Department of Surgery, Randers Region Hospital, Randers, Denmark.
Acta Anaesthesiol Scand. 2013 Sep;57(8):1010-6. doi: 10.1111/aas.12100. Epub 2013 Mar 18.
Acute post-operative pain is a predictor in the development of chronic pain after laparoscopic cholecystectomy. Music has been shown to reduce surgical stress. In a randomized, clinical trial, we wanted to test the hypothesis that perioperative and post-operative soft music reduces pain, nausea, fatigue and surgical stress in patients undergoing laparoscopic cholecystectomy as day surgery.
The study was performed in otherwise healthy Danish patients eligible for day surgery. Ninety-three patients were included and randomized to either soft music or no music perioperatively and post-operatively. Using visual analog score pain, nausea and fatigue at baseline, 1 h, 3 h, 1 day and 7 days after surgery were recorded. C-reactive protein and cortisol were sampled before and after surgery.
Music did not lower pain 3 h after surgery, which was the main outcome. The music group had less pain day 7 (P = 0.014). Nausea was low in both groups and was not affected by music. The music group experienced less fatigue at day 1 (P = 0.042) and day 7 (P = 0.015). Cortisol levels decreased during surgery in the music group (428.5-348.0 nmol/l), while it increased in the non-music group (443.5-512.0 nmol/l); still, the difference between the two groups were only significant using general linear models as post-hoc analysis. Soft music did not affect C-reactive protein levels.
Soft music did not reduce pain 3 h after laparoscopic cholecystectomy. Soft music may reduce later post-operative pain and fatigue by decreasing the surgical stress response.
急性术后疼痛是腹腔镜胆囊切除术后慢性疼痛发展的预测因素。音乐已被证明可减轻手术应激。在一项随机临床试验中,我们想验证假设,即围手术期和术后播放柔和的音乐可减轻行日间手术的腹腔镜胆囊切除术后患者的疼痛、恶心、疲劳和手术应激。
该研究在适合日间手术的丹麦健康患者中进行。纳入 93 例患者,并随机分为围手术期和术后接受柔和音乐或无音乐组。使用视觉模拟评分法记录基线、术后 1 h、3 h、1 天和 7 天的疼痛、恶心和疲劳。术前和术后采集 C 反应蛋白和皮质醇样本。
音乐并未降低术后 3 h 的主要结局疼痛。音乐组在第 7 天的疼痛程度较低(P=0.014)。两组恶心程度均较低,音乐对其无影响。音乐组在术后第 1 天(P=0.042)和第 7 天(P=0.015)的疲劳程度较低。音乐组的皮质醇水平在手术期间下降(428.5-348.0 nmol/l),而无音乐组的皮质醇水平升高(443.5-512.0 nmol/l);然而,仅在使用一般线性模型作为事后分析时,两组之间的差异才有统计学意义。柔和音乐并未影响 C 反应蛋白水平。
音乐并不能降低腹腔镜胆囊切除术后 3 h 的疼痛。柔和音乐可能通过降低手术应激反应,减轻术后晚期疼痛和疲劳。