Graff Veena, Cai Lu, Badiola Ignacio, Elkassabany Nabil M
Anesthesiology & Critical Care, University of Pennsylvania, Philadelphia, Pennsylvania, USA
Anesthesiology & Critical Care, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Reg Anesth Pain Med. 2019 Jul 18. doi: 10.1136/rapm-2018-100251.
Music medicine is a non-pharmacologic intervention that is virtually harm-free, relatively inexpensive and has been shown to significantly decrease preoperative anxiety. In this study we aim to compare the use of music to midazolam as a preoperative anxiolytic prior to the administration of an ultrasound-guided single-injection peripheral nerve block.
In this randomized controlled study we compared the anxiolytic effects of intravenous midazolam (1-2 mg) with noise-canceling headphone-delivered music medicine. All patients received a preoperative ultrasound-guided single-injection peripheral nerve block indicated for a primary regional anesthetic or postoperative analgesia.
The change in the State Trait Anxiety Inventory-6 (STAI-6) anxiety scores from after to before the procedure were similar in both groups (music group -1.6 (SD 10.7); midazolam group -4.2 (SD 11); p=0.14; mean difference between groups -2.5 (95% CI -5.9 to 0.9), p=0.1). Patient satisfaction scores with their procedure experience were higher in the midazolam group (p=0.01); however, there were no differences in physician satisfaction scores of their procedure experience between groups (p=0.07). Both patient and physician perceptions on difficulties in communication were higher in the music group than in the midazolam group (p=0.005 and p=0.0007, respectively).
Music medicine may be offered as an alternative to midazolam administration prior to peripheral regional anesthesia. However, further studies are warranted to evaluate whether or not the type of music, as well as how it is delivered, offers advantages over midazolam that outweigh the increase in communication barriers.
Clinicaltrials.gov #NCT03069677.
音乐疗法是一种几乎无伤害、成本相对较低的非药物干预措施，已证实其能显著减轻术前焦虑。本研究旨在比较在超声引导下单次注射外周神经阻滞前，使用音乐与咪达唑仑作为术前抗焦虑药物的效果。
在这项随机对照研究中，我们比较了静脉注射咪达唑仑（1 - 2毫克）与通过降噪耳机播放音乐疗法的抗焦虑效果。所有患者均接受术前超声引导下单次注射外周神经阻滞，用于主要区域麻醉或术后镇痛。
两组患者在手术前后状态 - 特质焦虑量表 - 6（STAI - 6）焦虑评分的变化相似（音乐组 -1.6（标准差10.7）；咪达唑仑组 -4.2（标准差11）；p = 0.14；组间平均差异 -2.5（95%置信区间 -5.9至0.9），p = 0.1）。咪达唑仑组患者对手术体验的满意度评分更高（p = 0.01）；然而，两组医生对手术体验的满意度评分没有差异（p = 0.07）。音乐组患者和医生对沟通困难的感知均高于咪达唑仑组（分别为p = 0.005和p = 0.0007）。
在进行外周区域麻醉前，音乐疗法可作为咪达唑仑给药的替代方法。然而，需要进一步研究以评估音乐的类型及其播放方式是否具有优于咪达唑仑的优势，且这种优势是否能超过沟通障碍的增加。
Clinicaltrials.gov #NCT03069677
