Music Before Breast Surgery May Calm Nerves

Listening to music before undergoing ambulatory surgery for the diagnosis or treatment of breast cancer lessens patients’ anxiety levels. This conclusion comes from a new study published in the Journal of Clinical Oncology.

A group of researchers, led by Jaclyn Bradley Palmer, music therapist at University Hospitals Seidman Cancer Center, randomly divided 207 women who were scheduled for breast biopsy into three groups. One group listened to preferred live music prior to surgery (69 patients), one listened to preferred recorded music (70 patients), and one received usual care and no music before the procedure (68 patients).

“We discovered that anxiety levels dropped significantly from pretest to posttest in patients who heard one preferred song of either live or recorded music before surgery,” Bradley Palmer said in a statement. “In this trial, both live and recorded preoperative music therapy interventions reduced anxiety significantly more than usual preoperative management by 28 and 27 points, representing percent reductions of 43 percent and 41 percent, respectively.”

For the study, a registered nurse research assistant administered a pretest to obtain a baseline reading of each participant’s anxiety level. For the live music group, each patient listened to a preferred song performed vocally with guitar or keyboard accompaniment by the music therapist at her bedside. Patients in the recorded music group listened to their recorded preferred song through headphones while the music therapist stood outside the room.

The music therapist held a five-minute therapy session, which included the preferred song and a brief conversation about the song choice and surrounding emotions.

The usual care group received customary preoperative care for five minutes without music and did not have contact with the music therapist.

Posttest data were collected from each patient by the registered nurse research assistant following the preoperative experimental or control condition.

Compared with the usual care group, the live- and recorded-music groups had greater reductions, but “there wasn’t a significant difference in anxiety between live music and recorded music,” said Bradley Palmer. “It seems like music, no matter how it is delivered, had a similar effect on reducing a patient’s preoperative anxiety.”

In addition to measuring anxiety levels, the researchers also looked at the amount of propofol needed for sedation, recovery time, and patient satisfaction but found that the results in the live- and recorded-music groups did not differ significantly from those in the usual care group.

“We know that music touches parts of our brain: the emotional center that creates release of our body’s natural opiates, for example, endorphins, enkephalins, and serotonin,” Deforia Lane, PhD, director of Art and Music Therapy at UH Seidman Cancer Center and one of the coauthors of the study, said in a statement. “All of those things that are released, are triggered by auditory stimulation, and music is prime in that … and it’s without using any pharmacologic intervention—it is simply using the music as medicine.”

The researchers concluded that music therapy has the ability to manage preoperative anxiety in an effective, safe, time-efficient, and enjoyable way.

“Anxiety often results when an actual event conflicts with what was anticipated, thus activating the sympathetic branch of the autonomic nervous system,” the authors noted. “Conversely, because it delivers what is expected, preferred music may stimulate the relaxation response through activation of the parasympathetic branch of the autonomic nervous system. Familiar melodies, rhythmic patterns, and song lyrics may provide a welcome contrast to distress by delivering the predictable in an unpredictable environment, thus restoring balance to the autonomic nervous system.”

Bradley Palmer J, Lane D, Mayo D, et al. Effects of music therapy on anesthesia requirements and anxiety in women undergoing ambulatory breast surgery for cancer diagnosis and treatment: A randomized controlled trial [published online ahead of print August 17, 2015]. J Clin Oncol.