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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.

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