Background
Methods
Identification and selection of studies
Data extraction and management
Assessing the risk of bias in included studies
Summary measures
Data synthesis
Risk of bias across studies
Additional analyses
Results
Study selection
Description of included studies
First author (publication year) | Country | Surgical procedure | Description of therapeutic suggestions a |
n
| Description of control group |
n
| Anesthesia | Outcomes |
---|---|---|---|---|---|---|---|---|
Bethune et al. (1993) [47] | UK | Coronary artery bypass grafting | Positive; based on text used by Evans & Richardson (1988) [48]; music at the beginning | 16 | Blank tape with musical leader | 17 | I | Mental distress (mood, anxiety) Pain intensity Recovery (nausea, mobility, general recovery) Length of procedure |
Block et al. (1991) [15] | USA | Operation on the fallopian tubes, vertical banding gastroplasty, total abdominal hysterectomy, ovarian cystectomy, cholecystectomy, myomectomy | Smooth, rapid recovery during a short post-operative stay; no pain, nausea or vomiting; rapid return of bowel and bladder function; rapid healing and mobility; comfort; relaxation; good appetite, sleep, mood, and feeling | 109 | Blank tape | 100 | I | Medication (antiemetics, Analgesics) Length of procedure |
Boeke et al. (1988) [49] | NL | Elective cholecystectomy | Relaxation, wellbeing, pleasant feeling in every respect, absence of nausea and vomiting, good recovery; with seaside sounds | 24 | Nonsense suggestions with seaside sounds | 26 | N | Mental distress (well-being) Pain intensity Recovery (nausea, general recovery) Length of procedure Physiological parameters (blood loss) |
Bonke et al. (1986) [50] | NL | Biliary tract surgery | Relaxation, well-being, comfortable feelings in every respect, lack of nausea or vomiting, no difficulty with bladder function or bowel movement, rapid recovery | 31 | Monotonous low-frequency noise, resembling the sound of a vacuum cleaner | 30 | N | Mental distress (well-being, relaxation) Pain intensity Medication (analgesics) Recovery (PONV, general recovery) Length of procedure Physiological parameters (blood loss) |
Caseley-Rondi et al. (1994) [51] | Canada | Elective total abdominal hysterectomy and/or bilateral salpingo oophorectomy | Simple and positive; alternating with Japanese melodies | 48 | Blank tape alternating with Japanese melodies | 48 | I | Mental distress (mood, anxiety) Pain intensity Medication (analgesics) Recovery (nausea, general recovery) |
Cowan et al. (2001) [52] | USA | Bariatric surgical patients | Positive; cognitive-behavioural approach: reinforcement of information received preoperatively, encouragement of performance of recovery regimes, positive interactions with personnel, improved self-image, relaxation | 10 | Blank tape | 17 | I | Recovery (turning, coughing, breathing, mobility) |
Dawson et al. (2001) [29] | UK | Total abdominal hysterectomy with/without bilateral salpingo oophorectomy | (1) No pain (2) No sickness (3) No sickness, no pain | 35 34 34 | White noise | 35 | N (no N2O) | Pain intensity Medication (antiemetics, analgesics) Recovery (PONV) Length of procedure |
De Houwer et al. (1996) [53] | Belgium | Coronary artery bypass grafting | Relaxation, fast recovery; based on Bonke et al. (1986) [50]; with background relaxing music | 19 | Blank tape | 21 | T | Mental distress (mood, anxiety) Recovery (general recovery) Length of procedure Physiological parameters (blood pressure, noradrenalin, adrenalin) |
Eberhart et al. (1998) [54] | Germany | Thyroidectomy | Smooth postoperative recovery; relaxation, security, absence of nausea and vomiting | 36 | Blank tape | 35 | N | Medication (antiemetics, analgesics) Recovery (PONV) Length of procedure |
Evans & Richardson (1988) [48] | UK | Total abdominal hysterectomy | Direct (no sickness, no pain), third person (operation is going very well and the patient is fine), description of normal postoperative procedures and coping advices | 19 | Blank tape | 20 | I | Mental distress (anxiety, mood) Pain intensity Recovery (PONV, pyrexia, bowel difficulties, flatulence, mobility, micturation, general recovery, complications) Length of procedure Physiological parameters (blood loss) |
Furlong (1990) [55] | USA | Abdominal gynecological surgery | Positive | 10 | Blank tape | 9 | I | Mental distress (mood) Medication (analgesics) Length of procedure |
Furlong & Read (1993) [56] | USA | Gynecological surgery or mastectomy | Positive; with background music | 52 | Blank tape | 56 | I | Mental distress (anxiety) Pain intensity Medication (analgesics) Recovery (PONV, mobility, bowel difficulties, micturition, wound healing) |
Jelicic et al. (1993) [30] | NL | Cholecystectomy | (1) Affirmative (relaxation, comfort, quick healing) and non-affirmative (absence of tension, nausea); alternating with seaside sounds (2) Affirmative (3) Non-affirmative | 21 20 20 | Irrelevant text, i.e. excerpts from a cookery book | 21 | N | Mental distress (well-being) Length of procedure Physiological parameters (blood loss) |
Korunka et al. (1992) [40] | Austria | Hysterectomy | Positive; followed by indirect (general wellbeing, absence of pain) | 55 | Operation sounds | 53 | I | Pain intensity Medication (analgesics) Length of procedure |
Lebovits et al. (1999) [57] | USA | Elective hernia repair | Positive postoperative course, well-being and relaxation, minimal side effects, no difficult voiding, minimal discomfort such as sore throat, muscle aches and emetic symptoms; requirement of minimal pain medication | 34 | History of hospital | 36 | T | Pain intensity Medication (analgesics) Recovery (PONV, side effects) Length of procedure |
