Music during caesarean section under regional anaesthesia for improving maternal and infant outcomes.
BACKGROUND
Evidence on the benefits of music during caesarean section under regional anaesthesia to improve clinical and psychological outcomes for mothers and infants has not been established.


OBJECTIVE
To evaluate the effectiveness of music during caesarean section under regional anaesthesia for improving clinical and psychological outcomes for mothers and infants.


METHODS
We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 September 2008).


METHODS
We included randomised controlled trials comparing music added to standard care during caesarean section under regional anaesthesia to standard care alone.


METHODS
Two review authors, Malinee Laopaiboon and Ruth Martis, independently assessed eligibility, risk of bias in included trials and extracted data. We analysed continuous outcomes using a mean difference (MD) with a 95% confidence interval (CI).


RESULTS
One trial involving 76 women who planned to have their babies delivered by caesarean section met the inclusion criteria, but data were available for only 64 women. This trial was of low quality with unclear allocation concealment and only a few main clinical outcomes reported for the women. The trial did not report any infant outcomes. It appears that music added to standard care during caesarean section under regional anaesthesia had some impact on pulse rate at the end of maternal contact with the neonate in the intra-operative period (MD -7.50 fewer beats per minute, 95% CI -14.08 to -0.92) and after completion of skin suture for the caesarean section (MD -7.37 fewer beats per minute, 95% CI -13.37 to -1.37). There was also an improvement in the birth satisfaction score (maximum possible score of 35) (MD of 3.38, 95%CI 1.59 to 5.17). Effects on other outcomes were either not significant or not reported in the one included trial.


CONCLUSIONS
The findings indicate that music during planned caesarean section under regional anaesthesia may improve pulse rate and birth satisfaction score. However, the magnitude of these benefits is small and the methodological quality of the one included trial is questionable. Therefore, the clinical significance of music is unclear. More research is needed to investigate the effects of music during caesarean section under regional anaesthesia on both maternal and infant outcomes, in various ethnic pregnant women, and with adequate sample sizes.
Laopaiboon
Malinee
M
Department of Biostatistics and Demography, Faculty of Public Health, Khon Kaen University, Khon Kaen, Thailand, 40002. malinee@kku.ac.th
Lumbiganon
Pisake
P
Martis
Ruth
R
Vatanasapt
Patravoot
P
Somjaivong
Busaba
B
D000765:Anesthesia, Conduction; D000773:Anesthesia, Obstetrical; D002585:Cesarean Section / Q000523:psychology; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D007231:Infant, Newborn; D009147:Music Therapy / Q000379:methods*; D011247:Pregnancy; D016032:Randomized Controlled Trials as Topic; D015656:Respiratory Mechanics / Q000502:physiology; D013537:Sutures