Listening to Music Pre-Cataract Surgery Significantly Reduces Anxiety Levels in Patients

Listening to Music Pre-Cataract Surgery Significantly Reduces Anxiety Levels in Patients

November 26, 2021

Cataract extraction is one of the most common procedures, but any type of surgery can be stressful for patients and result in increased blood pressure, heart rate, and intraocular pressure (IOP).

According to a new study published in JAMA Ophthalmology, researchers discovered that patients who listened to music before cataract surgery had less anxiety and 39% less hypertensive events.

A hypertensive event, the study’s primary endpoint, defined as a systolic blood pressure of more than 160mm Hg and/or a diastolic blood pressure of more than 100mm Hg combined with a tachycardia rate of more than 85 beats per minute.

The investigation took place at Cochin Hospital in Paris from 2017 to 2018 and included 310 patients undergoing phacoemulsification for elective cataract surgery in their first eye under local anesthesia.

Half of the patients were randomly assigned to a 20-minute music session using the Music Care online app with the "U sequence" technique, which is designed to gradually relax the listener through certain sequences of rhythms and sound volumes.

The other half received the identical noise-cancelling headphones but without any music. Just before surgery, the musical intervention was stopped.

Participants were instructed to select their preferred musical program, adjust the volume on their headphones, and begin a 20-minute session. The identical insulating headphones were placed on the participants' ears in the control arm (155 participants), but there was no music. Individuals in both groups wore their headphones and sleeping masks for 20 minutes each.

Out of 311 patients, only 309 were analyzed, since one participant in the music arm had already undergone cataract surgery in the other eye. Patients were roughly 69 years old, and females represented 57% of participants.

The difference between the two groups was extraordinary.

Anxiety levels—the study’s secondary endpoint— were lower in the music arm (1.4) compared with the control arm (3.1), or a difference of 1.5. Researchers used a visual analog scale ranging from zero to ten to measure anxiety levels.

Individuals who listened to music prior to cataract surgery also required fewer midazolam sedative drug injections during the procedure:  0.04 vs. 0.54, or a 0.50 difference.

A 20-minute music intervention before cataract surgery based on the U sequence algorithm appears to offer an effective treatment for anxiety by reducing hypertension, levels of anxiety, and the need for sedative drugs during the procedure, the authors suggested, highlighting the importance of listening to music in reducing potential debilitating effects.

“Furthermore, this treatment is easily accessible and distributable via its computer- and smartphone-based application,” researchers wrote in their paper. “Overall, we would like to stress the positive effects of using a web app-based music intervention as potential large-scale treatment for those who experience anxiety and possibly in the context of other types of surgical procedures.”