Department of Pediatrics, University of Alberta, Edmonton, AB, Canada; Stollery Children's Hospital, Edmonton, AB, Canada.
Department of Pediatrics, University of Alberta, Edmonton, AB, Canada.
J Crit Care. 2019 Oct;53:75-80. doi: 10.1016/j.jcrc.2019.06.006. Epub 2019 Jun 4.
To systematically synthesize randomized controlled trial data on the efficacy of music to provide sedation and analgesia, and reduce incidence of delirium, in critically ill patients.
Relevant databases (Medline, PubMed, Embase, CINAHL, Cochrane, Alt Healthwatch, LILACS, PsycINFO, CAIRSS, RILM) were searched from inception to April 26, 2018. We also searched the reference lists of included publications and for ongoing trials. The selection of relevant articles was conducted by two researchers at two levels of screening. Data collection followed the recommendations from the Cochrane Systematic Reviews Handbook. We used the Cochrane Collaboration's tool for assessing risk of bias. Quality of the evidence was rated according to GRADE.
The review identified six adult studies and no neonatal or pediatric studies. A descriptive analysis of study results was performed. Meta-analysis was not feasible due to heterogeneity. One study reported a reduction in sedation requirements with the use of music while the other five did not find any significant differences across groups.
This systematic review revealed limited evidence to support or refute the use of music to reduce sedation/analgesia requirements, or to reduce delirium in critically ill adults, and no evidence in pediatric and neonatal critically ill patients.
系统综合随机对照试验数据，评估音乐在重症患者中的镇静和镇痛效果，以及降低谵妄发生率的作用。
从建库至 2018 年 4 月 26 日，检索相关数据库（Medline、PubMed、Embase、CINAHL、 Cochrane、Alt Healthwatch、LILACS、PsycINFO、CAIRSS、RILM）。我们还检索了纳入文献的参考文献列表和正在进行的试验。两名研究人员在两级筛查中对相关文章进行了选择。数据收集遵循 Cochrane 系统评价手册的建议。我们使用 Cochrane 协作组的偏倚风险评估工具。根据 GRADE 对证据质量进行评级。
综述确定了 6 项成人研究，没有新生儿或儿科研究。对研究结果进行了描述性分析。由于异质性，无法进行荟萃分析。一项研究报告称，使用音乐可减少镇静需求，而其他五项研究未发现组间有任何显著差异。
本系统综述结果表明，现有证据有限，无法支持或反驳音乐在重症成人中减少镇静/镇痛需求或降低谵妄发生率的作用，也没有儿科和新生儿重症患者的相关证据。
