The effect of music intervention in stress response to cardiac surgery in a randomized clinical trial.
OBJECTIVE
To evaluate the effect of bed rest with music on the first postoperative day to decrease stress for patients who have undergone heart surgery.


METHODS
A repeated-measures randomized controlled trial was used. The study took place in a cardiothoracic intermediary unit of a university hospital in Sweden. Fifty-eight patients who had undergone open coronary artery bypass grafting or aortic valve replacement surgery were included. Stress response was assessed by determining the serum cortisol, heart rate, respiratory rate, mean arterial pressure, arterial oxygen tension, arterial oxygen saturation, and subjective pain and anxiety levels. At 12:00 noon on postoperative day 1, patients were allocated to receive 30 minutes of uninterrupted bed rest with music and then 30 minutes of bed rest or alternatively 60 minutes of uninterrupted bed rest. The music was soft and relaxing, included different melodies in new-age style, played with a volume at 50 to 60 dB, and distributed through a music pillow connected to an MP3 player.


RESULTS
After 30 minutes of bed rest, there was a significant difference in s-cortisol levels between the groups; 484. 4 mmol/L in the music group versus 618.8 mmol/L in the control group (P < .02). However, this difference in s-cortisol levels was not found 30 minutes later (ie, after a total of 60 minutes). There was no difference in heart rate, respiratory rate, mean arterial pressure, arterial oxygen tension, arterial oxygen saturation, and subjective pain and anxiety levels between the groups.


CONCLUSIONS
There is sufficient practical evidence of stress reduction to suggest that a proposed regimen of listening to music while resting in bed after open heart surgery be put into clinical use.
Nilsson
Ulrica
U
Department of Cardiothoracic Surgery and Center for Health Care Sciences, Orebro University Hospital, PO Box 1324, Orebro SE-70113, Sweden.
D000223:Adaptation, Psychological; D000368:Aged; D000704:Analysis of Variance; D001007:Anxiety / Q000517:prevention & control; D001510:Bed Rest; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D005260:Female; D006339:Heart Rate; D006439:Hemodynamics; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D008297:Male; D008875:Middle Aged; D009147:Music Therapy; D010101:Oxygen Consumption; D010146:Pain / Q000517:prevention & control; D010147:Pain Measurement; D011184:Postoperative Period; D012143:Respiratory Physiological Phenomena; D013315:Stress, Psychological / Q000097:blood / Q000209:etiology / Q000628:therapy*
D006854:Hydrocortisone