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Music is an effective alternative to sedatives for reducing anxiety before surgery, study finds

Listening to music
Photo by Zoltan Tasi on Unsplash
This finding supports a growing body of research that has shown music can significantly reduce the anxiety and pain experienced by patients before and after surgery.

Listening to relaxing music may be as effective as taking a sedative at reducing patients’ anxiety before surgery, according to a study published last Friday in the journal Regional Anesthesia & Pain Medicine.

The study, a small randomized controlled trial, found that patients who listened to music before being injected with anesthesia reported levels of anxiety similar to those of patients who were given an intravenous sedative.

This finding supports a growing body of research that has shown music can significantly reduce the anxiety and pain experienced by patients before and after surgery.

Reducing anxiety before surgery is important. By elevating the levels of stress hormones circulating in the body, anxiety can impede a patient’s recovery process. To minimize that anxiety, therefore, most patients are given a benzodiazepine drug, such as midazolam, right before they are operated on.


Such drugs, however, have the potential of causing adverse effects, including problems with blood flow and breathing. They can also, ironically, trigger anxiety in some patients.

Music, on the other hand, is “virtually harm-free,” as the authors of the current study point out. It’s also inexpensive, they add.

“Music lights up the emotional area of the brain, the reward system and the pleasure pathways,” Dr. Veena Graff, the study’s lead author and an assistant professor of clinical anesthesiology at the University of Pennsylvania, told BBC News. “It means patients can be in their own world, they can be comfortable and have full control.”

How the study was done

Most past studies that investigated whether music reduced anxiety as well as anti-anxiety medications had patients taking the medications in pill form, which is not how it’s usually done in a surgical setting. The current study compared music with midazolam delivered intravenously.

For the study, Graff and her colleagues recruited 157 patients who were already scheduled to undergo surgery with a type of anesthetic known as a peripheral nerve block, which blocks pain to a specific area of the body. The procedure is routinely done before many outpatient surgeries, especially orthopedic surgeries involving the arms, hands, legs and feet.

The patients were randomly divided into two groups. One group (80 patients) was injected with 1 or 2 milligrams of midazolam three minutes before receiving the peripheral nerve block. The second group (77 patients) did not receive the midazolam, but were instead given noise-canceling headphones, through which they listened to a specific piece of music.

That music was the song “Weightless” by the British band Marconi Union. A few years ago, the band worked with sound therapists to create this particular track of music, which has been dubbed the “world’s most relaxing song.”

Using standardized questionnaires, the researchers compared how the two groups’ levels of anxiety changed after receiving either the midazolam or the music. They found that the groups reported similar drops in anxiety. The music was as effective as the medication in calming patients’ nerves.

Less satisified

Interestingly, the patients who listened to music were less satisfied with their pre-anesthesia experience than those who had midazolam. Graff and her colleagues say that may be because they did not get to choose the music. And, indeed, many of the patients in that group indicated that they would have preferred to select their own music.

The patients’ doctors, however, reported being just as satisfied with giving the patients music as with giving them an anti-anxiety medication. But both doctors and patients indicated they had more difficulty communicating when the music was being used, probably because of the noise-canceling headphones.

“Further studies are warranted to evaluate whether or not the type of music, as well as how it is delivered, offers advantages over midazolam that outweigh the increase in communication barriers,” Graff and her co-authors write.

FMI:  An abstract of the study can be found on the Regional Anesthesia & Pain Management’s website, although the full study is behind a paywall. You can listen to “Weightless” through the YouTube video below.

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Comments (1)

  1. Submitted by Pat Berg on 07/23/2019 - 05:23 pm.

    I just tried listening to “Weightless” (couldn’t stand it for more than a couple of minutes – like New Age elevator music on Ambien – in fact, I’m not sure it even actually qualifies as “music”) and I can definitely see why “the patients who listened to music were less satisfied with their pre-anesthesia experience”. Run the experiment again, and this time let people choose music they would actually find engaging, for Pete’s sake!

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