Music therapy has been shown to reduce anxiety and physiologic responses to stress in the perioperative setting compared to only using pharmacological interventions. Research indicates that music therapy provides distraction, promotes relaxation, and decreases anxiety. It can also increase satisfaction, enhance pain management, and decrease anxiety in postoperative patients. When used together with pharmacologic pain management, music therapy promotes well-being and a positive surgical experience.

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In patients undergoing surgery, does the use of music therapy as a nursing
intervention reduce anxiety and physiologic responses to stress in the
perioperative setting compared to only offering pharmacological interventions?
Nora VanderPal, BSN
VITERBO UNIVERSITY
Clinical Practice
RecommendationsPatients undergoing surgery and other significant medical
procedures have high levels of stress and anxiety related
to several different factors. These feelings and their
corresponding physiologic responses may be caused by
the surgical experience, coping with acute pain, treatment
regimens, financial burdens of care, and disruptions of
their personal and professional lives. Traditional methods
of reducing anxiety in presurgical patients have been
focused primarily on the use of pharmacologic
interventions. However, such interventions may result in
delayed awakening and subsequent late discharge from
postoperative care and sometimes even an adverse
reaction to the medication itself.
Moreover, unrelieved postoperative pain can lead to
complications, such as ineffective breathing patterns and
delayed ambulation resulting in increased postoperative
morbidity, delayed recovery and reduced patient
satisfaction. Music listening is a non-pharmacological
method that can focus attention, facilitate breathing, and
stimulate the relaxation response.
Summary of Findings
Limitations
Abstract
Search for Evidence
Evidence Based Practice nursing research articles were found using CINAHL
Plus with Full Text from EBSCOhost.
Music is a non-invasive low cost intervention that can
easily be implemented in the perioperative setting of any
healthcare facility.
• Music therapy should be offered to patients in the
preoperative setting.
• Music acts as an anxiolytic diversion from negative
stimuli and an integrated hypothalamic relaxation
response resulting in reduced heart rate and blood
pressure.
• Music therapy provides distraction, promotes
relaxation, and decreases anxiety
• Music therapy should be offered to patients in the
postoperative setting.
• Distraction from negative experiences through the
use of music therapy can increase satisfaction,
enhance pain management and decrease anxiety
in patients recovering from surgery.
Research indicates that music therapy provides distraction,
promotes relaxation, and decreases anxiety. Music therapy
has a beneficial effect on a patient’s perceived pain,
relaxation, respiratory rate, self-reported anxiety level, and
the amount of analgesia required for effective pain
management. When used in conjunction with
pharmacologic pain management strategies, music therapy
promotes a sense of well-being and an overall positive
experience. Although there was minor evidence suggesting
that music has a significant influence on physiologic
parameters indicative of stress and anxiety, such as heart
rate and blood pressures alone, when used in conjunction ,
music therapy can produce positive effects on individuals
experiencing stress and medically-induced anxiety.
Evaluation of the long term effects of music therapy during
the perioperative period include a significantly lower
respiratory rate and a decrease in mean arterial pressure.
Several participants receiving music volunteered comments
postoperatively about how much they enjoyed hearing the
music and that it provided comfort to them. As healthcare
providers search for ways to provide services to their
clients that can produce greater satisfaction, perioperative
music may be an efficacious and cost effective intervention.
1. In some studies, participants knew their levels of pain and anxiety were being studied
2. The 20 minute music intervention in one study may have been insufficient to produce
physiologically measurable effects.
3. Music responses might have been more significant if subjects brought their own music
selections from home.
4. The studies should be replicated with a larger sample size and with different patient
populations to validate findings.
Background
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Individuals in the perioperative setting experience high
levels of anxiety and stress with consequent physiologic
responses. Even patients with a low predisposition to
anxiety may become apprehensive in this setting and
show physical and psychological changes including
increased heart rate, blood pressure, palpitations,
vasoconstriction, nausea, vomiting and gastric stasis.
Music as a therapeutic intervention has been recognized
for its ability to modify the limbic system to provide pain
relief, relaxation, and reduction in psychological stress.
Therefore the question begs asking: Does the use of
music therapy as a nursing intervention in conjunction
with pharmacologic therapies effectively reduce anxiety
and physiologic responses to stress in the perioperative
setting?