Music to be considered as an alternative to preoperative drug used to calm nerves

According to results revealed by a clinical trial, music may be used as an alternative to drugs which are used routinely to calm nerves before the use of regional anesthesia.

According to experts, music has a similar effect like the sedative midazolam which is used to reduce anxiety, usually before a peripheral nerve block- a type of anesthetic procedure which takes place under an ultrasound guidance. The purpose is usually to numb the specific region of the body.

According to experts, preoperative anxiety is common and can cause raised levels of stress hormones in the body which in return affects recovery after surgery. The anxiety is usually treated with the benzodiazepines, such as midazolam. However, these drugs are prone to side-effects, which includes disturbed blood flow, affected breathing and paradoxically increased levels of hostility and agitation. Application of such drugs also requires close and continuous monitoring by clinicians.

The clinical study thus proposes music medicine which also has the capability of reducing preoperative anxiety, however it cannot be directly compared with intravenous midazolam. The researchers of the clinical study wanted to find if music medicine was capable of substituting midazolam, which could calm nerves before practicing a peripheral (regional) nerve block.

For the study, experts, randomly chose 157 adults who would receive either 1-2 mg of midazolam (80) which would be injected 3 minutes before the peripheral nerve block or they would listen to Marconi Union’s Weightless series of music via noise cancelling headphones (77) for the same period.

The levels of anxiety before and after the use of each anxiety calming method were scored on the basis of a validated measure (State Trait Anxiety Inventory-6, or STAI-6 for short). In addition, satisfaction among doctors and patients were scored on a 10-point scale, 0 reflecting the lowest level of satisfaction.

It was observed that changes in the levels of preoperative anxiety were identical to both the groups, although it was observed that people in the music group were less satisfied than those who were given midazolam. One of the reasons attributed was because patients couldn’t choose the music they could listen to.

However, a difference in satisfaction level among doctors was observed. They observed a difficulty in communication due to noise cancelling headphones. Furthermore, they also concluded that a 3 minute time was perhaps too short and the measure used to evaluate satisfaction was not a validated scale.

It was however concluded that music can be offered as an alternative to midazolam before the procedure of a regional nerve block. “However,” experts cautioned, “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.”

The research was published online in the journal Regional Anesthesia & Pain Medicine.