Music as an aid for postoperative recovery in adults: a systematic review and meta-analysis.
BACKGROUND
Music is a non-invasive, safe, and inexpensive intervention that can be delivered easily and successfully. We did a systematic review and meta-analysis to assess whether music improves recovery after surgical procedures.


METHODS
We included randomised controlled trials (RCTs) of adult patients undergoing surgical procedures, excluding those involving the central nervous system or head and neck, published in any language. We included RCTs in which any form of music initiated before, during, or after surgery was compared with standard care or other non-drug interventions. We searched MEDLINE, Embase, CINAHL, and Cochrane Central. We did meta-analysis with RevMan (version 5.2), with standardised mean differences (SMD) and random-effects models, and used Stata (version 12) for meta-regression. This study is registered with PROSPERO, number CRD42013005220.


RESULTS
We identified 4261 titles and abstracts, and included 73 RCTs in the systematic review, with size varying between 20 and 458 participants. Choice of music, timing, and duration varied. Comparators included routine care, headphones with no music, white noise, and undisturbed bed rest. Music reduced postoperative pain (SMD -0·77 [95% CI -0·99 to -0·56]), anxiety (-0·68 [-0·95 to -0·41]), and analgesia use (-0·37 [-0·54 to -0·20]), and increased patient satisfaction (1·09 [0·51 to 1·68]), but length of stay did not differ (SMD -0·11 [-0·35 to 0·12]). Subgroup analyses showed that choice of music and timing of delivery made little difference to outcomes. Meta-regression identified no causes of heterogeneity in eight variables assessed. Music was effective even when patients were under general anaesthetic.


CONCLUSIONS
Music could be offered as a way to help patients reduce pain and anxiety during the postoperative period. Timing and delivery can be adapted to individual clinical settings and medical teams.


BACKGROUND
None.
Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
Jenny
J
Hole
BartsHealth NHS Trust, Whitechapel, London, UK.
Martin
M
Hirsch
Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK; BartsHealth NHS Trust, Whitechapel, London, UK. Electronic address: elizabeth.ball@bartshealth.nhs.uk.
Elizabeth
E
Ball
Health Economics Research Group, Brunel University, Uxbridge, UK.
Catherine
C
Meads
D000328:Adult; D000698:Analgesia / Q000379:methods; D001007:Anxiety / Q000628:therapy; D006801:Humans; D007902:Length of Stay; D009146:Music; D009147:Music Therapy / Q000379:methods; D010149:Postoperative Pain / Q000628:therapy; D017060:Patient Satisfaction; D011184:Postoperative Period