The effect of intra-operative compared to postoperative music on postoperative pain was evaluated in a controlled trial. In all, 151 patients undergoing day case surgery for inguinal hernia repair or varicose vein surgery under general anaesthesia were randomly allocated to three groups: group 1 listened to music intra-operatively, group 2 listened to music postoperatively and group 3, the control group, listened to ‘white noise’. The anaesthetic and postoperative analgesic techniques were standardised. Pain was assessed using a numeric rating scale (0–10) and patients requirements for postoperative morphine, paracetamol and ibuprofen was recorded. The effect of music on nausea, fatigue and anxiety was also investigated. The results showed that patients exposed to music intra-operatively or postoperatively reported significantly lower pain intensity at 1 and 2 h postoperatively and patients in the postoperative music group required less morphine at 1 h compared to the control group. No differences were noted in the other variables. This study demonstrates that there is a short-term pain-reducing effect of music therapy however, the beneficial effects do not differ if the patient is exposed to music intra-operatively or postoperatively.
An optimal postoperative pain control programme should be effective and safe, produce minimal side-effects, facilitate recovery and be easily managed by patients and staff. It should include both pharmacological and non-pharmacological methods, either used alone or in combination [1–3]. Music is a non-pharmacological technique that is inexpensive, non-invasive and has no side-effects that has been shown to reduce postoperative pain [3–7]. Interventions with music pre-operatively can modulate the patient's response to stress [8–10], music intra-operatively can also reduce sedative requirements , and music postoperatively has been shown to reduce fatigue  and can also be used to distract the from noise in the postanaesthesia care unit (PACU) . It has also been suggested that the use of headphones with music may reduce or eliminate awareness during anaesthesia . However, other studies have failed to confirm the impressive results of music therapy .
Previous studies have reported the pain-reducing effects of music played intra-operatively and postoperatively [6,7]. However, it is unclear when the most effective timing for music therapy is, intra-operatively or postoperatively. Therefore, the aim of this study was to evaluate the most appropriate timing for music therapy either during surgery or during the recovery period following surgery. We also measured the duration of analgesia, nausea, fatigue and anxiety.
2003. Vol. 58, no 7, 699-703 p.