Abstract 4136561: Music therapy for postprocedural pain in patients undergoing cardiac surgery: a meta-analysis of randomized controlled trials

Background: Patients undergoing cardiac surgeries often experience significant levels of pain and anxiety, which can impair effective recovery. Music therapy has been proposed as a non-pharmacological intervention to alleviate these symptoms. This meta-analysis aimed to evaluate the effectiveness of music therapy in patients undergoing cardiac surgeries. Methods: We systematically searched PubMed, Embase, and Cochrane databases for randomized controlled trials (RCTs) analyzing music therapy in patients undergoing cardiac surgeries. We pooled mean differences (MD), and standardized mean differences (SMD) for continuous outcomes with 95% confidence intervals (CI) with a random-effects model. We performed a trial sequential analysis (TSA) to assess the random risk of pain, and conducted a subgroup analysis to compare heart and respiratory rate between children and adults. We used R version 4.3.2 and TSA version 0.9.5.10 for statistical analyses. Results: Our meta-analysis included 20 RCTs comprising 1379 patients, of whom 715 (51.9%) were randomized to music therapy. Compared with control, music significantly reduced postoperative pain (SMD -0.59; 95% CI: -0.76 to -0.41; p<0.05; Figure A), and anxiety (SMD -0.59; 95% CI: -0.74 to -0.44; p<0.05; Figure B). There was a significant difference between groups in heart rate (MD -5.68 bpm; 95% CI: -9.73 to -1.63; p<0.05), overall there was an important subgroup interaction between children and adults (p=0.01). In children, music therapy reduced the respiratory rate (MD -5.98 ipm; 95% CI: -6.71 to -5.25) compared to control, whereas in adults, no significant differences were observed among these groups, overall, there was a significant subgroup interaction (p<0.01). For the primary endpoint, TSA suggested a low risk of type 1 error, therefore these results may be conclusive. Conclusion: In patients undergoing cardiac surgery, music therapy reduced postoperative pain, anxiety, heart rate, and respiratory rate.