Perioperative Psychological and Music Interventions in Elderly Patients Undergoing Spinal Anesthesia: Effect on Anxiety, Heart Rate Variability, and Postoperative Pain

Abstract

PurposeThe aim of this study was to evaluate the effects of perioperative psychological and music interventions in elderly patients undergoing elective surgery on anxiety, post-operative pain, and changes in heart rate variability (HRV) to ascertain if perioperative psychological and music interventions can affect overall anxiety levels.Materials and MethodsFourty elderly patients undergoing elective surgery were randomized to two groups; one group received psychological and music intervention, and the other was the control. The intervention group underwent psychological intervention and listening to music for 30 min before surgery.ResultsThe mean change in HRV as determined by low frequency (LF) power measurements. After the intervention, the ratio of mean LF to high frequency (HF) power decreased significantly in the intervention group compared to before the intervention (p<0.05). In the control group, mean LF measurements and the ratio of LF:HF did not change significantly. In the intervention group, mean HF power was significantly higher after the procedure than before (p<0.01). Moreover, the mean self-rating anxiety score of the intervention group decreased after the procedure compared to before (p<0.05). The mean visual analogue score of the intervention group 6 hours after surgery was significantly lower than that of the control group (p<0.01).ConclusionPerioperative psychological and music interventions can reduce anxiety and postoperative pain in elderly patients.

Can Preoperative Psychological Assessment Predict Outcomes After Temporomandibular Joint Arthroscopy?

“…Psychological counseling, music, preoperative education, hypnosis, gabapentin, and pregabalin have been shown to decrease anxiety and improve outcomes after various surgical procedures. [41][42][43][44][45][46] Although there is no literature to support or refute the use of selective serotonin reuptake inhibitors or serotonin norepinephrine reuptake inhibitors in the management of preoperative anxiety, these classes of drugs are routinely used to treat generalized anxiety disorder and could be beneficial in the perioperative period in select patients undergoing surgical procedures for TMD. Further outcome-based studies in the surgical management of TMD that assess anxiety are needed.…”

Music: an effective anxiolytic during caesarean section under spinal anaesthesia

“…They stated that anxiety leads to activation of sympathetic system causing stimulation of hypothalamic autonomic system and rising of heart rate, which is slowed down by music due to reduction in anxiety. 9 Other recent study by Kahloul M et al, on patients under general anaesthesia (GA) also showed lowering of HR with music. 10 Shu MW et al, and Ebneshahidi A et al, in their studies did not find any change in HR between music and control groups which is contrary to our study results.…”

“…This difference in values were highly significant (p = 0.009) (Table 4). [1][2][3][4][5][6][7][8][9][10] Researchers have quoted various mechanisms, which include release of neurogenic endorphins by music helping to decrease the anxiety and stress.…”

Extra note of music in anaesthesia

“…This study concluded that intervention via use of music in perioperative period significantly reduced sympathetic and enhanced parasympathetic activity by reducing anxiety. 9 Another research evaluated effect of music on 100 patients undergoing caesarean sections. Authors found a highly significant lowering of anxiety and a high patient satisfaction score in music group as compared to control group.…”