Billar Ryan, Kappen Pablo, Mohammadian Sepehr, van den Berg Corinne, de Rijke Yolanda, van den Akker Erica, van Rosmalen Joost, Schnater J Marco, Vincent Arnaud, Dirven Clemens, Klimek Markus, Wijnen René, Jeekel Johannes, Huygen Frank, Tiemensma Jitske
Department of Pediatric Surgery, Erasmus Medical Center - Sophia Children's Hospital, Rotterdam, the Netherlands.
Department of Neurosurgery, Erasmus Medical Center, Rotterdam, the Netherlands.
Complement Ther Med. 2023 Oct;77:102969. doi: 10.1016/j.ctim.2023.102969. Epub 2023 Aug 12.
Clarifying the effect of music on pain endurance in an experimental design could aid in how music should be applied during both surgical and non-surgical interventions. This study aims to investigate the effect of music on pain endurance and the involvement of the sympathetic adrenomedullary axis (SAM) and the hypothalamic-pituitary-adrenocortical axis (HPA).
In this randomized controlled trial all participants received increasing electric stimuli through their non-dominant index finger. Participants were randomly assigned to the music group (M) receiving a 20-minute music intervention or control group (C) receiving a 20-minute resting period. The primary outcome was pain endurance, defined as amount milliampere tolerated. Secondary outcomes included anxiety level, SAM-axis based on heart rate variability (HRV) and salivary alpha-amylase, and HPA-axis activity based on salivary cortisol.
In the intention-to-treat analysis, the effect of music on pain tolerance did not statistically differ between the M and C group. A significant positive effect of music on pain endurance was noted after excluding participants with a high skin impedance (p = 0.013, CI 0.35; 2.85). Increased HRV was observed in the M-group compared to the C-group for SDNN (B/95%CI:13.80/2.22;25.39, p = 0.022), RMSSD (B/95%CI:15.97/1.64;30.31, p = 0.032), VLF (B/95%CI:212.08/60.49;363.67, p = 0.008) and HF (B/95%CI:821.15/150.78;1491.52, p = 0.0190). No statistical significance was observed in other secondary outcomes.
The effect of the music intervention on pain endurance was not statistically significant in the intention-to-treat analysis. The subgroup analyses revealed an increase in pain endurance in the music group after correcting for skin impedance, which could be attributed to increased parasympathetic activation.
在实验设计中阐明音乐对疼痛耐力的影响，有助于了解在手术和非手术干预过程中应如何应用音乐。本研究旨在调查音乐对疼痛耐力的影响以及交感肾上腺髓质轴（SAM）和下丘脑-垂体-肾上腺皮质轴（HPA）的参与情况。
在这项随机对照试验中，所有参与者通过其非优势食指接受逐渐增强的电刺激。参与者被随机分配到接受20分钟音乐干预的音乐组（M）或接受20分钟休息期的对照组（C）。主要结局是疼痛耐力，定义为耐受的毫安量。次要结局包括焦虑水平、基于心率变异性（HRV）和唾液α-淀粉酶的SAM轴，以及基于唾液皮质醇的HPA轴活性。
在意向性分析中，音乐对疼痛耐受性的影响在M组和C组之间无统计学差异。在排除皮肤阻抗高的参与者后，注意到音乐对疼痛耐力有显著的积极影响（p = 0.013，CI 0.35；2.85）。与C组相比，M组的SDNN（B/95%CI：13.80/2.22；25.39，p = 0.022）、RMSSD（B/95%CI：15.97/1.64；30.31，p = 0.032）、VLF（B/95%CI：212.08/60.49；363.67，p = 0.008）和HF（B/95%CI：821.15/150.78；1491.52，p = 0.0190）的HRV增加。在其他次要结局中未观察到统计学显著性。
在意向性分析中，音乐干预对疼痛耐力的影响无统计学显著性。亚组分析显示，校正皮肤阻抗后，音乐组的疼痛耐力增加，这可能归因于副交感神经激活增加。
