THE VALUE of music in reducing perioperative anxiety in patients undergoing surgery or caesarean delivery has been quantified by researchers in a 2026 systematic review and meta-analysis, which found an effectiveness similar to that of benzodiazepines.<\/p>\n
The calculated number needed to treat (NNT) was 4, meaning that only four patients need to listen to music perioperatively for one of them to benefit from the intervention.<\/p>\n
This translates to a reduction in perioperative anxiety by 12 mm on the Visual Analog Scale for Anxiety, or 5.7 points on the State-Trait Anxiety Index, for one patient when four are treated.<\/p>\n
Calculating the NNT of Music Intervention<\/p>\n
Music intervention has previously been established as an effective therapy for reducing perioperative anxiety but, until now, had not been assigned an NNT.<\/p>\n
Hence, researchers aimed to provide the measurement to support clinicians in considering the real-world value of implementing the intervention.<\/p>\n
They found that patients experienced a significant, moderate-to-large anxiety reduction after recorded music interventions in surgical settings.<\/p>\n
Researchers conducted a comprehensive literature search, collating data from randomised controlled trials that analysed the effect of the intervention on perioperative anxiety (measured with any validated tool).<\/p>\n
They subsequently calculated effectiveness, using Furukawa\u2019s method to translate statistical evidence into the NNT for clinical application.<\/p>\n
Effectiveness Similar to Benzodiazepines Without Potential Side-Effects<\/p>\n
Pharmacological treatment of anxiety in surgical settings has mostly centred around the use of benzodiazepines.<\/p>\n
In recent years, side-effects, including respiratory depression, drowsiness, and dependency, have gained increasing attention in discourse surrounding the use of the drugs in perioperative care, particularly in older populations.<\/p>\n
The only NNT for the use of benzodiazepines is a score of 4 for their effect in the treatment of a panic disorder, researchers reported.<\/p>\n
It follows that authors warned that no NNT for the effect of the drugs in the specific context of preoperative anxiety is known, limiting direct comparison.<\/p>\n
Nonetheless, the clinical implications of the calculated NNT are significant, researchers highlighted, because music intervention can be seen as similarly as effective as benzodiazepines but does not carry the same side-effects (nor cost).<\/p>\n
Authors said this could encourage clinicians to implement music intervention into daily practice.<\/p>\n
References<\/p>\n
Stoop JM et al. The number needed to treat for music as a medicine against perioperative anxiety: A systematic review and meta-analysis. Anesth Analg. 2026;142(4):625-634.<\/p>\n
Mahanna-Gabrielli E et al. Pro-con debate: judicious benzodiazepine administration for preoperative anxiolysis in older patients. Anesth Analg. 2023;137:280-288.<\/p>\n
Breilmann J et al. Benzodiazepines versus placebo for panic disorder in adults. Cochrane Database Syst Rev. 2019;DOI:10.1002\/14651858.CD010677.pub2.<\/p>\n
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