Effect of sound therapy on postoperative stress and satisfaction in patients undergoing outpatient surgery: a single-blind randomized trial

Day surgery procedures represent an essential part of surgical practice worldwide. However, outpatients may experience anxiety, fear, and stress, which can negatively affect their ability to follow the established ambulatory surgery pathway. While medications are commonly administered to reduce postoperative stress, several non-pharmacological strategies can be implemented to avoid their use. Sound therapy (ST) is a complementary, drug-free, safe, and cost-effective intervention. The purpose of this study was to evaluate the impact of ST on postoperative stress and patient satisfaction in patients undergoing outpatient surgery. We conducted a single-blind randomized study at the Regional Hospital of Bellinzona and Valli (Switzerland) between July 2023 and December 2023, in accordance with CONSORT guidelines. Ambulatory procedures included venous catheter implantation, inguinal/umbilical hernia surgery, subcutaneous tissue surgery, phlebectomy, and proctology. The ST group listened to natural and musical sounds during hospitalization, while the control group received standard care. Both groups were managed during the pre- and postoperative periods according to clinical practice and completed the Leiden Perioperative care Patient Satisfaction (LPPS) questionnaire before discharge. No additional stress scales were used; however, blood pressure and heart rate were recorded as objective indicators of stress. During the study period, 32 patients were included, 15 randomized to the ST arm and 17 to the control arm. The average age of the patients was 51.1 ± 16.2 years, and the majority were male (68.8%). Most participants (95.8%) had an uneventful postoperative course, and no patient required anxiolytic medication. Postoperative stress was evaluated using the LPPS questionnaire, with mean scores in the ‘fear and stress’ domain slightly higher in the ST group compared with the control group (179 ± 8 vs. 171 ± 20, p = 0.174). Although no statistically significant differences were observed, this pilot study shows that sound therapy is a feasible and well-tolerated adjunct in ambulatory surgery. The observed trends are preliminary and require confirmation in larger, adequately powered studies to clarify whether sound therapy can influence postoperative stress or patient satisfaction. Comitato Etico Cantonale Ticino registration number 2023 − 01190 Ref. CE4396, date of trial registration: 26/06/2023. ClinicalTrials.gov ID: NCT05953870, registration date 23/06.2023.