The effect of music and music in combination with therapeutic suggestions on postoperative recovery

Abstract: The aim of this thesis was to test the effect of music with or without therapeutic suggestions performed intra- or postoperatively on patients' postoperative recovery. A total of 422 patients were included in four studies with a mean age of 53 years. Of these patients 75 were included in two studies. The surgical procedures were hysterectomy, hernia repair surgery and varicectomy. The anaesthesia and postoperative analgesia were standardized.All patients were allocated random into one of three groups; two intervention groups and one control group. The intervention groups were exposed to; music or music and therapeutic suggestions intraoperatively in one study and postoperatively in another study. In the third and fourth study the role of music intraoperatively versus music postoperatively was evaluated.To evaluate the effect on postoperative recovery of these interventions pain, nausea, anxiety, fatigue, sleep, well-being, urinary problems, headache, mobilization, bowel function, hospital stay, blood pressure, oxygen saturation, heart rate, serum-cortisol and blood-glucose and plasma immunoglobulin A were assessed.The results showed that patients that were exposed to intraoperative music rated less postoperative pain after 1 and 2 hours at the postoperative care unit (PACU) and the first day after surgery, required less morphine for the first hour at the PACU, were less fatigued at discharge and had an earlier mobilization compared to the control group. Patients exposed to intraoperative music in combination with therapeutic suggestions rated less mean pain intensity for the first 2 hours at the PACU, required less ketobemidone the day of surgery and were less fatigued at discharge compared to the control group. Patients listening to postoperative music rated less postoperative pain after 1 and 2 hours and less mean pain intensity for the first 2 hours after surgery, required less morphine for the first hour at the PACU, rated less postoperative anxiety after 1 hour, had less marked increase in glucose levels and greater reduction in cortisol levels after 2 hours and had an increased oxygen saturation after 1 hour at the PACU compared to the control patients. The patients listening to postoperative music in combination with therapeutic suggestions rated less mean pain for the first 2 hours at the PACU compared to the control group. However, in general the analgesic effects of the interventions were modest and of relatively short duration.Music or music in combination with therapeutic suggestions during surgery and postoperative recovery can be used as an adjunct in multimodal regimes to improve patient recovery process. These interventions are simple, inexpensive and non invasive tools that can be applied in intra- and postoperative care.