Music Therapy for Pain and Anxiety�Management in Nasal Bone Fracture�Reduction
By Barbara Adeeb Kirolos
Introduction :-
Music therapy uses the naturally mood-lifting properties of music to help people improve their mental health and overall well-being. It’s a goal-oriented intervention that may involve: Making music, Writing songs, Singing, Dancing, Listening to music and Discussing music.
Music therapy was tested in different procedures, such as colposcopies, endoscopies, cystoscopies, breast biopsies, cardiac catheterization, ophthalmologic surgery, extracorporeal lithotripsy, abdominal or gynecological surgery, and orthopedic surgery, in the pre- and postoperative periods.
Abstract :-
Nasal bone reduction is done after 7:10 days it can be done under general, local or tropical anesthesia.
Although there is no major functional difference in these three methods' results, General anesthesia has more disadvantages as greater risk, higher cost and longer hospitalization that's why local anesthesia is preferred.
So this Randomized Controlled Clinical Trial was done to evaluate if listening to music through binaural headphones aids to reduce the perception of pain and relives anxiety associated with local anesthesia for this case.
Playlist of the used music
The chosen music is rhythmically slow songs (60-80 beats per minute) .
All the group one listened to it by Bluetooth headphones and that didn’t interfere the communication between patient and doctor.
Patient chosen and preparing :-
A randomized group of patients ,with specific criteria, who underwent a nasal bone fracture were selected to complete this study.
Criteria of selection | Criteria of exclusion |
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36 patients were chosen for the study 17 at the music group and 19 at the control group.
There were 25 men and 11 women, with a median age of 30.5 years.
Only one patient had a pervious experience of nasal bone fracture reduction.
The recorded data:- �
1-prior to the intervention.
2-at the time of the administration of the local anesthetic.
3-at the time of the reduction of the fracture.
4-15 minutes after the procedure while in the recovery room.
For evaluating the trial:-
(STAI) survey & respond to (VAS) report was applied 3 times :
Methods:-
The music group listened to slow songs during the whole procedure (10 mins pre, during and 10 mins post operative) and the control one didn’t.
Anesthesia :-
By using Two 2-mL ampoules of 2% lidocaine and 1:100,000 adrenaline bilateral endonasal block of the infratrochlear and infraorbital nerves is done, without anesthesia of the nasal septum.
After 5mins of anesthesia , the reduction was performed.
The same known steps of closed reduction was done for
both groups.
After reduction was done :-
patients was in the recovery room for a 1-hour clinical observation before discharging. Pain medication was : paracetamol 500 mg/8h and ketoprofen 100 mg/12h for 7 days then they came for follow up.
Main results :-
For anxiety:-
Both groups started almost equal scores preoperative
But control group scored high increase of anxiety scores after the procedure, whereas the music group maintained or even decreased its STAI scores below the initial values.
For pain:-
Both groups started from the same level preoperatively but the music group showed lower level of pain postoperatively immediate and at later follow up.
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Recognizing the physiological changes showed :-
1- for Blood Pressure:-
2- for Heart Rate:-
No significant difference was reported for both groups.
Discussion:-
The music effect occurs by means of modulating the emotional-affective dimension of pain mechanisms at a central level.
By asking the patient and analyzing the recorded results it seems to be enough to assess music therapy as useful in pain and anxiety management.
The general opinion of the music group was that ,they were satisfied with the intervention of music and they thought it would be interesting to extend its use and incorporate it into their everyday practice of therapeutic options.
Conclusion :-
Music gives an inner sense of comfort and helps to overcome the feeling of pain.
Listening to music ,softly not loudly, is a safe and low-cost method to aid in management of pain and anxiety associated with the reduction of nasal bone fractures under local anesthesia.
So we can consider it a complementary treatment for pain and anxiety management for other medical procedures of similar pain levels without general anesthesia.
This form of treatment may be helpful for people with depression and anxiety, and it may help improve the quality of life for people with physical health problems.
Anyone can engage in music therapy; you don’t need a background in music to feel its beneficial effects.