title: The Effects of Perioperative Music Interventions in Pediatric Surgery: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
abstract: OBJECTIVE
  Music interventions are widely used, but have not yet gained a place in guidelines for pediatric surgery or pediatric anesthesia. In this systematic review and meta-analysis we examined the effects of music interventions on pain, anxiety and distress in children undergoing invasive surgery.
  
  
  METHODS
  We searched 25 electronic databases from their first available date until October 2014.
  
  
  METHODS
  Included were all randomized controlled trials with a parallel group, crossover or cluster design that included pediatric patients from 1 month to 18 years old undergoing minimally invasive or invasive surgical procedures, and receiving either live music therapy or recorded music.
  
  
  METHODS
  4846 records were retrieved from the searches, 26 full text reports were evaluated and data was extracted by two independent investigators.
  
  
  METHODS
  Pain was measured with the Visual Analogue Scale, the Coloured Analogue Scale and the Facial Pain Scale. Anxiety and distress were measured with an emotional index scale (not validated), the Spielberger short State Trait Anxiety Inventory and a Facial Affective Scale.
  
  
  RESULTS
  Three RCTs were eligible for inclusion encompassing 196 orthopedic, cardiac and day surgery patients (age of 1 day to 18 years) receiving either live music therapy or recorded music. Overall a statistically significant positive effect was demonstrated on postoperative pain (SMD -1.07; 95%CI-2.08; -0.07) and on anxiety and distress (SMD -0.34 95% CI -0.66; -0.01 and SMD -0.50; 95% CI -0.84; - 0.16.
  
  
  CONCLUSIONS
  This systematic review and meta-analysis indicates that music interventions may have a statistically significant effect in reducing post-operative pain, anxiety and distress in children undergoing a surgical procedure. Evidence from this review and other reviews suggests music therapy may be considered for clinical use.
authors.affiliation: Department of Pediatrics, Erasmus MC, Rotterdam, the Netherlands.
authors.forename: Marianne J E
authors.initials: MJ
authors.lastname: van der Heijden
authors.affiliation: Department of Neuroscience, Erasmus MC, Rotterdam, the Netherlands.
authors.forename: Sadaf
authors.initials: S
authors.lastname: Oliai Araghi
authors.affiliation: Department of Pediatrics, division of Neonatology and Department of Pediatric Surgery, Intensive care Erasmus MC, Rotterdam, the Netherlands.
authors.forename: Monique
authors.initials: M
authors.lastname: van Dijk
authors.affiliation: Department of Neuroscience, Erasmus MC, Rotterdam, the Netherlands.
authors.forename: Johannes
authors.initials: J
authors.lastname: Jeekel
authors.affiliation: Department of Epidemiology, Erasmus MC, Rotterdam, the Netherlands; Department of Radiology, Erasmus MC, Rotterdam, the Netherlands; Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America.
authors.forename: M G Myriam
authors.initials: MG
authors.lastname: Hunink
mesh_terms: D001007:Anxiety; D016208:Databases, Factual; D006801:Humans; D009147:Music Therapy; D010146:Pain / Q000473:pathology; D010147:Pain Measurement; D016032:Randomized Controlled Trials as Topic; D013315:Stress, Psychological