Effects of music therapy on physiological response and anxiety in perioperative ophthalmic patients: a systematic review.

Purpose: The purpose of this study is to evaluate the effectiveness of music therapy on physiological response and anxiety in perioperative ophthalmic patients. Furthermore, to explore the differentiation of intervention effects based on different intervention timing and music types.

Methods: Five databases including PubMed, Embase, Web of Science, the Cochrane library and CINAHL were adopted for comprehensive search, from the inception of the database to October 2024. Reported according to the PRISMA 2020 statement. Methodological quality was assessed using Version 2 of the Cochrane tool for assessing risk of bias in randomized trial (Rob2). Revman manager 5.4 software was used for meta-analysis.

Results: Nine studies (1331 patients) were included. The meta-analysis results showed that the intervention effect of the music intervention group was better than that of the control group, which had positive effects on lower systolic blood pressure (SBP) [mean difference (MD)=-5.86, 95% confidence interval (CI)=-7.97~-3.74, Z = 5.44, p < 0.001], lower diastolic blood pressure (DBP) (MD=-3.57, 95%CI=-6.80~-0.35, Z = 2.17, p = 0.03) and reducing anxiety [standard mean difference (SMD)=-0.80, 95%CI=-0.94~-0.66, Z = 11.2, p < 0.001)], but not statistically significant for heart rate/pulse rate (HR/PR) change (MD=-1.08, 95%CI=-2.29 ~ 0.12, Z = 1.77, p = 0.08). The subgroup analysis results showed that music intervention before surgery, as well as before and during surgery, could reduce the function of SBP and DBP (p-values all less than 0.05); All types of music have significance in reducing SBP (p-values all less than 0.001); Better intervention effect in binaural beats music (BBM) group than control group in decreasing HR/PR (p = 0.01) can be found; Regardless of the timing of intervention (preopertive, p < 0.001; intraoperative, p = 0.008; preoperative and intraoperative, p < 0.001) or the type of music (BBM, p < 0.001; other types of music, p < 0.001), music therapy has a significant effect on reducing patient perioperative anxiety compared to the control group.

Conclusion: Overall, music therapy contributes to reducing both SBP and DBP, and anxiety level for perioperative ophthalmic patients. The intervention timing of preoperative, or both in preoperative and intraoperative, as well as music type of binaural beats, may have better effects on clinical indicators.

Prospero registration: This systematic review was registered a priori with PROSPERO in September 22, 2023. PROSPERO registration number: CRD42023465797.