1. Singh Joy, Subhashni D.


According to this study:


* Music decreased anxiety and the need for sedation in critically ill patients undergoing mechanical ventilation.



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Patients in ICUs who need mechanical ventilation often experience anxiety. That anxiety is usually addressed through sedation, which carries its own dangers. Researchers in Minnesota sought to determine whether the use of music could decrease stress and anxiety-and, consequently, the need for sedation-in mechanically ventilated patients.


Patients were randomized to one of three groups: music with noise-canceling headphones, noise-canceling headphones without music, and standard care. Music group participants were provided with relaxing music, which they were encouraged to listen to whenever they felt anxious or wanted to relax. The headphone-only group was encouraged to wear headphones to reduce ICU noise.


The study took place at 12 ICUs in five hospitals over a 4.5-year period and included 126 patients listening to music, 122 using headphones only, and 125 receiving standard care. Anxiety scores, determined using a visual analogue scale, were 36% lower in the music group than in the standard care group. Similarly, sedation-intensity scores, determined using a quartile-based formula that allowed researchers to compare the use of sedatives in different drug classes, were 36% lower over time in the music group than in the standard care group. Specifically, on the fifth day of participation, patients in the standard care group received an average of five doses of sedative, compared with three in the music group. In comparison with the headphones-only group, the music group received sedation less frequently, but differences in anxiety and sedation scores weren't significant.


Among the study's limitations was the fact that anxiety assessments were performed only once daily at most, and the number of assessments per patient varied. Nurses didn't report the protocol being burdensome, though, suggesting that a music intervention may require limited effort to implement.




Chlan LL, et al. JAMA. 2013;309(22):2335-44