The effect of patient-selected or preselected music on anxiety during cesarean delivery: a randomized controlled trial

Abstract

Background: Women undergoing cesarean delivery may have significant anxiety prior to surgery. Nonpharmacological approaches to anxiety reduction are favored in this patient population.

Objective: The aim of this study was to determine the effects of patient-selected or preselected music on anxiety in parturients undergoing scheduled cesarean delivery.

Materials and methods: This is a prospective, randomized controlled trial (IRB protocol #2015P002043; ClinicalTrials.gov, NCT02732964), of 150 parturients undergoing elective cesarean delivery. Parturients were randomized to patient-selected music (Pandora^®), preselected music (Mozart), or no music (control). The primary outcome was anxiety after music exposure (versus no music) in the preoperative holding room. Secondary outcomes included postoperative anxiety, postoperative pain, and patient satisfaction.

Results: Baseline anxiety and anxiety following preoperative exposure did not differ in the Pandora versus control group (3.8 ± 2.4 versus 4.6 ± 2.6, mean difference −0.8 [95% CI −1.8 to 0.2], p = .12), but was lower in the Mozart group versus control group (3.5 ± 2.5 versus 4.6 ± 2.5, mean difference −1.1 [95% CI −2.2 to −0.1], p = .03). Postoperative anxiety did not differ in the Pandora versus control group (1.0 ± 1.4 versus 1.3 ± 2.0, mean difference −0.3 [95% CI −1.0 to 0.4], p = .43), or in the Mozart versus control group (0.8 ± 1.3 versus 1.3 ± 2.0, mean difference −0.5 [95% CI −1.2 to 0.2], p = .15). Postoperative pain was not different in the Pandora group versus control group (0.8 ± 1.5 versus 1.4 ± 1.9, mean difference −0.6 [95% CI −1.3 to 0.1], p = .10), but was lower in the Mozart versus control group (0.6 ± 1.3 versus 1.4 ± 1.9, mean difference −0.8 [95% CI −1.4 to −0.1], p = .03). Total patient satisfaction scores were not different among the control, Pandora, and Mozart groups.

Conclusion: While preselected Mozart music results in lower anxiety prior to cesarean delivery, patient-selected Pandora music does not. Further investigation to determine how music affects patients, clinicians, and the operating room environment during cesarean delivery is warranted.

Clinical trial registration: NCT02732964.

Keywords:

• Anxiety
• cesarean delivery
• Mozart sonatas
• music
• pain
• patient satisfaction

Ethical approval

The study was approved by the Partners Human Research Committee, Protocol #2015P002043.

Acknowledgments

The authors appreciate Agnieszka Trzcinka M.D. for reviewing the final manuscript and Chuan-Chin Huang Ph.D. for performing the statistical analysis of the data.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Notes on contributors

Dan Michael Drzymalski

Dan M. Drzymalski, MD: This author helped design the study, conduct the study, analyze the data, and write the manuscript.

Mario Isaac Lumbreras-Marquez

Mario I. Lumbreras-Marquez, MBBS: This author helped design the study, conduct the study, analyze the data, and write the manuscript.

Lawrence Ching Tsen

Lawrence C. Tsen, MD: This author helped design the study, conduct the study, analyze the data, and write the manuscript.

William Reid Camann

William R. Camann, MD: This author helped design the study, conduct the study, analyze the data, and write the manuscript.

Michaela Kristina Farber

Michaela K. Farber, MD MS: This author helped design the study, conduct the study, analyze the data, and write the manuscript.