Perioperative Music Therapy Enhances Pain Management and Sleep Quality in Patients Aged 50–70 Years Undergoing Total Knee Arthroplasty: A Randomized Controlled Trial

Lin Yang,1,* Xu Liu,2,* Xiaoli Fu,3 Zhong Qing,4 Yusheng Li,2 Guang Yang1 1Department of Anesthesiology, Honghui Hospital, Xi’an, People’s Republic of China; 2Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, People’s Republic of China; 3Department of Anesthesiology, Northwest Women’s and Children’s Hospital, Xi’an, People’s Republic of China; 4Department of Orthopedics, Honghui Hospital, Xi’an, People’s Republic of China*These authors contributed equally to this workCorrespondence: Guang Yang, Email [email protected]: Music therapy (MT) has recently shown its value in alleviating pain in surgical patients. To explore its perioperative analgesic effects in patients undergoing total knee arthroplasty (TKA) under general anesthesia, we conducted a randomized single-blind clinical trial.Patients and Methods: Eighty-six patients aged 50– 70 years (ASA II–III) undergoing TKA at Honghui Hospital were randomly assigned to either a music group or a control group. The music group listened to music via headphones from 10 minutes before anesthesia induction until awakening after surgery. The control group wore headphones without music for the same period. All patients received standardized general anesthesia with BIS values maintained between 40 and 60. Postoperatively, a patient-controlled analgesia (PCA) pump was used. Outcome measures included Visual Analogue Scale (VAS) pain scores, analgesic dosage, PCA usage, Nausea VAS (NVAS), Pittsburgh Sleep Quality Index (PSQI), and satisfaction with analgesia at 1h, 2h, 3h, 12h, 24h, and 48h after surgery.Results: The music group showed significantly fewer PCA presses at 1h and 3h post-operation (p < 0.05), with no significant differences at later time points. Sleep quality and analgesia satisfaction on the first postoperative night were also significantly better in the music group (p < 0.05). No significant differences were found in VAS, NVAS, or analgesic dosage at most time points.Conclusion: Perioperative music therapy can effectively support PCA for a specific postoperative period, alleviating early postoperative pain, enhancing sleep, and improving patient satisfaction with analgesia in TKA patients.Keywords: music therapy, self-controlled analgesia, total knee arthroplasty, pain manage