Research and Scholarship

Impact of Music on Postoperative Pain, Anxiety, and Narcotic Use After Robotic Prostatectomy: A Randomized Controlled Trial

Kirtishri Mishra, MD, Erin Jesse, MD, Laura Bukavina, MD, MPH, Emily Sopko, APRN, CNP, Itunu Arojo, MD, Austin Fernstrum, MD, Al Ray III, MD, Amr Mahran, MD, MS, Adam Calaway, MD, Seneca Block, MA, MT-BC, and Lee Ponsky, MD

From (1)University Hospitals Cleveland Medical Center, Urology Institute, Cleveland, Ohio; (2)Case Western Reserve University School of Medicine, Cleveland, Ohio; (3)Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, Ohio; (4)University Hospitals Connor Integrative Health Network, Department of Music Therapy, Cleveland, Ohio

Authors’ disclosures of conflicts of interest are found at the end of this article.

Correspondence to: Lee Ponsky, MD, University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, Department of Urology, 11100 Euclid Ave, Cleveland, OH 44106. E-mail: lee.ponsky@uhhospitals.org

ABSTRACT

Background: Music is a safe and cost-effective intervention that can reduce postoperative pain and anxiety. We investigated the effects of music therapy on postoperative recovery in patients undergoing robotic-assisted laparoscopic prostatectomy (RALP). Methods: Subjects were males 18 years and older undergoing RALP at a single tertiary care institution. Patients were randomized to music or control groups. The music group received 30 minutes of music in the recovery area and on postoperative day (POD) 1, while the control group was not provided postoperative music. Inpatient narcotic use (morphine milligram equivalent, or MME) and outpatient narcotic use were measured, and the State-Trait Anxiety Inventory (STAI) survey was completed on POD 1 and POD 7 by an inpatient advanced practitioner (AP). T-test and Chi-square were used to compare the groups. Linear regression was used to adjust for age, blood loss, and inpatient MME. Results: A total of 40 patients were prospectively recruited. There was no statistically significant difference in the hourly MME (2.06 [0.71–3.17] vs. 1.55 [0.83- 3.37]) or total MME (49.52 [17–76] vs. 37.25 [20-69]) used in the music vs. non-music arms, respectively. Evaluation of STAI questionnaire revealed no overall differences in anxiety levels among the two groups on POD 1 or POD 7. After adjusting for age, blood loss, and inpatient MME use, patients assigned to the music intervention had a 26% reduction in post-hospitalization use. Conclusion: Our prospective randomized study suggests that music can be an AP-driven adjunct to facilitate postoperative patient comfort and reduce narcotic use upon discharge in prostate cancer patients.

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