Cleveland Clinic Foundation, Crile Building, A100, 2049 E 100th Street, Cleveland, OH, 44195, USA.
Erasmus Medical Center, Erasmus University, Rotterdam, Netherlands.
Hernia. 2024 Oct;28(5):1831-1841. doi: 10.1007/s10029-024-03092-y. Epub 2024 Jun 18.
Although intraoperative music is purported to mitigate postoperative pain after some procedures, its application has never been explored in abdominal wall reconstruction (AWR). We sought to determine whether intraoperative music would decrease early postoperative pain following AWR.
We conducted a placebo-controlled, patient-, surgeon-, and assessor-blinded, randomized controlled trial at a single center between June 2022 and July 2023 including 321 adult patients undergoing open AWR with retromuscular mesh. Patients received noise-canceling headphones and were randomized 1:1 to patient-selected music or silence after induction, stratified by preoperative chronic opioid use. All patients received multimodal pain control. The primary outcome was pain (NRS-11) at 24 ± 3 h. The primary outcome was analyzed by linear regression with pre-specified covariates (chronic opioid use, hernia width, operative time, myofascial release, anxiety disorder diagnosis, and preoperative STAI-6 score).
178 patients were randomized to music, 164 of which were analyzed. 177 were randomized to silence, 157 of which were analyzed. At 24 ± 3 h postoperatively, there was no difference in the primary outcome of NRS-11 scores (5.18 ± 2.62 vs 5.27 ± 2.46, p = 0.75). After adjusting for prespecified covariates, the difference of NRS-11 scores at 24 ± 3 h between the music and silence groups remained insignificant (p = 0.83). There was no difference in NRS-11 or STAI-6 scores at 48 ± 3 and 72 ± 3 h, intraoperative sedation, or postoperative narcotic usage.
For patients undergoing AWR, there was no benefit of intraoperative music over routine multimodal pain control for early postoperative pain reduction.
ClinicalTrials.gov: NCT05374096.
尽管有研究表明术中音乐可以减轻某些手术后的术后疼痛，但它在腹壁重建（AWR）中的应用尚未得到探索。我们旨在确定术中音乐是否会降低 AWR 后的早期术后疼痛。
我们在 2022 年 6 月至 2023 年 7 月期间在一家单中心进行了一项安慰剂对照、患者、外科医生和评估者双盲、随机对照试验，纳入了 321 名接受开放式 AWR 和后肌网片的成年患者。患者接受降噪耳机，并在诱导后按术前慢性阿片类药物使用情况分层随机分为患者选择的音乐或静音。所有患者均接受多模式疼痛控制。主要结局为 24±3 小时的疼痛（NRS-11）。主要结局通过线性回归分析，预设协变量（慢性阿片类药物使用、疝宽度、手术时间、筋膜松解术、焦虑症诊断和术前 STAI-6 评分）。
178 名患者被随机分配至音乐组，其中 164 名进行了分析。177 名患者被随机分配至静音组，其中 157 名进行了分析。术后 24±3 小时，NRS-11 评分的主要结局无差异（5.18±2.62 与 5.27±2.46，p=0.75）。在调整了预设协变量后，音乐组和静音组在 24±3 小时时 NRS-11 评分的差异仍然不显著（p=0.83）。在 48±3 小时和 72±3 小时、术中镇静或术后使用阿片类药物时，NRS-11 评分和 STAI-6 评分均无差异。
对于接受 AWR 的患者，与常规多模式疼痛控制相比，术中音乐对减轻早期术后疼痛没有益处。
ClinicalTrials.gov：NCT05374096。
