Abstract：
OBJECTIVE: Although intraoperative music is purported to mitigate postoperative pain after some procedures, its application has never been explored in abdominal wall reconstruction (AWR). We sought to determine whether intraoperative music would decrease early postoperative pain following AWR.
METHODS: We conducted a placebo-controlled, patient-, surgeon-, and assessor-blinded, randomized controlled trial at a single center between June 2022 and July 2023 including 321 adult patients undergoing open AWR with retromuscular mesh. Patients received noise-canceling headphones and were randomized 1:1 to patient-selected music or silence after induction, stratified by preoperative chronic opioid use. All patients received multimodal pain control. The primary outcome was pain (NRS-11) at 24 ± 3 h. The primary outcome was analyzed by linear regression with pre-specified covariates (chronic opioid use, hernia width, operative time, myofascial release, anxiety disorder diagnosis, and preoperative STAI-6 score).
RESULTS: 178 patients were randomized to music, 164 of which were analyzed. 177 were randomized to silence, 157 of which were analyzed. At 24 ± 3 h postoperatively, there was no difference in the primary outcome of NRS-11 scores (5.18 ± 2.62 vs 5.27 ± 2.46, p = 0.75). After adjusting for prespecified covariates, the difference of NRS-11 scores at 24 ± 3 h between the music and silence groups remained insignificant (p = 0.83). There was no difference in NRS-11 or STAI-6 scores at 48 ± 3 and 72 ± 3 h, intraoperative sedation, or postoperative narcotic usage.
CONCLUSIONS: For patients undergoing AWR, there was no benefit of intraoperative music over routine multimodal pain control for early postoperative pain reduction.
BACKGROUND: ClinicalTrials.gov: NCT05374096.
METHODS: We conducted a placebo-controlled, patient-, surgeon-, and assessor-blinded, randomized controlled trial at a single center between June 2022 and July 2023 including 321 adult patients undergoing open AWR with retromuscular mesh. Patients received noise-canceling headphones and were randomized 1:1 to patient-selected music or silence after induction, stratified by preoperative chronic opioid use. All patients received multimodal pain control. The primary outcome was pain (NRS-11) at 24 ± 3 h. The primary outcome was analyzed by linear regression with pre-specified covariates (chronic opioid use, hernia width, operative time, myofascial release, anxiety disorder diagnosis, and preoperative STAI-6 score).
RESULTS: 178 patients were randomized to music, 164 of which were analyzed. 177 were randomized to silence, 157 of which were analyzed. At 24 ± 3 h postoperatively, there was no difference in the primary outcome of NRS-11 scores (5.18 ± 2.62 vs 5.27 ± 2.46, p = 0.75). After adjusting for prespecified covariates, the difference of NRS-11 scores at 24 ± 3 h between the music and silence groups remained insignificant (p = 0.83). There was no difference in NRS-11 or STAI-6 scores at 48 ± 3 and 72 ± 3 h, intraoperative sedation, or postoperative narcotic usage.
CONCLUSIONS: For patients undergoing AWR, there was no benefit of intraoperative music over routine multimodal pain control for early postoperative pain reduction.
BACKGROUND: ClinicalTrials.gov: NCT05374096.
摘要：
目的：虽然术中音乐被认为可以减轻某些手术后的术后疼痛，它在腹壁重建（AWR）中的应用从未被探索过。我们试图确定术中音乐是否会减少AWR后的早期术后疼痛。
方法：我们进行了安慰剂对照，患者-,外科医生-，评估员失明，2022年6月至2023年7月在一个单中心进行的随机对照试验,包括321例接受开放AWR并带后肌网的成年患者.患者接受降噪耳机，并在诱导后1：1随机分配给患者选择的音乐或静音，按术前长期使用阿片类药物进行分层。所有患者均接受多模式疼痛控制。主要结果是24±3h的疼痛（NRS-11）。通过使用预先指定的协变量（慢性阿片类药物使用，疝宽度,手术时间,肌筋膜释放,焦虑症诊断，和术前STAI-6评分)。
结果：178名患者被随机分配到音乐，其中164份进行了分析。177人被随机分配到沉默，其中157个进行了分析。术后24±3小时，NRS-11评分的主要结局无差异(5.18±2.62vs5.27±2.46,p=0.75)。在调整了预先指定的协变量后，音乐组和沉默组之间在24±3小时的NRS-11得分差异不明显（p=0.83）。在48±3和72±3h时，NRS-11或STAI-6评分无差异，术中镇静,或术后麻醉剂的使用。
结论：对于接受AWR的患者，对于术后早期疼痛减轻,术中音乐对常规多模式疼痛控制没有益处.
背景：ClinicalTrials.gov：NCT05374096。
方法：我们进行了安慰剂对照，患者-,外科医生-，评估员失明，2022年6月至2023年7月在一个单中心进行的随机对照试验,包括321例接受开放AWR并带后肌网的成年患者.患者接受降噪耳机，并在诱导后1：1随机分配给患者选择的音乐或静音，按术前长期使用阿片类药物进行分层。所有患者均接受多模式疼痛控制。主要结果是24±3h的疼痛（NRS-11）。通过使用预先指定的协变量（慢性阿片类药物使用，疝宽度,手术时间,肌筋膜释放,焦虑症诊断，和术前STAI-6评分)。
结果：178名患者被随机分配到音乐，其中164份进行了分析。177人被随机分配到沉默，其中157个进行了分析。术后24±3小时，NRS-11评分的主要结局无差异(5.18±2.62vs5.27±2.46,p=0.75)。在调整了预先指定的协变量后，音乐组和沉默组之间在24±3小时的NRS-11得分差异不明显（p=0.83）。在48±3和72±3h时，NRS-11或STAI-6评分无差异，术中镇静,或术后麻醉剂的使用。
结论：对于接受AWR的患者，对于术后早期疼痛减轻,术中音乐对常规多模式疼痛控制没有益处.
背景：ClinicalTrials.gov：NCT05374096。
