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PEDIATRIC ANESTHESIA

Interactive Music Therapy as a Treatment for Preoperative Anxiety in Children: A Randomized Controlled Trial

Zeev N. Kain, MD MBA^*,,, Alison A. Caldwell-Andrews, PhD^*, Dawn M. Krivutza^*, Megan E. Weinberg, MA^*, Dorothy Gaal, MD^*, Shu-Ming Wang, MD^*, and Linda C. Mayes, MD^,

Departments of *Anesthesiology, Pediatrics, and Child Psychiatry, Yale University School of Medicine, New Haven, Connecticut

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

In this study, we examined whether interactive music therapy is an effective treatment for preinduction anxiety. Children undergoing outpatient surgery were randomized to 3 groups: interactive music therapy (n = 51), oral midazolam (n = 34), or control (n = 38). The primary outcome of the study was children’s perioperative anxiety. We found that children who received midazolam were significantly less anxious during the induction of anesthesia than children in the music therapy and control groups (P = 0.015 and P = 0.005, respectively). We found no difference in anxiety during the induction of anesthesia between children in the music therapy group and children in the control group. An analysis controlling for therapist revealed a significant therapist effect; i.e., children treated by one of the therapists were significantly less anxious than children in the other therapist group and the control group on separation to the operating room (OR) (P < 0.05) and on entrance to the OR (P < 0.05), but not on the introduction of the anesthesia mask (P = not significant). Children in the midazolam group were the least anxious even after controlling for therapist effect (P < 0.05). We conclude that music therapy may be helpful on separation and entrance to the OR, depending on the therapist. However, music therapy does not appear to relieve anxiety during the induction of anesthesia.

IMPLICATIONS: Depending on the music therapist, interactive music therapy may relieve anxiety on separation and entrance to the operating room but appears less effective during the induction of anesthesia.

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