Music may offer an alternative to preoperative drug routinely used to calm nerves

Scientists wanted to find out if it might offer a suitable alternative to midazolam to calm the nerves before carrying out a peripheral (regional) nerve block.

Music medicine is a non-pharmacologic intervention that is virtually harm-free, relatively inexpensive and has been shown to decrease preoperative anxiety significantly. In a new study, scientists plan to contrast the use of music with midazolam as a preoperative anxiolytic before the administration of an ultrasound-guided single-injection peripheral nerve block.

The study suggests that music may offer an option in contrast to the use of a medication routinely used to calm the nerves before the use of regional anesthesia.

Music medicine has been used to lower preoperative anxiety before, but it has not been directly compared with intravenous midazolam.

When tested, scientists found that music shows similar impacts as the sedative midazolam in reducing anxiety before a peripheral nerve block- a kind of anesthetic method done under ultrasound guidance, and intended to numb a particular region of the body.

Preoperative anxiety is common, and it can raise levels of stress hormones in the body, which in turn can affect recovery after surgery. It is usually treated with benzodiazepines, such as midazolam. But these drugs have side effects, including changing breathing, disturbing blood flow, and paradoxically increasing levels of agitation and hostility.

For the study, scientists assigned 157 adults to receive either 1-2 mg of midazolam (80), injected 3 minutes before the use of a peripheral nerve block, or to listen to Marconi Union’s Weightless series of music via noise-canceling headphones (77) for the same period.

Levels of anxiety were scored utilizing an approved measure (State-Trait Anxiety Inventory-6, or STAI-6 for short) before and after using each anxiety calming method. Satisfaction among patients and specialists were scored on a 10-point scale, with 0 showing the least degree of satisfaction.

The change in the State-Trait Anxiety Inventory-6 (STAI-6) anxiety scores from after to before the procedure were similar in both groups.

However, patients in the music group seem less satisfied than that given midazolam, maybe because patients were unable to choose the music they listened to.

On the other hand, doctors in both groups seem to have the same satisfaction levels.

Also, both patient and physician perceptions on difficulties in communication were higher in the music group than in the midazolam group.

Nevertheless, their findings prompt them to conclude that music may be offered as an alternative to midazolam before carrying out a regional nerve block.

Scientists noted, “However, further studies are warranted to evaluate whether or not the type of music, as well as how it is delivered, offers advantages over midazolam that outweigh the increase in communication barriers.”

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