Reza Nikandish, Ali Sahmedini Mohammad, Saeed Khademi, Abul-Qasim Avand, Reza Tabatabaee Hamid
Department of Anesthesia, Fasa Medical College, Fasa, Fars Province, Iran.
Middle East J Anaesthesiol. 2007 Oct;19(3):573-86.
The relief of post-cesarean delivery pain is important. Good pain relief improves mobility and reduces the risk of thromboembolic disease, which may have been increased during pregnancy. Pain may impair the mother's ability to optimally care for her infant in the immediate postpartum period and may adversely affect early interactions between mother and infant. It is necessary, therefore that pain relief be safe and effective and results in no adverse neonatal effects during breast-feeding. Music may be considered as a potential method of post cesarean pain therapy due to its noninvasiveness and lack of side effects. In this study we evaluated the effect of intraoperative music under general anesthesia for reducing the postoperative morphine requirements after cesarean section.
In a double blind placebo-controlled trial, 100 women (ASA I) scheduled for elective cesarean section under general anesthesia, were randomly allocated into two groups of fifty. After standardization of anesthesia, patients in the music group were exposed to a compact disk of Spanish guitar after induction of anesthesia up to the time of wound dressing. In the control group patients were exposed to white music. Post operative pain and anxiety were evaluated by visual analog scale (VAS) up to six hours after discharge from PACU. Morphine was given intravenously for reducing pain to VAS < or = 3 postoperatively.
There was not statistically significant difference in VAS for pain between two groups up to six hours postoperatively (P>0.05). In addition, morphine requirements were not different between two groups at different time intervals up to six hours postoperatively (P>0.05). There were not statistically significant difference between two groups regarding postoperative anxiety score and vomiting frequency (P>0.05).
As per conditions of this study, intraoperative Spanish music was not effective in reducing postoperative pain after cesarean section. In addition postoperative morphine requirement, anxiety, and vomiting were not affected by the music during general anesthesia.
剖宫产术后疼痛的缓解至关重要。良好的疼痛缓解可改善活动能力并降低血栓栓塞性疾病的风险，而在孕期这种风险可能已经增加。疼痛可能会损害母亲在产后即刻最佳照顾婴儿的能力，并可能对母婴早期互动产生不利影响。因此，疼痛缓解必须安全有效，且在母乳喂养期间不会对新生儿产生不良影响。由于音乐具有非侵入性且无副作用，可被视为剖宫产术后疼痛治疗的一种潜在方法。在本研究中，我们评估了全身麻醉下术中音乐对降低剖宫产术后吗啡需求量的效果。
在一项双盲安慰剂对照试验中，100例计划在全身麻醉下行择期剖宫产的妇女（ASA I级）被随机分为两组，每组50例。麻醉标准化后，音乐组患者在麻醉诱导后直至伤口包扎时播放一张西班牙吉他音乐光盘。对照组患者则播放白色噪音。通过视觉模拟评分法（VAS）评估术后疼痛和焦虑，直至患者从麻醉后恢复室（PACU）出院后6小时。术后静脉注射吗啡以将疼痛降至VAS≤3。
术后6小时内两组间疼痛的VAS评分无统计学显著差异（P>0.05）。此外，术后6小时内不同时间间隔两组间吗啡需求量也无差异（P>0.05）。两组间术后焦虑评分和呕吐频率无统计学显著差异（P>0.05）。
根据本研究的条件，术中西班牙音乐在降低剖宫产术后疼痛方面无效。此外，全身麻醉期间的音乐对术后吗啡需求量、焦虑和呕吐均无影响。