Liu et al. (1992) [58] | UK | Total abdominal hysterectomy | Affirmative and non-affirmative (comfort and rapid recovery; absence of pain or feelings of sickness) | 24 | History of hospital | 25 | I | Mental distress (mood) Pain intensity Medication (analgesics) Recovery (nausea, pyrexia, wound healing, mobility, flatulence) Length of procedure Physiological parameters (blood loss) |
Liu et al. (1993) [59] | UK | Surgical repair of fractured neck of femur | Positive (relating to comfort, mobility, nausea, general recovery and discharge after surgery) | 58 | History of hospital | 61 | GA | Pain intensity Medication (analgesics, antiemetics) Recovery (ADL, mobility, pyrexia) |
Maroof et al. (1997) [60] | Saudi Arabia | Elective abdominal hysterectomy | Positive (good progress, well-being after surgery, absence of sickness) | 25 | Blank tape | 25 | I | Medication (antiemetics) Recovery (PONV, fluid replacement) Length of procedure |
Mastropietro (1998) [31] | USA | Open gynaecological procedures through a midline incision | (1) Synchronized with soothing music presented when stress test was positive (comfortable, relaxed intraoperative and postoperative experience) (2) Randomly presented with soothing music (comfortable, relaxed intraoperative and postoperative experience) | 24 | ||||
McLintock (1990) [61] | UK | Elective abdominal hysterectomy by Pfannenstiel’s incision | Positive (positive progress, feelings of warmth, comfort, calmness and relaxation; absence of pain) | 30 | Blank tape | 30 | I | Pain intensity Medication (analgesics) Recovery (PONV) |
McWilliams (1990) [62] | USA | Lumbar laminectomy surgery | Suggestions interspersed with environmental sounds | 30 | Environmental sounds alone | 30 | GA | Medication (analgesics, antiemetics) Recovery (general recovery) |
Melzack et al. (1996) [63] | Canada | Cholecystectomy or hyterectomy | Positive; regarding the recovery process (e.g., feeling fine, mild pain only); interspersed with music | 10 | Excerpts from physiology book | 10 | I | Pain intensity Length of procedure |
Moix et al. (1996) [64] | Spain | Abdominal hysterectomy | Affirmative (feeling of relaxation during surgery, good progress, easy and rapid recovery, rapid mobility, comfort, good appetite, digestion, micturition, sleep and mood) | 14 | Monotonous sounds | 13 | I | Pain intensity Medication (analgesics) Recovery (vomiting, pyrexia, digestion, appetite, sleep, bowel function, general recovery, micturition, complications) Length of procedure Physiological parameters (blood pressure, heart rate) |
Münch & Zug (1990) [65] | Germany | Thyroidectomy | General (comfort and well-being), direct (relaxing and feeling well, no vomiting, no nausea, only little pain); classical music played in a modern fashion | 18 | Blank tape | 18 | N | Mental distress (well-being) Pain intensity Recovery (PONV) Length of procedure |
Nilsson et al. (2001) [66] | Sweden | Hysterectomy | Relaxing and encouraging; music (relaxing and calming; accompanied by soothing sounds of sea waves) | 31 | Operation room sounds | 28 | I | Mental distress (well-being) Pain intensity Medication (analgesics) Recovery (nausea, fatigue, mobility) Length of procedure Physiological parameters (blood loss) |
Oddby-Muhrbeck et al. (1995) [67] | Sweden | Elective breast surgery | Affirmative (safe atmosphere, quick recovery, feelings of hunger and thirst) | 35 | Low electronic sound set | 35 | I | Pain intensity Medication (analgesics) Recovery (PONV, general recovery) Length of procedure Physiological parameters (blood loss) |
Pearson (1961) [39] | USA | Thyroidectomy, gastrectomy, hernia repair, hysterectomy, pelvic laparoscopy, vein stripping | In a permissive manner (relaxation and selfresponsibility of the patient for the course of recovery) | 43 | Blank tape | 38 | GA | Medication (analgesics) Recovery (general recovery) |
Rosenberg (1992) [68] | USA | Hysterectomy, myomectomy, other gynaecological procedures, cholecystectomy | Positive (smooth, comfortable, and rapid recovery, absence of sickness and pain), procedural/ sensory information about course of surgery and recovery; imagery, recommendations for dealing with postoperative events and sensations | 33 | Blank tape | 32 | I | Mental distress (anxiety) Pain intensity Medication (analgesics, antiemetics) Recovery (mobility, pyrexia, micturation) Length of procedure |
Steinberg et al. (1993) [69] | USA | Total abdominal hysterectomy or breast reconstruction by transverse rectus abdominus musculocutaneous reconstruction flap | Positive (relating to nausea and anxiety) | 30 | Blank tape | 30 | I | Mental distress (anxiety) Pain intensity Medication (analgesics) Recovery (PONV) |
van der Laan et al. (1996) [70] | USA | Hysterectomy, myomectomy, gynecologic laparotomy | Nonspecific affirmative (feelings of relaxation and security) | 20 | Story of Peter Pan | 20 | I | Mental distress (anxiety) Pain intensity Medication (analgesics) Recovery (nausea) Length of procedure |
Williams et al. (1994) [42] | UK | Major gynaecological surgery | Positive (smooth and uncomplicated progress of surgery, well-being after surgery, absence of sickness) | 22 | Blank tape | 29 | I | Medication (analgesics) Recovery (PONV, fluid replacement) Length of procedure Physiological parameters (blood loss) |
Woo et al. (1987) [71] | USA | Hysterectomy | Positive (rapid recovery) | 7 | Ocean sounds | 7 | I | Medication (analgesics) |