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Patient comfort and satisfaction of the perioperative period is more and more important to clinical research. This is due to changing social requirements that can be recognized in the healthcare system. Music as a cheap and easy to establish tool seems to be applicable to improve patients’ satisfaction in a perioperative setting. In this trial we tried to answer the question if pre- and intraoperative music is suitable to influence the perioperative well-being of patients that had to undergo breast surgery or a gynecological laparoscopy. To do this we did a randomized controlled trail that was partly blinded and discussed the results on basis of a systematic review of the literature. Therefore we examined 80 female patients that had to undergo a gynecological operation. They answer the BSKE (EWL)-questionnaire at three times. Before the BDI was done to exclude a depression that could possibly influence the results. In addition the PPP-33 questionnaire was used to get secondary information concerning the perioperative satisfaction. Postoperative pain and well-being was also measured by a VAS. BIS-Monitoring was used to measure depth of anesthesia during the whole procedure.
It is known that audible information can be processed during general anesthesia, even in a state of narcosis that is widely accepted as adequate and monitored by BIS. We therefore tried to focus on the intraoperative effect of music intervention.
Our results and the results of the literatures’ review showed that there is a benefit of preoperative music concerning perioperative well-being. It has also a positive effect on operation related anxiety. No further benefit could be accomplished by intraoperative music. These results are similar to the results found in the literature. It can safely be concluded that the placing of explicit information during a general anesthesia does not seem to be possible. In what way implicit memory due to process of acoustic information during general anesthesia influence the perioperative well-being is not definitively answered. Further studies should investigate the neurophysiological mechanisms of implicit memory to detect further possibilities to interact clinical in a beneficial way.
Clinical implication: Music in a perioperative setting seems to be the right tool to improve postoperative well-being and reduce operation related anxiety in patients undergoing gynecological surgery. Relaxing music should be given as additional therapy in the preoperative period. Intraoperative music therapy does not seem to have any additional benefit. Nevertheless the chance of implicit memory during general anesthesia should be considered.