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Is Music Beneficial during Labor Epidural Technique Placement?: Unexpected Findings from a Randomized Controlled Trial
Abstract Number: O1-06
Abstract Type: Original Research
Many patients and health educators believe that music can have a positive impact on labor and delivery, and several music service playlists claim to “put your mind and body in a perfect place” during labor. (1-2) Because little scientific evidence exists to support these claims, we sought to determine if women who listened to music during labor epidural technique placement would experience greater satisfaction, less anxiety, and less pain.
One hundred laboring parturients were enrolled in a prospective, randomized, controlled trial to receive an epidural technique placement with (N=50) or without (N=50) music. Exclusion criteria included the preexisting use of music in the room, or the absence of labor. The intervention group listened to the patient’s preferred music on a Pandora® station broadcast through an iPod with an external amplified speaker; the control group listened to no music. Music was started 10 minutes prior and ended 15 minutes after the epidural technique. All women received a standardized epidural technique and local anesthetic dose (3-5mL of 1.5% lidocaine with epinephrine followed by 10-15mL of 0.125% bupivacaine with 2mcg/mL fentanyl). The primary outcome was patient satisfaction, as measured by a Press Ganey-based survey. Secondary outcomes included anxiety, pain scores, and obstetric outcomes. Fisher’s exact test was used to analyze satisfaction and delivery data, while t-test was used to analyze anxiety and pain scores.
All 100 women completed the study, although 12 were excluded from analysis for protocol violations (music N=7; control N=5). Patient characteristics were similar in both groups, except for greater cervical dilation (4.12cm vs. 3.28cm) in the music group at time of the epidural technique (p=0.004). The mean duration of music was 32.5 minutes. Although no differences were observed in patient satisfaction (p=0.49) or pain (p=0.17), the music group experienced higher levels of anxiety after epidural placement (p=0.012) and a greater cesarean delivery rate (26% vs. 7%; p=0.02). Instrumented vaginal delivery rates were similar in both groups (7% vs. 5%; p=0.68).
Music during labor epidural technique placement does not improve patient satisfaction or pain, but appears associated with higher post-procedure anxiety. A higher rate of cesarean delivery was also observed in the music group that could not be explained by the presence of operative delivery risk factors in both groups. Further investigation is needed to determine if music during labor epidural technique placement is more distracting than relaxing, and has an effect on mode of delivery. (2-3)
1. Music for Labor and Delivery 2012.
2. Simavli 2014.
3. Ryding 1998.