Pediatric Anesthesia: New Research Results

Very interesting study done using music with pediatric surgery patients. School-aged children's experiences of postoperative music medicine on pain, distress, and anxiety STEFAN NILSSON RN, MSC*†, EVA KOKINSKY MD, PhD*, ULRICA NILSSON RNA, PhD‡, BIRGITTA SIDENVALL RN, PhD† AND KARIN ENSKÄR RN, PhD† *Department of Paediatric Anaesthesia and Intensive Care Unit, The Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Göteborg , †Department of Nursing Science, School of Health Sciences, Jönköping University, Jönköping and ‡Department of Anaesthesiology and Intensive Care and Centre for Health Care Sciences, Örebro University Hospital, Örebro, Sweden Correspondence to Stefan Nilsson, Department of Paediatric Anaesthesia and Intensive Care Unit, The Queen Silvia Children's Hospital, Sahlgrenska University Hospital, 416 85 Göteborg, Sweden (email: stefan.r.nilsson@vgregion.se). ABSTRACT Aim: To test whether postoperative music listening reduces morphine consumption and influence pain, distress, and anxiety after day surgery and to describe the experience of postoperative music listening in school-aged children who had undergone day surgery. Background: Music medicine has been proposed to reduce distress, anxiety, and pain. There has been no other study that evaluates effects of music medicine (MusiCure®) in children after minor surgery. Methods: Numbers of participants who required analgesics, individual doses, objective pain scores (Face, Legs, Activity, Cry, Consolability [FLACC]), vital signs, and administration of anti-emetics were documented during postoperative recovery stay. Self-reported pain (Coloured Analogue Scale [CAS]), distress (Facial Affective Scale [FAS]), and anxiety (short State-Trait Anxiety Inventory [STAI]) were recorded before and after surgery. In conjunction with the completed intervention semi-structured qualitative interviews were conducted. Results: Data were recorded from 80 children aged 7–16. Forty participants were randomized to music medicine and another 40 participants to a control group. We found evidence that children in the music group received less morphine in the postoperative care unit, 1/40 compared to 9/40 in the control group. Children's individual FAS scores were reduced but no other significant differences between the two groups concerning FAS, CAS, FLACC, short STAI, and vital signs were shown. Children experienced the music as 'calming and relaxing.' Conclusions: Music medicine reduced the requirement of morphine and decreased the distress after minor surgery but did not else influence the postoperative care.

Music Before Surgery Proven Effective

Yet another medical research study has come out documenting that listening to calm, relaxing music before surgery can calm the patient better than powerful midazolam. Time to order those pre-surgery headphones: www.surgicalheadphones.com. Introduction: Patients who await surgery often suffer from fear and anxiety, which can be prevented by anxiolytic drugs. Relaxing music may be an alternative treatment with fewer adverse effects. This randomised clinical trial compared pre-operative midazolam with relaxing music. Method: Three hundred and seventy-two patients scheduled for elective surgery were randomised to receive pre-operative prevention of anxiety by 0.05–0.1 mg/kg of midazolam orally or by relaxing music. The main outcome measure was the State Trait Anxiety Inventory (STAI X-1), which was completed by the patients just before and after the intervention. Results: Of the 177 patients who completed the music protocol, the mean and (standard deviation) STAI-state anxiety scores were 34 (8) before and 30 (7) after the intervention. The corresponding scores for the 150 patients in the midazolam group were 36 (8) before and 34 (7) after the intervention. The decline in the STAI-state anxiety score was significantly greater in the music group compared with the midazolam group (P<0.001, 95% confidence interval range −3.8 to −1.8). Conclusion: Relaxing music decreases the level of anxiety in a pre-operative setting to a greater extent than orally administrated midazolam. Higher effectiveness and absence of apparent adverse effects makes pre-operative relaxing music a useful alternative to midazolam for pre-medication. Relaxing music as pre-medication before surgery: a randomised controlled trial H. BRINGMAN 1 , K. GIESECKE 2,3 , A. THÖRNE 1,3 and S. BRINGMAN 1,3 1 Department of Surgery, 2 Department of Anaesthesia, Södertälje Hospital, SE-152 86 Södertälje, Sweden and 3 Department of Clinical Science, Intervention and Technology Karolinska Institutet, Karolinska University Hospital, Huddinge, SE-141 86 Stockholm, Sweden Correspondence to Address: Sven Bringman Department of Surgery Södertälje Hospital SE-152 86 Södertälje Sweden e-mail: sven.bringman@ki.se This paper was presented as an oral presentation at the Swedish Surgical Week, Umeå, August 2008.