The benefits of perioperative music interventions for patients undergoing neurosurgery: a mixed-methods systematic review

Several studies have demonstrated music intervention as a safe and inexpensive option for reducing anxiety and pain perioperatively. We performed a systematic review to evaluate its possible benefit in perioperative neurosurgical management.The following databases were searched with no restrictions on publication date: PubMed, Embase, CINAHL, PsycINFO, CENTRAL and ClinicalTrials.gov. All studies that quantitatively or qualitatively assessed the effects of any music-based intervention administered within one week of cranial or spinal neurosurgery were eligible. Meta-analysis could not be performed, and quantitative findings were instead summarised narratively. We then synthesised qualitative observations through thematic analysis before conducting an integrative review. PROSPERO registration: CRD42019152626.Seven studies, of sample sizes ranging from 8 to 60, were included, with the timing, duration, frequency and type of music intervention varying considerably across studies. Quantitative analysis involving five studies showed a significant decrease in anxiety following music intervention in four studies (p < 0.05), and reduced pain perception in three studies (p < 0.05). Mixed evidence was obtained for physiological outcomes including heart rate and blood pressure. Risk of bias was moderate to high. Quantitative findings were generally supported by qualitative analysis which provided additional insight into the factors influencing music intervention's effectiveness.Despite the heterogeneity in study characteristics, this review, which is the first mixed-methods systematic review assessing the effects of perioperative music intervention, not only reveals a potential role for music intervention in neurosurgery, but also highlights the possible importance of considering qualitative evidence in future studies to better characterise its effectiveness.