Music Therapy Postoperatively for Pain Control
Appraised by: Jesse Gall SN, Cayla Nelson SN, Amanda Erickson SN, Ashlee Kalvoda SN
(NDSU Nursing at Sanford Health Bismarck, ND)
Clinical Question:
In postoperative patients, does listening to music help reduce pain?
Articles:
Cutshall, S., Anderson, P., Prinsen, S., Wentworth, L., Olney, T., Messner, P., . . . Bauer, B.
(2011). Effect of the combination of music and nature sounds on pain and anxiety in
cardiac surgical patients: A randomized study. Alternative Therapies in Health and Medicine.
17(4), 16-23. Retrieved September 17, 2015, from Ebscohost.
Jose, J., Verma, M., & Arora, S. (2012). An experimental study to assess the effectiveness of
music therapy on the post operative pain perception of patients following cardiac
surgery in a selected hospital of New Delhi. International Journal of Nursing Education,
4(2), 199-201. Retrieved September 17, 2015, from EBSCOhost.
Lin, P., Lin, M., Huang, L., Hsu, H., & Lin, C. (2011). Music therapy for patients receiving spine
surgery. Journal of Clinical Nursing, 20, 960-968. doi:10.1111/j.13652702.2010.03456.x
Vaajoki, A., Pietilä, A., Kankkunen, P., & Vehviläinen-Julkunen, K. (2011). Effects of listening
to music on pain intensity and pain distress after surgery: An intervention. Journal of
Clinical Nursing, 21, 708-717. doi:10.1111/j.1365-2702.2011.03829.x
Synthesis of Evidence:
A prospective clinical study with two parallel groups was conducted by Vaajoki, Peitila,
Kankkunen, and Vehvilainen-Julkunen (2011). One hundred and sixty-eight men and women were chosen
for this study between March 2007- April 2009 to identify if listening to music after abdominal surgery
helped alleviate pain intensity and pain distress for three days postoperatively. Forty-two men and fortyone women were in the music group. Forty-eight men and thirty-seven women were in the control group.
Pain intensity and pain distressed were measured using the VAS pain assessment tool eight times before
and after intervention. Patients who were apart of the control group were treated the same as music group,
their only difference being the music intervention. Pain while deep breathing, resting and shifting
positions were all assessed each time. At the end of the study results showed that in the music group, the
patient’s pain intensity and distress in bed rest, deep breathing, and shifting positions were significantly
lower on the second postop day compared to control group. Some limitations to this study include that
music interventions were occasionally interrupted by other nursing tasks that needed patients full
attention.
A stratified randomized controlled trial was conducted by Cutshall et al (2011) to decide whether
or not music/nature sounds decreases pain and anxiety on cardiac surgical patients. There were 100
participants, forty-nine were the music group and fifty-one were the control group. The VAS scale was
used to evaluate pain, anxiety, relaxation, and overall satisfaction before and after the treatment. The
music group received 20 minutes of standard postoperative care and music two times a day on
postoperative days 2 through 4, while the control group received the standard postoperative care and 20
minutes of quiet resting period on days 2 through 4. Cutshall et al (2011) reported a significant decrease
in pain scores in the music group. There was also a decrease in the need for opioids postoperative day 3
for the music group. The relaxation scores also improved. There were no major barriers in this study.
A quasi-experimental study design was conducted by Lin, Lin, Huang, Hsu, and Lin (2010) to
determine if music therapy had effects on anxiety, postoperative pain, and physiological reactions in
patients undergoing spinal surgery. Sixty patients were recruited from a veteran’s hospital. The study
group listened to music the evening before the surgery to the second day after surgery, while the control
group did not listen to any music. Patients’ level of anxiety and pain were measured with the VAS scale.
Heart rate, blood pressure, and a 24-hour urinalysis were measure for physiological reactions. Lin et al
(2010) showed that the differences between the two groups in VAS scores for both anxiety and pain were
statistically significant. One hour after surgery, the mean blood pressure was also significantly lower in
the study group than the control group, but there were no significant differences found in the urinalysis
for levels of norepinephrine or epinephrine. Some limitations of this study included that the research was
conducted at a veteran’s hospital, so there were low numbers of females and the advanced age of the
Chinese patients.
A randomized control study was conducted by Jose, Verma, and Arora (2012) to determine the
level of pain perception among patients admitted in the cardiothoracic and vascular surgery department.
Sixty-four subjects were selected but only sixty participated in the study. The one group was exposed to
music after surgery for 30 minutes, while the other group rested for 30 minutes. Pain perception was
measured using a numerical pain rating scale, structured opinionaire, blood pressure, and pulse rate. Jose,
Verma, and Arora (2012) found there was a significant reduction in anxiety and pain in the group that
received music compared to the control group. A limitation to the study is that patients were unable to
choose the music they listened to after surgery. By having patients choose their favorite type of music,
scores could be altered.
Each study had moderate sample sizes that detected statistically significant results. All four
studies had an intervention of music therapy and a control group without music therapy. All four studies
used the VAS numeric pain scale. All four studies provided a good description of the measurements. All
of the studies reviewed suggest that music is an appropriate and effective intervention used to alleviate
pain in postoperative patients.
Bottom Line:
All four articles concluded that music therapy is an effective measure in reducing patient’s pain
perception postoperative. In three of the articles music therapy had a positive effect on blood pressure and
heart rate.
Implications for Nursing Practice:
Evidence suggests that offering music therapy to postoperative patient will in fact help reduce
pain. We recommend patients have access to music, whether it is via TV music channels or personal
music players.