Abstract
Preoperative anxiety is common among adults undergoing elective surgery and has been associated with adverse clinical outcomes. This study evaluated the effectiveness of music intervention in reducing preoperative anxiety compared with standard care. In this randomized controlled trial, 104 women scheduled for elective gynecological surgery with elevated anxiety levels (State-Trait Anxiety Inventory-State scale ≥ 39) were enrolled. Participants were randomized in a 1:1 ratio to receive either the two sessions of preoperative music intervention (one on the eve of surgery and another in the anesthesia preparation room) or a control condition consisting of headphones without music. The primary outcome was the change in anxiety between post-intervention on the day of surgery (T3) and baseline (T0; pre-intervention on the eve of surgery). The secondary outcome included changes in anxiety levels between 24 h postoperatively (T4) and T0; changes in blood pressure and heart rate from T0 to T3 and T4; 24-h numeric rating scale (NRS) pain scores and patient's satisfaction at T4. A total of 95 patients were analysed (median age, 43.0 years). From T0 to T3, anxiety scores decreased in the music group but increased in the control group (median change, - 5.0 vs. 3.0). The change in anxiety scores over this period differed significantly between groups (median difference=-8.0; 95% CI, -14.0 to -2.5; P = 0.003). After adjustment for multiple comparisons, no significant between-group differences were observed in anxiety change between T4 and T0, changes in blood pressure and heart rate from T0 to T3 and T4, or 24-h NRS pain scores. Patient satisfaction scores were significantly higher in the music group. Two-session music interventions may reduce preoperative anxiety among patients with high baseline anxiety undergoing elective gynecological surgery; however, this effect is not sustained postoperatively.Clinical trial registration: This study was approved by the Ethics Committee of the Chinese Clinical Trial Register (ChiCTR2400089224) on 04/09/2024.