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The Mozart Panacea: A Randomized Controlled Trial Of Music On Anxiety, Hemodynamic Changes, And Patient Satisfaction During Cesarean Delivery
Abstract Number: T-08
Abstract Type: Original Research
Anxiety prior to cesarean delivery (CD) has been associated with hypotension after spinal anesthesia (1). Because music is a non-pharmacological method that may reduce anxiety (2), we sought to determine if it might be suitable for the obstetric setting. Our hypothesis was that music during CD would mitigate spinal induced hypotension by lowering patient anxiety, and that music would improve patient satisfaction.
After obtaining informed consent, parturients scheduled for CD were randomized to Mozart (pre-selected music), Pandora (patient-selected music), or control (no music). Music was broadcast through an iPod with an external amplified speaker starting 30 minutes prior to surgery and lasting until 30 minutes after surgery. Anxiety was measured using a verbal analog scale (0-10) at the time of enrollment, immediately preoperatively, and postoperatively. Noninvasive blood pressure was measured at baseline and every minute for 10 minutes after spinal anesthesia, and absolute percent change in systolic arterial pressure (%∆SAP) was calculated. Patient satisfaction was evaluated using a previously validated survey (3). Student’s t-test was used to analyze anxiety, %∆SAP, and satisfaction scores, while the effect of anxiety on %∆SAP was assessed by one-way ANOVA.
Thirty-six of 60 patients have been recruited (Mozart N=13; Pandora N=14; control N=9), and patient characteristics were similar in all groups. The mean duration of music was 181.7 minutes. The anxiety levels preoperatively and the %∆SAP after spinal anesthesia were no different between control and both music groups. However, the Mozart group experienced lower postoperative anxiety levels (p=0.039), higher patient satisfaction (p=0.007), and found the operating room atmosphere more comfortable (p=0.001) compared to controls (see Table).
Perioperative music during CD does not improve preoperative anxiety or %∆SAP, but Mozart music appears associated with lower postoperative anxiety and higher patient satisfaction. The most important factor for higher patient satisfaction was experiencing a comfortable operating room atmosphere. Because patient satisfaction has been linked to reimbursements via pay-for-performance metrics, further investigation is needed to determine if music during CD can be a panacea to patients who have high anxiety levels.
1. Orbach-Zinger 2012
2. Conrad 2007
3. Morgan 1999