Effect of music on hemodynamic fluctuations in women during induction of general anesthesia: a prospective randomized controlled multicenter trial

Abstract

Abstract Background Anxiety can cause perioperative stress and increase sympathetic nervous system activity, potentially contributing to negative clinical outcomes, including hemodynamic instability, prolonged anesthesia induction and cardiac arrhythmias. We aim to investigate the effect of music on hemodynamic fluctuations during induction of general anesthesia and reducing preoperative anxiety for women underwent elective non-cardiac surgery. Methods It is a multicenter, double-blind, randomized, parallel-group clinical trial. Participants were women who were underwent elective non-cardiac surgery under general anesthesia. Patients were randomized 1:1 to either a music intervention group (MI) or a control group (Control). The MI participants listened to their preferred music for more than 30 minutes in the waiting area. The State-Trait Anxiety Inventory (STAI) was used to measure anxiety levels in the groups, and hemodynamic parameters (heart rate [HR], mean arterial pressure [MAP]) were continuously recorded before induction (T0), at loss of consciousness (T1), immediately before intubation (T2), and after intubation (T3). Intubation-related adverse events were also recorded. The primary outcome was the incidence of MAP changes more than 20% above baseline during T0–T2. Results A total of 164 patients were included in the final analyses. Incidence of MAP instability (change greater than 20% above baseline) during T0–T2 was lower in the MI (P = 0.03), and the 95% confidence interval for the rate difference (− 0.2708 to − 0.0164) demonstrated the superiority of MI. HR instability were less frequent in MI participants both in T0–T2 (P = 0.04) and T2–T3 (P = 0.005). The overall incidence of preoperative anxiety was 53.7% (88/164). After the music intervention, the mean score of STAI was significantly lower in the MI than in the Control, with a between-group difference of 8.01 (P < 0.001) by analysis of covariance. Conclusions Preoperative music intervention effectively prevented hemodynamic instability during anesthesia induction and significantly reduced preoperative anxiety in women underwent elective non-cardiac surgery. Trial Registration: The study is registered in the Chinese Clinical Trial Registry on 26/11/2020 (ChiCTR2000040254, http://www.chictr.org.cn/showprojen.aspx?proj=64383).