School of Medicine, Nankai University, Tianjin, 300071, China.
School of Public Health, Gansu University of Chinese Medicine, Lanzhou, 730000, China.
BMC Anesthesiol. 2024 Sep 28;24(1):339. doi: 10.1186/s12871-024-02732-1.
This study aimed to compile data on the effectiveness of music therapy for patients undergoing cardiothoracic surgery.
After cardiac and thoracic surgery, patients often experience physiological and psychological complications, such as anxiety, pain, stress, depression and changes in vital signs, which have a great impact on prognosis.
A systematic search of six databases was performed to identify randomized controlled trials investigating music therapy and cardiothoracic surgery. The data were extracted from the qualified research, the data without heterogeneity were analysed by random-effects model (REM) meta-analysis, and the data with heterogeneity were analysed by fixed-effects model (FEM) meta-analysis. We evaluated anxiety, pain, duration of mechanical ventilation, hospital length of stay, stress hormones, opioid consumption, and vital signs, including heart rate (HR), respiratory rate (RR), oxygen saturation (SpO2), diastolic blood pressure (DBP), and systolic blood pressure (SBP) after cardiothoracic surgery. The meta-analysis and sensitivity analysis were performed with RevMan 5.4 and Stata 14 software, and trial sequential analysis was conducted using TSA 0.9.5.10 Beta software. This study was conducted in accordance with the PRISMA guidelines and was registered with PROSPERO.
The study included 24 randomized controlled trials with a total of 1576 patients. Our analysis showed that music therapy can significantly reduce the anxiety scores (SMD= -0.74, 95% CI [-0.96, -0.53], p < 0.01) and pain scores (SMD= -1.21, 95% CI [-1.78, -0.65], p < 0.01) of patients after cardiothoracic surgery. Compared with the control group, music therapy dramatically raised postoperative SpO2 (SMD = 0.75, 95% CI [0.11, 1.39], p = 0.02). In addition, the experimental group had significant statistical significance in reducing HR, SBP and opioid consumption. However, there was no significant difference in respiratory rate, stress hormones, diastolic blood pressure, length of hospital stay, or the duration of mechanical ventilation between the two groups.
Music therapy can significantly reduce anxiety, pain, HR, SBP, and postoperative opioid use and even improve SpO2 in patients who undergo cardiothoracic surgery. Music therapy has a positive effect on patients after cardiothoracic surgery with few side effects, so it is promising for use in clinics.
RROSPERO (registration number: CRD42023424602).
本研究旨在汇编音乐疗法对心胸外科手术患者有效性的数据。
心脏和胸部手术后，患者常经历焦虑、疼痛、压力、抑郁和生命体征变化等生理和心理并发症，这对预后有很大影响。
系统检索了六个数据库，以确定调查音乐疗法和心胸外科手术的随机对照试验。从合格的研究中提取数据，对无异质性的数据采用随机效应模型（REM）荟萃分析，对有异质性的数据采用固定效应模型（FEM）荟萃分析。我们评估了焦虑、疼痛、机械通气时间、住院时间、应激激素、阿片类药物消耗以及心胸外科手术后的生命体征，包括心率（HR）、呼吸频率（RR）、血氧饱和度（SpO2）、舒张压（DBP）和收缩压（SBP）。使用 RevMan 5.4 和 Stata 14 软件进行荟萃分析和敏感性分析，并使用 TSA 0.9.5.10 Beta 软件进行试验序贯分析。本研究按照 PRISMA 指南进行，并在 PROSPERO 上进行了注册。
研究纳入了 24 项随机对照试验，共 1576 名患者。我们的分析表明，音乐疗法可显著降低心胸外科手术后患者的焦虑评分（SMD=-0.74，95%CI[-0.96，-0.53]，p<0.01）和疼痛评分（SMD=-1.21，95%CI[-1.78，-0.65]，p<0.01）。与对照组相比，音乐疗法显著提高了术后 SpO2（SMD=0.75，95%CI[0.11，1.39]，p=0.02）。此外，实验组在降低 HR、SBP 和阿片类药物消耗方面具有显著统计学意义。然而，两组之间的呼吸频率、应激激素、舒张压、住院时间或机械通气时间无显著差异。
音乐疗法可显著降低心胸外科手术患者的焦虑、疼痛、HR、SBP 和术后阿片类药物使用量，甚至可提高 SpO2。音乐疗法对心胸外科手术后患者具有积极作用，副作用少，有望在临床上应用。
RROSPERO（注册号：CRD42023424602）。
