The effect of music on the neurohormonal stress response to surgery under general anesthesia.
Several pharmacological interventions reduce perioperative stress hormone release during surgery under general anesthesia. Listening to music and therapeutic suggestions were also studied, but mostly in awake patients, and these have a positive effect on postoperative recovery and the need for analgesia. In this study, we evaluated the effect of listening to music under general anesthesia on the neurohormonal response to surgical stress as measured by epinephrine, norepinephrine, cortisol, and adrenocorticotropic hormone (ACTH) blood levels. Thirty female patients scheduled for abdominal gynecological procedures were enrolled and randomly divided into two groups: group NM (no music) and group M (music). In group M, music was played from after the induction of anesthesia until the end of surgery. In the NM group, the patients wore the headphones but no music was played. We established three sample times for hormonal dosage during the procedure and one in the recovery room. Hemodynamic data were recorded at all times, and postoperative consumption of morphine in the first 24 h was noted. There was no group difference at any sample time or in the postoperative period in terms of mean arterial blood pressure, heart rate, isoflurane end-tidal concentration, time of the day at which the surgery was performed, bispectral index (BIS) value, doses of fentanyl, or consumption of postoperative morphine. There was no difference between the two groups with regard to plasmatic levels of norepinephrine, epinephrine, cortisol, or ACTH at any sample time, although the blood level of these hormones significantly increased in each group with surgical stimulation. In conclusion, we could not demonstrate a significant effect of intraoperative music on surgical stress when used under general anesthesia.


CONCLUSIONS
Listening to music under general anesthesia did not reduce perioperative stress hormone release or opioid consumption in patients undergoing gynecological surgery.
Migneault
Brigitte
B
Departments of *Anesthesiology, †Biochemistry, and ‡Gynecology, Centre Hospitalier de l'Université de Montréal, Hôpital Notre-Dame, Montréal, Canada; and §Department of Psychiatry, Washington University Medical Center, St. Louis, Missouri.
Girard
François
F
Albert
Caroline
C
Chouinard
Philippe
P
Boudreault
Daniel
D
Provencher
Diane
D
Todorov
Alexandre
A
Ruel
Monique
M
Girard
Dominique C
DC
D000293:Adolescent; D000324:Adrenocorticotropic Hormone / Q000097:blood; D000328:Adult; D000368:Aged; D000768:Anesthesia, General; D018685:Anesthetics, Inhalation / Q000493:pharmacokinetics; D001794:Blood Pressure / Q000187:drug effects; D004837:Epinephrine / Q000097:blood; D005260:Female; D013509:Gynecologic Surgical Procedures; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007530:Isoflurane / Q000493:pharmacokinetics; D008297:Male; D008875:Middle Aged; D009146:Music / Q000523:psychology*; D018377:Neurotransmitter Agents / Q000097:blood*; D009638:Norepinephrine / Q000097:blood; D013312:Stress, Physiological / Q000503:physiopathology*
D018685:Anesthetics, Inhalation; D018377:Neurotransmitter Agents; D000324:Adrenocorticotropic Hormone; D007530:Isoflurane; D006854:Hydrocortisone; D009638:Norepinephrine; D004837:Epinephrine