The impact of music on postoperative pain and anxiety following cesarean section.
BACKGROUND
The relief of post-cesarean delivery pain is important. Good pain relief improves mobility and reduces the risk of thromboembolic disease, which may have been increased during pregnancy. Pain may impair the mother's ability to optimally care for her infant in the immediate postpartum period and may adversely affect early interactions between mother and infant. It is necessary, therefore that pain relief be safe and effective and results in no adverse neonatal effects during breast-feeding. Music may be considered as a potential method of post cesarean pain therapy due to its noninvasiveness and lack of side effects. In this study we evaluated the effect of intraoperative music under general anesthesia for reducing the postoperative morphine requirements after cesarean section.


METHODS
In a double blind placebo-controlled trial, 100 women (ASA I) scheduled for elective cesarean section under general anesthesia, were randomly allocated into two groups of fifty. After standardization of anesthesia, patients in the music group were exposed to a compact disk of Spanish guitar after induction of anesthesia up to the time of wound dressing. In the control group patients were exposed to white music. Post operative pain and anxiety were evaluated by visual analog scale (VAS) up to six hours after discharge from PACU. Morphine was given intravenously for reducing pain to VAS < or = 3 postoperatively.


RESULTS
There was not statistically significant difference in VAS for pain between two groups up to six hours postoperatively (P>0.05). In addition, morphine requirements were not different between two groups at different time intervals up to six hours postoperatively (P>0.05). There were not statistically significant difference between two groups regarding postoperative anxiety score and vomiting frequency (P>0.05).


CONCLUSIONS
As per conditions of this study, intraoperative Spanish music was not effective in reducing postoperative pain after cesarean section. In addition postoperative morphine requirement, anxiety, and vomiting were not affected by the music during general anesthesia.
Reza
Nikandish
N
Department of Anesthesia, Fasa Medical College, Fasa, Fars Province, Iran. nikandishr@fums.ac.ir
Ali
Sahmedini Mohammad
SM
Saeed
Khademi
K
Abul-Qasim
Avand
A
Reza
Tabatabaee Hamid
TH
D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000627:therapeutic use; D000768:Anesthesia, General; D014151:Anti-Anxiety Agents / Q000627:therapeutic use; D000932:Antiemetics / Q000008:administration & dosage / Q000627:therapeutic use; D001007:Anxiety / Q000523:psychology*; D002585:Cesarean Section / Q000009:adverse effects* / Q000523:psychology*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008787:Metoclopramide / Q000008:administration & dosage / Q000627:therapeutic use; D008874:Midazolam / Q000627:therapeutic use; D009020:Morphine / Q000008:administration & dosage / Q000627:therapeutic use; D009146:Music / Q000523:psychology*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy / Q000523:psychology*; D011184:Postoperative Period; D011247:Pregnancy; D011446:Prospective Studies
D000701:Analgesics, Opioid; D014151:Anti-Anxiety Agents; D000932:Antiemetics; D009020:Morphine; D008787:Metoclopramide; D008874:Midazolam