiety Inventory) and physiological measures of anxiety (heart rate, blood pressure, and electrodermal activity and serum cortisol, epinephrine, and norepinephrine), patients were evaluated before, during, and after administration of the intervention. We found that after intervention, subjects in the Music group reported significantly lower anxiety levels as compared with the Control group (F_1,91 = 15.4, P = 0.001). That is, the postintervention anxiety level of subjects in the Music group decreased by 16% as compared with the preintervention level, whereas the anxiety level of the Control group did not change significantly. Two-way repeated-measures analysis of variance performed for the electrodermal activity, blood pressure, heart rate, cortisol, and catecholamine data demonstrated no group difference and no time x group interaction (P = not significant). In conclusion, under the conditions of this study, patients who listened to music before surgery reported lower levels of state anxiety. Physiological outcomes did not differ, however, between the two study groups.

IMPLICATIONS: Patients who listen to music of their choice during the preoperative period report less anxiety.

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