The effect of music on serum cortisol levels and anxiety in patients undergoing lower segment cesarean section under spinal anesthesia: A randomized controlled interventional study

Background and Aims: Surgical procedures performed using spinal anesthesia techniques present a special challenge to anesthesiologists, because patients are awake and exposed to multiple anxiety-provoking visual and auditory stimuli. Therefore, this study was carried out to define the effect of music on the level of cortisol and anxiety in patients under spinal anesthesia undergoing elective lower-segment cesarean section (LSCS). Methods: The study was conducted on 60 patients undergoing LSCS under spinal anesthesia. The patients were divided into two groups containing 30 patients each. Group A received music through headphones and group B did not receive any music. Blood samples for serum cortisol and visual analog score for anxiety (VASA) were evaluated in both groups in pre-operative and post-operative periods. Results: Student's t-test was used for comparison of serum cortisol levels. The mean cortisol levels in group A were 32.44 ± 14.42 μg/dl in the pre-operative and 33.59 ± 12.74 μg/dl in the post-operative period (P = 0.583). However, in group B, the mean cortisol levels were 25.24 ± 13.54 μg/dl in the pre-operative period and 30.22 ± 17.04 μg/dl in the post-operative period. The difference was highly significant (P = 0.023). The mean VASA 1 score in group A as 5.22 ± 0.73 and in group B was 6.00 ± 0.82. The difference was not significant (P = 0.608). However, VASA 2 in group A was 4.90 ± 0.66 and group B was 5.89 ± 0.99. This difference was highly significant (P = 0.0001). Conclusion: This study's results showed that listening to music during surgery under spinal anesthesia significantly reduces cortisol levels (P = 0.023) as well as anxiety score (P = 0.0001).