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节奏与骨科:音乐疗法在石膏室操作中的效果,一项前瞻性临床试验。

Rhythm and orthopedics: The effect of music therapy in cast room procedures, a prospective clinical trial.

作者信息

Tolunay Tolga, Bicici Vedat, Tolunay Hatice, Akkurt Mehmet Orcun, Arslan Arslan Kagan, Aydogdu Ali, Bingol Izzet

机构信息

Department of Orthopaedics, Yildirim Beyazit University Yenimahalle Training and Research Hospital, Yeni Batı Mah.2367.sokak No:4, Batıkent, Yenimahalle, 06370, Ankara, Turkey.

Department of Cardiology, Yildirim Beyazit University Yenimahalle Training and Research Hospital, Yeni Batı Mah.2367.sokak No:4, Batıkent, Yenimahalle, 06370, Ankara, Turkey.

出版信息

Injury. 2018 Mar;49(3):593-598. doi: 10.1016/j.injury.2018.02.008. Epub 2018 Feb 7.

Abstract

INTRODUCTION

Cast room procedures generally cause anxiety in patients. Anxiety complicates the procedure as well as increases the risk of a complication. Listening to music was found to be the safest and most common non-drug treatment method. The aim of this study is to evaluate the effect of listening to music on adult patients in cast room procedures. This study points out the relation between anxiety and anxiety relevant cardiac arrhythmia.

MATERIALS AND METHODS

The study was performed on 199 patients with stable general condition, aged above 18. The patients were divided into two groups. Randomization method used in the study was coin flip. The first group (Group 1) listened to music during cast room procedures whereby the second group (Group 2) did not listen to music. Length of the procedure, complication, blood pressure and heart rate evaluations before and after the procedure, Visual Analogue Scale (VAS scores for pain), State-Trait Anxiety Inventory (STAI) anxiety score, patient satisfaction, willingness of the patient to repeat the procedure, P wave dispersion (Pd) and corrected QT interval dispersion (QTcd) as electrocardiographic arrhythmia predictors were evaluated. The Clinical Research Ethics Committee approval was obtained for this study.

RESULTS

Significant difference was shown between the two groups for the following criteria: VAS scores (p = 0.005), anxiety scores (p = 0.032), processing time (p = 0.027), and QTcd values (p = 0.031). Patient satisfaction (p < 0.001) and willingness to repeat the procedure (p < 0.001) were higher for the group who listened to music. No significant difference in Pd values, blood pressure and heart rate was reported within the groups.

CONCLUSION

Music therapy is a non-invasive, safe, nonpharmacologic, anxiolytic, and analgesic treatment. Music therapy should become standard protocol in cast room procedures. One of the most important achievements of this study was the fact that music decreases anxiety and anxiety-related cardiac arrhythmia. Therefore, conducting further prospective studies including high cardiac risk patients especially with arrhythmia is crucial.

摘要

引言

石膏固定室的操作通常会使患者产生焦虑情绪。焦虑会使操作变得复杂,同时增加并发症的风险。听音乐被认为是最安全、最常见的非药物治疗方法。本研究的目的是评估听音乐对石膏固定室成年患者的影响。本研究指出了焦虑与焦虑相关心律失常之间的关系。

材料与方法

本研究对199例18岁以上一般情况稳定的患者进行。患者被分为两组。研究中使用的随机化方法是抛硬币。第一组(第1组)在石膏固定室操作期间听音乐,而第二组(第2组)不听音乐。评估操作时间、并发症、操作前后的血压和心率、视觉模拟量表(疼痛的VAS评分)、状态-特质焦虑量表(STAI)焦虑评分、患者满意度、患者重复该操作的意愿、作为心电图心律失常预测指标的P波离散度(Pd)和校正QT间期离散度(QTcd)。本研究获得了临床研究伦理委员会的批准。

结果

两组在以下标准上存在显著差异:VAS评分(p = 0.005)、焦虑评分(p = 0.032)、处理时间(p = 0.027)和QTcd值(p = 0.031)。听音乐组的患者满意度(p < 0.001)和重复该操作的意愿(p < 0.001)更高。组内Pd值、血压和心率无显著差异。

结论

音乐疗法是一种非侵入性、安全、非药物性的抗焦虑和镇痛治疗方法。音乐疗法应成为石膏固定室操作的标准方案。本研究最重要的成果之一是音乐可降低焦虑和与焦虑相关的心律失常。因此,开展进一步的前瞻性研究,尤其是纳入高心脏风险患者,特别是有心律失常的患者,至关重要。

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