Original Articles
Not All Sounds Have Negative Effects on Children Undergoing Cardiac Surgery

https://doi.org/10.1053/j.jvca.2015.01.005Get rights and content

Objective

This study was designed to evaluate the role of music therapy on the level of stress in children undergoing repair of congenital heart disease.

Design

Prospective, randomized, double-blind, controlled clinical trial.

Setting

Children’s university hospital.

Participants

Fifty children aged 4 to 12 years undergoing repair of congenital heart disease.

Interventions

Patients were randomized into 2 equal groups (control group and music group); in the control group, patients listened to a blank CD, and in the music group, patients listened to a recorded CD of music and songs preferred by the child. Demographic data, clinical data, and preoperative vital signs were recorded. Baseline stress markers (blood glucose and cortisol levels) were sampled. Patients were assessed intraoperatively until extubation for vital signs and stress markers and after extubation for pain and sedation scales. An interview was conducted within the first postoperative week with the patients and their parents for assessment of post-traumatic stress disorder and negative postoperative behavior changes.

Measurements and Main Results

There were no significant differences in demographic characteristics, clinical data, vital signs, preoperative and at-extubation blood glucose levels, and preoperative blood cortisol levels between groups. Significant differences were found between groups in blood glucose levels and cortisol levels at all intraoperative times, but only in cortisol blood levels at extubation. Significant differences were found in pain score, sedation score, occurrence of child post-traumatic stress disorder, and occurrence of negative postoperative behavior.

Conclusion

Listening to favorable music by children undergoing repair for congenital heart disease resulted in less stress and more relaxation.

Section snippets

Materials and Methods

Written informed consent was obtained from all parents of the children undergoing cardiac surgery. Consent was given after a detailed description of the study was discussed with the parents and their children. The study was approved by the research ethics board of Assiut University hospitals.

Fifty patients aged 4 to 12 years were allocated randomly into 2 equal groups (control group and music group) by using computer-generated random numbers contained in an opaque sealed envelope. Patients with

Statistical Analysis

Data were computerized and analyzed using the SPSS (SPSS 16.0 software, Chicago, IL) computer program. The normality of the data was assessed by Kolmogorov-Smirnov test. Data are presented as mean±SD or numbers and percentages when appropriate. Comparison between groups was by Student’s t-test or Mann-Whitney U test when appropriate. Fischer's exact test of χ2 test was used to assess group differences for categoric variables; p < 0.05 was considered significant.

Results

Patients’ general characteristics and different intraoperative times were summarized in Table 1; there were no statistically significant differences between groups. There also were no statistically significant differences between the control and music groups regarding mean blood pressure, heart rate, SPO2, and temperature (Table 2). There were statistically significant differences in plasma cortisol levels between groups at sternotomy, at cross-clamping, at rewarming, and at extubation; not at

Discussion

Music is used to regulate mood and arousal in everyday life and to promote physical and psychological health and well-being in clinical settings.17 Adrenocorticotropic hormone, cortisol, epinephrine, and norepinephrine frequently are used markers of surgical stress.18

This study found that there was no statistically significant difference between groups in preoperative plasma cortisol level, which indicated that during the preoperative period the patients were not exposed to any intervention to

Conclusion

Listening to pleasant music by children undergoing repair for congenital heart disease reduced occurrence of surgery-associated stress responses: plasma cortisol level, blood glucose level, postoperative pain, child post-traumatic stress disorder, and negative postoperative behavior changes.

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