Listening to music preoperatively significantly benefits patients during cataract surgery
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Twenty minutes of music, administered via a web-based application to patients before cataract surgery, significantly decreased hypertension episodes, heart rate, anxiety levels and need for sedative drugs, according to a study.
“We should further evaluate the feasibility of this approach in the context of a busy surgical practice, but the advantages of a non-pharmacological intervention to reduce anxiety in our patients are noticeable for surgery at large, not just cataract,” Gilles Guerrier, MD, PhD, said in an interview with Healio/OSN.
The study included 311 patients undergoing first-eye cataract surgery at Cochin Hospital in Paris. Half of the patients were randomly assigned to a group that listened to a 20-minute music session before surgery using the Music Care web app with the “U sequence” technique, which is designed to gradually relax the listener through specific sequences of rhythms and sound volumes. The other half were given the same insulating headphones with no music. The musical intervention was stopped just before surgery.
The difference between the two groups was significant.
“During surgery, the incidence of hypertensive events was significantly lower in the music arm, occurring in 21 patients (13.6%) as compared with 82 (52.9%) in the control arm. Heart rate levels were also lower, and anxiety levels, measured immediately before surgery using the visual analogue scale for anxiety, were 1.4 and 3.1 in the music and control arms, respectively. In addition, a reduction in the number of drugs injected to reduce anxiety or hypertension during the procedure was reported, and surgical time was, on average, shorter,” Guerrier said.
The magic of music
Anxiety is a problem for most patients undergoing surgery. Anxious patients can be demanding to the nursing staff before the operation, and finding the time to manage them may be difficult in a busy surgical practice. Anxiety may also be the cause of intraoperative complications related to increased heart rate and blood pressure or to head movements.
“You need very relaxed patients for awake surgery, particularly when it is in the eye,” Guerrier said. “We also know that the less anxious patients are, the better the outcomes of surgery will be. During surgery, they require fewer sedative drugs and less anesthetics, and after surgery, they experience less pain and have a smoother postoperative course.”
Music has a beneficial effect on brain chemicals, increases happiness and reduces anxiety.
“We have known this since the time of the ancient Greeks, and the effect is long lasting, as we have shown in our study. We stopped the music interventions before surgery, but the relaxation response lasted during the entire operation,” Guerrier said.
Several patients who participated in the study for their first eye asked to have music again when going back for the second eye.
“‘Where’s the music?’ they asked and were quite disappointed when we said there was not going to be any music this time,” Guerrier said.
Further studies will be necessary to assess how this kind of music intervention affects preoperative workflow, costs and time.
For more information:
Gilles Guerrier, MD, PhD, can be reached at Hôpital Cochin, Department of Anesthesia and Intensive Care, 27 rue du Faubourg Saint-Jacques, 75014 Paris, France; email: gilles.guerrier@aphp.fr.
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Guerrier G, et al. JAMA Ophthalmol. 2021;doi:10.1001/jamaophthalmol.2021.2767.
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