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音乐干预对儿科人群疼痛的控制:一项系统评价与荟萃分析

Music Intervention for Pain Control in the Pediatric Population: A Systematic Review and Meta-Analysis.

作者信息

Ting Berne, Tsai Chia-Lin, Hsu Wei-Ti, Shen Mei-Ling, Tseng Ping-Tao, Chen Daniel Tzu-Li, Su Kuan-Pin, Jingling Li

机构信息

Ph.D. Program for Aging, College of Medicine, China Medical University, Taichung 404, Taiwan.

Mind-Body Interface Laboratory (MBI-Lab), China Medical University Hospital, Taichung 404, Taiwan.

出版信息

J Clin Med. 2022 Feb 14;11(4):991. doi: 10.3390/jcm11040991.

Abstract

Music intervention (MI) has been applied as an effective adjunctive treatment for pain control in various clinical settings. However, no meta-analysis has yet been published on the analgesic effects of MI in infants and children. We performed a systematic review of PubMed, EMBASE, Web of Science, and Cochrane Library databases to identify randomized controlled trials (RCTs) with the keywords "pain" AND "music therapy" from inception to January 2022. Primary outcomes were pain intensity and vital signs. Standardized mean difference (SMD) values and the corresponding 95% confidence intervals (CIs) were computed using a random effect model. Subgroup analyses with age groups, types of pain, and music styles were conducted. A total of 38 RCTs involving 5601 participants met the selection criteria. MI significantly decreased the pain levels (SMD = -0.57, < 0.001), both in the newborn group ( = 0.007) and in the infant/children group ( < 0.001). MI significantly reduced heart rate (SMD = -0.50, < 0.001) and respiratory rate (SMD = -0.60, = 0.002) and increased peripheral capillary oxygen saturation (SMD = 0.44, < 0.001). In subgroup analyses of types of pain, MI had significant effects on prick pain ( = 0.003), chronic and procedural pain ( < 0.001), and postoperative pain ( = 0.018). As for music styles, significant analgesic effects were observed for classical music ( < 0.001), kids' music ( < 0.001), and pop music ( = 0.001), but not for world music ( = 0.196), special composition ( = 0.092), and multiple music combinations ( = 0.420). In conclusion, our analysis provides supportive evidence about the efficacy of MI, especially classical, kids', and pop music, in controlling prick, procedural, and postoperative pain in the pediatric population.

摘要

音乐干预(MI)已被用作各种临床环境中控制疼痛的有效辅助治疗方法。然而,尚未发表关于MI对婴幼儿镇痛效果的荟萃分析。我们对PubMed、EMBASE、科学网和考克兰图书馆数据库进行了系统综述,以识别从数据库建立至2022年1月期间,关键词为“疼痛”和“音乐疗法”的随机对照试验(RCT)。主要结局指标为疼痛强度和生命体征。使用随机效应模型计算标准化均数差(SMD)值及相应的95%置信区间(CI)。进行了年龄组、疼痛类型和音乐风格的亚组分析。共有38项涉及5601名参与者的RCT符合入选标准。MI显著降低了疼痛水平(SMD = -0.57,P < 0.001),在新生儿组(P = 0.007)和婴幼儿组(P < 0.001)中均如此。MI显著降低了心率(SMD = -0.50,P < 0.001)和呼吸频率(SMD = -0.60,P = 0.002),并提高了外周毛细血管血氧饱和度(SMD = 0.44,P < 0.001)。在疼痛类型的亚组分析中,MI对刺痛(P = 0.003)、慢性和程序性疼痛(P < 0.001)以及术后疼痛(P = 0.018)有显著影响。至于音乐风格,古典音乐(P < 0.001)、儿童音乐(P < 0.001)和流行音乐(P = 0.001)观察到显著的镇痛效果,但世界音乐(P = 0.196)、特殊作曲(P = 0.092)和多种音乐组合(P = 0.420)则未观察到。总之,我们的分析为MI,尤其是古典音乐、儿童音乐和流行音乐,在控制儿科人群的刺痛、程序性疼痛和术后疼痛方面的疗效提供了支持性证据。

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