Effect of music therapy on anxiety, stress and sedative requirements in patients undergoing lower limb orthopedic surgery under spinal anaesthesia: A randomized controlled study.

INTRODUCTION:Music is capable of evoking strong positive emotions, and elevating the mood of individual . These effects can potentially be used in clinical settings, where negative emotions such as pain often reduce an individual’s subjective well-being. Music has been reported to reduce stress before,during, and after medical procedures including surgery, angiography, and colonoscopy . Correspondingly, some studies suggest that listening to music reduces cortisol levels before, during and after such procedures. In relation to the lower stress levels of patients listening to music, many studies reported that sedative requirements are also reduced in patients undergoing surgery under regional anesthesia combined with sedation . Similar effects have been reported for sedated patients treated in intensive care units. The stress- and pain-reducing effects of music are presumably due to its capability to engage perceptual, emotional, and cognitive processes that (a) interfere with the perception of the noise of the operating theater, (b) consume attentional resources, and (c) evoke feelings of pleasure which interact with pain and unpleasant affects related to the surgical procedure. Cortisol (a corticosteroid hormone that is crucial for glucose metabolism, inflammation suppression, and stress adaptation) is the biochemical that has been investigated most frequently with regard to music.

In addition to such hormonal effects, stress levels also affect immune system activity; one of these effects is a transient increase of immunoglobulin A (IgA) in response to an increase in HPA axis activity . Effects of music on serum IgA concentrations were only investigated under general anesthesia, and statistically not significant. Nevertheless, some non-clinical studies suggest effects of music listening on salivary IgA concentrations in awake, healthy individuals . In the present aim of study is to compare the effect of music therapy on anxiety, stress, and sedative requirements in patients undergoing lower limb orthopedics surgery under spinal anaesthesia.