Music for the eyes: Music helps before surgery

Awake eye surgery is particularly stressful for patients. Music has long been known to reduce anxiety, minimise the need for sedatives, and make patients feel more at ease. The purpose of this pilot study was to evaluate the effect of music on anxiety in outpatients undergoing elective eye surgery under topical (local) anaesthesia.

A total of 62 patients were prospectively and randomly assigned to hear relaxing music or no music through headphones for around 15 minutes just before cataracts surgery, which also lasted an average 15 minutes (all patients had the same type of surgery to make the results comparable).

The music played was specifically composed to ease anxiety following strict criteria, including instrumental pieces only using a decreasing tempo and a progressive decrease in the number of instruments playing. Each patient was able to choose from a panel of 16 recorded music styles according to their own preferences, and listened through high quality headphones. There were various styles available, including jazz, flamenco, Cuban, classical and piano. The music was provided by MUSIC CARE, a Paris-based company that produces music aimed at preventing and managing pain, anxiety and depression.

Due to the massive use of disinfectant and other liquids during surgery, headphones would have been rapidly damaged if used during the actual procedure. However, there is evidence that music-induced relaxation lasts around 60 minutes after the music has stopped.

A surgical fear questionnaire (SFQ) was used to assess anxiety before and after a music session. Overall postoperative patient satisfaction was assessed using a standardised questionnaire. The proportion of patients receiving the sedative midazolam during surgery was also recorded.

The researchers found that significant differences were noted between groups in anxiety VAS after music session, with anxiety significantly reduced among the music group (score 23 out of 100) compared to the non-music group (score 65 out of 100). The music group also received significantly less sedatives during surgery compared with the non-music group (16% vs 32%). Postoperative satisfaction was significantly higher in the music group (mean score 71 out of 100 versus 55 for the non-music group).

Dr Guerrier says: "Music listening may be considered as an inexpensive, non-invasive, non-pharmacological method to reduce anxiety for patients undergoing elective eye surgery under local anaesthesia."

He adds: "The objective is to provide music to all patients before eye surgery. We intend to assess the procedure in other type of surgeries, including orthopaedics where regional anaesthesia is common. Moreover, post-operative pain may be reduced by decreasing pre-operative anxiety, which is another study we intend to perform."