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      Meta‐analysis evaluating music interventions for anxiety and pain in surgery

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          Abstract

          Background

          This study aimed to evaluate anxiety and pain following perioperative music interventions compared with control conditions in adult patients.

          Methods

          Eleven electronic databases were searched for full‐text publications of RCTs investigating the effect of music interventions on anxiety and pain during invasive surgery published between 1 January 1980 and 20 October 2016. Results and data were double‐screened and extracted independently. Random‐effects meta‐analysis was used to calculate effect sizes as standardized mean differences (MDs). Heterogeneity was investigated in subgroup analyses and metaregression analyses. The review was registered in the PROSPERO database as CRD42016024921.

          Results

          Ninety‐two RCTs (7385 patients) were included in the systematic review, of which 81 were included in the meta‐analysis. Music interventions significantly decreased anxiety (MD –0·69, 95 per cent c.i. –0·88 to –0·50; P < 0·001) and pain (MD –0·50, –0·66 to –0·34; P < 0·001) compared with controls, equivalent to a decrease of 21 mm for anxiety and 10 mm for pain on a 100‐mm visual analogue scale. Changes in outcome corrected for baseline were even larger: MD –1·41 (–1·89 to –0·94; P < 0·001) for anxiety and –0·54 (–0·93 to –0·15; P = 0·006) for pain. Music interventions provided during general anaesthesia significantly decreased pain compared with that in controls (MD –0·41, –0·64 to –0·18; P < 0·001). Metaregression analysis found no significant association between the effect of music interventions and age, sex, choice and timing of music, and type of anaesthesia. Risk of bias in the studies was moderate to high.

          Conclusion

          Music interventions significantly reduce anxiety and pain in adult surgical patients.

          Abstract

          Effective

          Related collections

          Most cited references102

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          Predictors of postoperative pain and analgesic consumption: a qualitative systematic review.

          Pain is a subjective and multidimensional experience that is often inadequately managed in clinical practice. Effective control of postoperative pain is important after anesthesia and surgery. A systematic review was conducted to identify the independent predictive factors for postoperative pain and analgesic consumption. The authors identified 48 eligible studies with 23,037 patients included in the final analysis. Preoperative pain, anxiety, age, and type of surgery were four significant predictors for postoperative pain. Type of surgery, age, and psychological distress were the significant predictors for analgesic consumption. Gender was not found to be a consistent predictor as traditionally believed. Early identification of the predictors in patients at risk of postoperative pain will allow more effective intervention and better management. The coefficient of determination of the predictive models was less than 54%. More vigorous studies with robust statistics and validated designs are needed to investigate this field of interest.
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            Music as an aid for postoperative recovery in adults: a systematic review and meta-analysis.

            Music is a non-invasive, safe, and inexpensive intervention that can be delivered easily and successfully. We did a systematic review and meta-analysis to assess whether music improves recovery after surgical procedures.
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              The prevalence of postoperative pain in a sample of 1490 surgical inpatients.

              To measure the prevalence of postoperative pain, an assessment was made of 1490 surgical inpatients who were receiving postoperative pain treatment according to an acute pain protocol. Measurements of pain (scores from 0 to 100 on a visual analogue scale) were obtained three times a day on the day before surgery and on days 0-4 postoperatively; mean pain intensity scores were calculated. Patients were classified as having no pain (score 0-5), mild pain (score 6-40), moderate pain (score 41-74) or severe pain (score 75-100). Moderate or severe pain was reported by 41% of the patients on day 0, 30% on days 1 and 19%, 16% and 14% on days 2, 3 and 4. The prevalence of moderate or severe pain in the abdominal surgery group was high on postoperative days 0-1 (30-55%). A high prevalence of moderate or severe pain was found during the whole of days 1-4 in the extremity surgery group (20-71%) and in the back/spinal surgery group (30-64%). We conclude that despite an acute pain protocol, postoperative pain treatment was unsatisfactory, especially after intermediate and major surgical procedures on an extremity or on the spine.
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                Author and article information

                Contributors
                a.kuhlmann@erasmusmc.nl
                Journal
                Br J Surg
                Br J Surg
                10.1002/(ISSN)1365-2168
                BJS
                The British Journal of Surgery
                John Wiley & Sons, Ltd (Chichester, UK )
                0007-1323
                1365-2168
                17 April 2018
                June 2018
                : 105
                : 7 , Cholangiocarcinoma issue ( doiID: 10.1002/bjs.2018.105.issue-7 )
                : 773-783
                Affiliations
                [ 1 ] Department of Paediatric Surgery Erasmus Medical Centre–Sophia Children's Hospital Rotterdam The Netherlands
                [ 2 ] Department of Neuroscience Erasmus Medical Centre Rotterdam The Netherlands
                [ 3 ] Department of Surgery Erasmus Medical Centre Rotterdam The Netherlands
                [ 4 ] Department of Internal Medicine Erasmus Medical Centre Rotterdam The Netherlands
                [ 5 ] Department of Epidemiology Erasmus Medical Centre Rotterdam The Netherlands
                [ 6 ] Department of Radiology Erasmus Medical Centre Rotterdam The Netherlands
                [ 7 ] Department of Health Policy and Management Harvard T. H. Chan School of Public Health Boston Massachusetts USA
                Author notes
                [*] [* ] Correspondence to: Dr A. Y. R. Kühlmann, Department of Paediatric Surgery, Erasmus MC–Sophia Children's Hospital, PO Box 2060, Room SK 1268, 3000CB Rotterdam, The Netherlands (e‐mail: a.kuhlmann@ 123456erasmusmc.nl )
                Author information
                http://orcid.org/0000-0002-7227-3337
                http://orcid.org/0000-0003-3161-7583
                http://orcid.org/0000-0002-4702-5227
                http://orcid.org/0000-0002-9856-0318
                http://orcid.org/0000-0002-2942-2798
                Article
                BJS10853
                10.1002/bjs.10853
                6175460
                29665028
                6fea7ac0-3ed2-46e4-9e15-2a99e37a0d52
                © 2018 The Authors. BJS published by John Wiley & Sons Ltd on behalf of BJS Society Ltd.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

                History
                : 19 October 2017
                : 08 December 2017
                : 09 February 2018
                Page count
                Figures: 3, Tables: 1, Pages: 11, Words: 6328
                Funding
                Funded by: Stichting Swart‐van Essen, Rotterdam, The Netherlands
                Funded by: Stichting Coolsingel, Rotterdam, The Netherlands
                Categories
                Systematic Review
                Systematic Reviews
                Custom metadata
                2.0
                bjs10853
                June 2018
                Converter:WILEY_ML3GV2_TO_NLMPMC version:version=5.5.0 mode:remove_FC converted:08.10.2018

                Surgery
                Surgery

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