Original Article
The Effect of Music on Postoperative Pain and Anxiety

https://doi.org/10.1016/j.pmn.2008.12.002Get rights and content

Abstract

The purpose of this study was to determine if listening to music or having a quiet rest period just before and just after the first ambulation on postoperative day 1 can reduce pain and/or anxiety or affect mean arterial pressure, heart rate, respiratory rate, and/or oxygen saturation in patients who underwent a total knee arthroplasty. Fifty-six patients having a total knee arthroplasty were randomly assigned to either a music intervention group or a quiet rest group. A visual analog scale was used to measure pain and anxiety. Physiologic measures, including blood pressure, heart rate, oxygen saturation, and respiratory rate, were also obtained. Statistical findings between groups indicated that the music group's decrease in pain and anxiety was not significantly different from the comparison rest group's decrease in pain (F = 1.120; p = .337) or anxiety (F = 1.566; p = .206) at any measurement point. However, statistical findings within groups indicated that the sample had a statistically significant decrease in pain (F = 6.699; p = .001) and anxiety (F = 4.08; p = .013) over time. Results of this research provide evidence to support the use of music and/or a quiet rest period to decrease pain and anxiety. The interventions pose no risks and have the benefits of improved pain reports and decreased anxiety. It potentially could be opioid sparing in some individuals, limiting the negative effects from opioids. Nurses can offer music as an intervention to decrease pain and anxiety in this patient population with confidence, knowing there is evidence to support its efficacy.

Section snippets

Study Design

An experimental design was used to examine the effects of music and/or a quiet rest period on postoperative pain, anxiety, and physiologic parameters on postoperative day 1. The study was approved by the Institutional Review Boards at the University of Central Florida and Florida Hospital.

Sample and Setting

This study was conducted on a 32-bed orthopedic unit in a hospital in central Florida that performed 727 total knee replacements in 2007. The subjects consisted of all patients who were scheduled for a TKA

Demographic Data

A total of 56 patients participated in the study (25 men, 31 women; mean age 63.89 years, range 46-84 years). No significant differences were found between the comparative rest group and the experimental group regarding any of the demographic characteristics, including gender, age, ethnicity, or education (Table 3). Table 4 describes clinical characteristics of the sample. No significant differences were found between the two groups on any of the clinical characteristics.

Research Question 1: Music and Pain

The mean pain scores

Discussion

The difference in pain and anxiety scores between the music intervention group and the quiet rest group was not statistically significant. These findings differ from those reported by Voss et al. (2004), in which the effects of music and a rest period on pain and anxiety were examined. Voss et al. (2004) found a statistical difference in pain and anxiety scores between subjects in the music group and subjects in the rest group during chair rest in a sample of cardiac surgical patients.

Conclusions

In conclusion, the results of this study provide evidence that pain and anxiety are reduced while listening to music or having a rest period when initiated just before and just after the first ambulation after a TKA. Additionally, the study found that, overwhelmingly, patients enjoyed the music, reporting that the music helped them to forget about their pain for a while and improved their general mood. Use of this intervention could be implemented into the routine plan of care for patients with

Acknowledgements

The authors are grateful for the support of M. Lindell Joseph PhD, RN and the Center for Nursing Research and Innovation at Florida Hospital. The authors also thank the nurses and physical therapists on the orthopedic unit where this study was conducted and the team in preadmission testing where consenting of participants took place.

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