Music takes the pain away post surgery

In today’s society, when it is so easy to over medicate children and adults alike it is nice to finally read something that looks for an alternative option. This particular case deals with pain management in children post surgery and the study shows that pediatric patients who listened to 30 minutes of songs by Rihanna, Taylor Swift and other singers of their choosing — or audio books — had a significant reduction in pain after major surgery.

The children, ages nine to 14, chose from a playlist of top music in different genres including pop, country, rock and classical. The researchers even included short audio books as another option in the study.

A strategy to control post-surgical pain without medication is important because opioid analgesics — most commonly used to control post-surgical pain — can cause breathing problems in children. Thus, caregivers usually limit the amount of opiods prescribed, and children’s pain is not well controlled.

“Audio therapy is an exciting opportunity and should be considered by hospitals as an important strategy to minimize pain in children undergoing major surgery,” said study senior author Dr. Santhanam Suresh. “This is inexpensive and doesn’t have any side effects.”

This is believed to be the first randomized study to evaluate and demonstrate the use of patient-preferred audio therapy as a promising strategy to control post-surgical pain in children. Prior studies looked at the effectiveness of music for pain during short medical procedures. Those studies also did not use objective measures of pain nor did they show whether the perception of pain was affected by the music itself or if an alternate audio therapy would be equally as effective.

The team believes the audio-therapy helped thwart a secondary pathway in the prefrontal cortex involved in the memory of pain.

“There is a certain amount of learning that goes on with pain,” Dr. Suresh said. “The idea is, if you don’t think about it, maybe you won’t experience it as much. We are trying to cheat the brain a little bit. We are trying to refocus mental channels on to something else.”

The researchers noted that letting patients choose their music or stories is an important part of the treatment, an obvious observation to some, but an important thing to state.

“Everyone relates to music, but people have different preferences.”

The most amazing part of it all, the therapy worked regardless of a patient’s initial pain score. Important since the proper dosage of pain medication in children is difficult to manage with the side effects.

“It didn’t matter whether their pain score was lower or higher when they were first exposed to the audio therapy,” Suresh said.

“It worked for everyone and can also be used in patients who have had ambulatory surgery and are less likely to receive opioids at home.”

The equal effectiveness of the audiobooks was an unexpected finding the authors noted. One of the most intersting aspects of the study was the ability for patients to continue their own audio therapy.

“After the study, several patients ended up bringing in their iPods and listening to their own music. They hadn’t thought of it before.”

In the study, about 60 pediatric patients received pain evaluations prior to and after receiving the audio therapy. They reported their pain levels based on identifying facial images such as a grimace or tears or a happy face to illustrate how they were feeling.

The children were divided into three groups; one heard 30 minutes of music of their choice, one heard 30 minutes of stories of their choice and one listened to 30 minutes of silence via noise-canceling headphones. The patients in the music and story groups had a significant reduction in pain. The patients who heard silence did not experience a change in pain.

Sources:
Sunitha Suresh B.S. & Santhanam Suresh (2015). The effect of audio therapy to treat postoperative pain in children undergoing major surgery: a randomized controlled trial, Pediatric Surgery International, DOI: http://dx.doi.org/10.1007/s00383-014-3649-9