New research suggests music can be a viable alternative to sedatives when prepping patients for peripheral nerve blocks. A Penn Medicine team lead by Dr. Veena Graff investigated music as a risk free alternative to intravenous sedatives prior to the anesthestic procedure. Routinely performed for outpatient orthopaedic surgeries such as hip and knee arthroscopy, the study carries implications for patient empowerment in orthopaedic practices.

Study Details

Pre-op sedatives such as midazolam are commonly prescribed before peripheral nerve blocks. The medications have been shown to have side effects of breathing problems, hostility, and increased agitation. This study was the first to compare an intravenous sedative to music to reduce anxiety. Results showed that patient anxiety was significantly reduced in the music group.

How it Works

Music activates sensory pathways that compete with pain pathways in the brain. This competition takes attention and emotional response away from the pain pathway. Music also helps patients who already report higher anxiety levels related to pain, more so than patients who are generally less concerned about pain. In fact, a University of Utah Pain Research Center study asked 143 subjects to listen to music and perform tasks while given safe levels of shocks with fingertip electrodes. The study concluded less pain was felt when subjects were focused on music-related tasks.

Graff’s randomized control trial group who listened to music reported levels of anxiety similar to patients who were given the intravenous sedative. Graff believes the success of the intervention can be attributed to how music interacts with the brain; “Music lights up the emotional area of the brain, the reward system and pleasure pathways.” Her study indicates music is a side-effect free method to reduce pre-op anxiety.

Implications

New pain management methods and offerings are becoming critical to fighting the practice of over-prescribing in the United States. As more regulatory bodies turn to patient satisfaction for reporting purposes, patient satisfaction itself includes many aspects of service that are difficult to quantify and report. Music as an alternative to medication is fairly easy to implement. In fact, Graff’s ambulatory surgical center has already rolled out a new procedure offering patients disposable headphones prior to surgery.

Offering patients a choice demonstrates your practice’s commitment to patient empowerment. Graff’s team recommends allowing patients to choose their own type of music and volume level to increase overall patient satisfaction post-procedure. Ultimately, your practice can implement this method to boost your odds of sending more satisfied patients out the door.