The Effect of Musical Interventions in Improving Short-term Pain Outcomes Following Total Knee Replacement: A Meta-analysis and Systematic Review


Journal of Orthopaedic Surgery and Research




BACKGROUND: A growing number of patients continue to receive total knee replacement (TKR) surgery. Nevertheless, such surgeries result in moderate to severe postoperative pain and difficulty in managing it. Musical interventions are regarded as a type of multimodal analgesia, achieving beneficial results in other clinical treatments. This study aims to evaluate the effect of musical interventions in improving short-term pain outcomes following TKR in order to determine a more reasonable and standard way of delivering musical intervention. METHODS: A systematic search was conducted to identify available and relevant randomized controlled trials (RCTs) regarding musical interventions compared against non-musical interventions in patients treated with TKR in Embase, MEDLINE, Cochrane Library, Web of Science, CNKI, and Wanfang Med Online up to 8 January 2020. The authors independently assessed study eligibility and risk of bias and collected the outcomes of interest to analyze. The statistical analysis was conducted using the Review Manager (RevMan) version 5.30 software. RESULTS: Eight RCTs comprised of 555 patients satisfied the inclusion criteria and were enrolled in the present study. The results showed no significant difference between the music and control groups in pain of the visual analog scale (VAS), during postoperative recovery room, back to the ward after surgery; anxiety degree of VAS; heart rate; respiratory rate; oxygen saturation; blood pressure, systolic blood pressure, and diastolic blood pressure. Nevertheless, significant differences were observed between the two groups in average increase in continuous passive motion (CPM) angles and LF/HF ratio (one kind index of heart rate variability). CONCLUSIONS: Musical interventions fail to demonstrate an obvious effect in improving short-term pain outcomes following TKR. A reasonable standardization of musical interventions, including musical type, outcome measures used, outcomes measured, duration, timing and headphones or players, may improve pain outcomes with certain advantages and should be further explored after TKR.

Music and Health Institute Terms

Anxiety; Blood Pressure; Heart Rate; Hospital Setting; Hospitalized Patients; Music Listening; Music Medicine; Orthopedic Surgery; Oxygen Saturation; Pain; Pain Management and Control; Postoperative Pain; Postoperative Patients; Recorded Music Listening; Respiratory Rate; Self-Report Measures; Surgery; Surgical Patients; Visual Analog Scale (VAS); Vital Signs

Indexed Terms

Elderly; Elderly; Arthroplasty, Replacement, Ankle; Pain Management; Postoperative Pain; Severity of Illness Index; Time Factors; Knee surgery; Meta-analysis; Music interventions; Pain; Systematic-review; Tka; Tkr; Total knee replacement

Study Type

Quantitative Methods; Systematic Review

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