Preoperative anxiety is a common experience in patients who are receiving a surgical procedure. Preoperative anxiety is a feeling of intense uneasiness due to a lack of understanding, control, inability to communicate feelings, as well as past negative medical experiences (Gooding & Millett, 2017). This can lead to many adverse effects psychologically as well as physically. While preoperative anxiety is experienced by all ages, 75% of children are especially susceptible to these feelings of distress before an operation (Billick & Fronk, 2020). Young children typically reveal their anxiety differently from adults with behaviors such as trembling, restlessness, crying, or being silent due to the inability to verbalize their concerns or communicate effectively because they are distressed (Getahun et al., 2020). These adverse effects can lead to complications during procedures, as well as have negative long-term effects on the child. Children who experience high levels of preoperative anxiety have a greater risk of injuring themselves by trying to take control, such as accidently ripping out an IV. In addition, preoperative anxiety has also been linked to negative long-term effects such as separation anxiety, tantrums, nightmares, and bedwetting up to 12 months after a surgical procedure (Gooding & Millet, 2017).
There are multiple methods in aiding a child who is experiencing preoperative anxiety, which can be broken down into pharmacological and non-pharmacological methods (Gooding & Millet, 2017). Sedatives are a commonly used pharmacological method to ease preoperative anxiety. One of the most popular medications used for preoperative anxiety is the benzodiazepine midazolam because of its fast-acting effects and its significant reduction of nausea in patients. However, midazolam has also been linked to negative post-operative effects on behavior, cognition, and mental state (Billick & Fronk, 2020). Along with pharmacological methods being linked with adverse effects post-operation, pharmacological methods tend to be costly (Gooding & Millet, 2017).
Music therapy is a non-pharmacological method that has been proven to be an excellent alternative to medication (Montgomery, 2016). Research has indicated that music can help individuals process emotions, and positively increase their emotional wellbeing (Montgomery, 2016). Scientific research has verified that music releases chemicals and hormones such as dopamine and endorphins within the brain. Dopamine is linked to an individual’s reward system and gives a sense of pleasure, while hormones such as endorphins also release a feeling of euphoria as well as being a known pain reliever. The release of these hormones has been shown to reduce feelings of anxiety in most individuals (Montgomery 2016). Additionally, music can also impact a person’s physical state. Scientific evidence shows that music can manipulate a person’s heart rate as well as blood pressure (Montgomery 2016). The ability to slow heart rate and lower blood pressure can lead to a calming effect on pediatric patients experiencing high levels of distress.
Due to music’s power over the brain and body, a board-certified music therapist who has been trained to use music to manipulate these factors can greatly impact the level of preoperative anxiety experienced before surgery. According to Gooding & Millet, their research found that music therapy reduced preoperative anxiety in pediatric patients as well as their caregiver (2020). The researchers also found that none of the participants within the study showed negative post-operative outcomes unlike studies using pharmacological means (Gooding & Millet, 2020). Although there needs to be further research about music therapy and its direct effects on preoperative anxiety, research points to it being a viable alternative to medications.
References
Fronk, E., & Billick, S. B. (2020). Pre-operative anxiety in pediatric surgery patients: Multiple case study analysis with literature review. Psychiatric Quarterly, 91(4), 1439–1451. https://doi.org/10.1007/s11126-020-09780-z
Getahun, A. B., Endalew, N. S., Mersha, A. T., & Admass, B. A. (2020). Magnitude and factors associated with preoperative anxiety among pediatric patients: Cross-sectional study. Pediatric health, medicine and therapeutics, 11, 485–494. https://doi.org/10.2147/PHMT.S288077
Millett, C. R., & Gooding, L. F. (2017). Comparing active and passive distraction-based music therapy interventions on preoperative anxiety in pediatric patients and their caregivers. Journal of Music Therapy, 54(4), 460–478. https://doi.org/10.1093/jmt/thx014
Montgomery, E. (2016, November 1). The Science of Music therapy. Peterson Family Foundation. Retrieved February 6, 2022, from https://petersonfamilyfoundation.org/music-therapy/science-music-therapy/