By: Angela Zhushma, RN
State University of New York Institute of Technology
 Over 80% of patient experience moderate to severe pain
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after having surgical procedures
Pain is most severe immediately after the surgery after the
effect of anesthetic analgesia ends
It’s usually managed by administering IV or oral narcotics
Music therapy as a complimentary intervention can act as a
distraction, thus helping with pain management
Inadequate postoperative pain management may lead to
disturbed rest and sleep, delayed wound healing, patient
dissatisfaction, prolonged recovery time, and increased
healthcare costs
* Therefore, it’s important to explore the effect of
music on post-operative pain*
The objective of the integrative review is to determine
if music used as a complimentary therapy in postoperative patients 18 years of age and older results in
less pain intensity compared to the use of narcotics
alone?
P- In post-operative patients 18 years and older
I- Music as a complimentary therapy
C- Pharmacological measures (use of narcotics)
O-Effect pain management (using numerical rating
scale (NRS) or the visual analogue scale (VAS))
 The databases CINAHL and MEDLINE were used with key
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search term ‘music’ along with ‘post-operative pain’, ‘pain
management’, and ‘post surgical’
The review included seven studies, all of which used a
control group and music group to compare results
Data from all these studies overall supported music as an
aid in reducing pain intensity when used in conjunction
with pain medication
Pain intensity was measured by the numerical rating scale
(NRS) or the visual analogue scale (VAS)
Several of these studies showed that pain intensity was
significantly lower in the music group than the control
group on the second post-operative day specifically
The literature review suggests that music intervention
should be offered to patients after surgery as it has been
shown to reduce pain intensity
Author (s)
Allred (2010)
Comeaux & SteeleMoses (2013)
Study Method
Surgery: Total Knee Arthroplasty
RCT
56 patients
Experimental group n=28
Control group n=28
Surgery: various
Quasi-experimental
Music group n=19
Control group n=22
Ikonomidou &
Surgery: Gynecologic laparoscopy
Rehnstrom (2004)
RCT
Music group n=29
Control group n=26
Lin et al. (2013)
Surgery: Spinal
Quasi-experimental
Music group n= 30
Control group n=30
Tse et al. (2005)
Surgery: Nasal
RCT
Music group n= 27
Control group n=30
Vaajoke et al (2011) Surgery: abdominal
RCT
Music group n=83
Control group n=85
Vaajoke et al.
Surgery: abdominal
(2013)
Quasi-experimental
Music group n=83
Control group n=85
Findings
Results from this study provide evidence that pain is reduced while listening to
music just before the 1st ambulation after a TKA. Overwhelmingly, patients
reported that music helped them forget about their pain and improved their
mood.
At Time One (first 24 hrs. post-op) no significant difference between the music
and control group was found in pain management. At Time 2 (2nd post-op day), a
significant increase in pain management was found.
No significant difference between the music and control group in pain scores
was found. However, opioid consumption was significantly lower.
Lower pain level throughout the entire observation period was found in the
music group compared to the control group.
Use of musical therapy resulted in significantly lower pain scores and analgesic
consumption in the first 24 hrs. post nasal surgery.
In the music group, patients’ pain intensity and pain distress during deep
breathing and in shift position were significantly lower on the 2nd post-operative
day compared with the control group.
On the 2nd post-op day, pain intensity and distress was significantly lower in the
music group compared to the control group.
 My role in this project was meeting with my clinician
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and discussing the findings of this research
The plan is to collaborate with the staff members who
provide pre-operative teaching to those having elective
surgery
They should encourage patients to bring music they
prefer from home
I will also recommend that our unit (which is a postsurgical floor) invest in several devices that will play
music for patients to use in the hospital
Patients would be provided ear buds to use for music
therapy
 Music therapy is an inexpensive intervention and can
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be easily implemented in the clinical settings
Hospitals could purchase CD players and MP3 players
for patients to use, which could be wiped down and
cleaned in between patient use.
Patients can be given their own ear buds to keep
Nurses should encourage patients to listen to music
after receiving pain medication for at least thirty
minutes
This will likely improve their pain management and
increase their overall satisfaction as studies indicate
Allred, K., Byers, J., & Sole, M. (2010). The effect of music on postoperative pain
and anxiety. Pain Management Nursing, 11(1), 15-25.
Comeaux, T., & Steele-Moses, S. (2013). The effect of complementary music
therapy on the patient's postoperative state anxiety, pain control, and
environmental noise satisfaction. MEDSURG Nursing, 22(5), 313-318.
Ikonomidou, E., Rehnström, A., & Naesh, O. (2004). Effect of music on vital signs
and postoperative pain. AORN Journal, 80(2), 269. doi:10.1016/S00012092(06)60564-4.
Lin, P., Lin, M., Huang, L., Hsu, H., & Lin, C. (2011). Music therapy for patients
receiving spine surgery. Journal Of Clinical Nursing, 20(7/8), 960-968.
doi:10.1111/j.13652702.2010.03452.x
Pyati, S., & Gan, T. (2007). Perioperative pain management. CNS Drugs, 21(3), 185211.
Tse, M., Chan, M., & Benzie, I. (2005). The effect of music therapy on
postoperative pain, heart rate, systolic blood pressure and analgesic
use following nasal surgery. Journal Of Pain & Palliative Care
Pharmacotherapy, 19(3), 21-29.
Vaajoki, A., Pietilä, A., Kankkunen, P., & Vehviläinen-Julkunen, K. (2011).
Effects of listeningto music on pain intensity and pain distress after
surgery: an intervention. Journal Of Clinical Nursing, 21(5/6), 708717. doi:10.1111/j.1365-2702.2011.03829.x
Vaajoki, A., Pietilä, A., Kankkunen, P., & Vehviläinen-Julkunen, K. (2013). Music
intervention study in abdominal surgery patients: challenges of an
intervention study in clinical practice. International Journal Of
Nursing Practice, 19, 206-213. doi:10.1111/ijn.12052.