Music could act as an alternative to common drug used to calm the nerves before giving regional anaesthesia (peripheral nerve block), according to the results of a clinical trial, published online in the journal Regional Anesthesia & Pain Medicine. Preoperative anxiety is common, and it can raise levels of stress hormones in the body, which in turn can affect recovery after surgery.
‘Music serves as an alternative to benzodiazepine sedative drug midazolam before carrying out a regional nerve block, but further studies are required to confirm the benefit.’It is usually treated with benzodiazepines, such as midazolam. But these drugs have side effects, including affecting breathing, disturbing blood flow, and paradoxically increasing levels of agitation and hostility. Use of these drugs also requires continuous monitoring by a skilled clinician.
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Music medicine has been used to lower preoperative anxiety before, but it has not been directly compared with intravenous midazolam.
The researchers 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.
They randomly 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 cancelling headphones (77) for the same period.
This track is considered to be one of the world's most relaxing: https://www.youtube.com/watch?v=UfcAVejslrU
Changes in the levels of preoperative anxiety were similar in both groups, although patients in the music group were less satisfied than those given midazolam, possibly because patients were not allowed to choose the music they listened to, suggest the researchers.
Both patients and doctors thought it was harder to communicate when music was used to calm nerves, possibly because of the use of noise cancelling headphones, and not standardising the volume of the music, suggest the researchers.
They accept that a comparison lasting just 3 minutes may have been too short, but this period was chosen because that is how long it takes for midazolam to reach peak effectiveness. And they acknowledge that the measure used to assess satisfaction wasn't a validated scale.
Nevertheless, their findings prompt them to conclude that music may be offered as an alternative to midazolam before carrying out a regional nerve block.
"However," they caution, "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."