TABLE 1.
Study Characteristics
| Study ID | Surgical Procedure | Anesthesia | Intervention | Moment | Duration | N | Control | N | Outcome Parameters |
| Allred, 2010 | Total knee arthroplasty | General or spinal with femoral block | Choice of easy listening, nonlyrical music | Postoperatively | POD 1, 20 min before and after first ambulation | 28 | Quiet rest period | 28 | Postoperative opioid requirement |
| Ames, 2017 | Surgical procedures requiring ICU stay | General | MusiCure | Postoperatively | POD 1-2, 50 min, 1-8 times | 20 | 50 min quiet rest | 21 | Postoperative opioid requirement |
| Ayoub, 2005∗ | Urological procedures | Regional | Own favorite music | Intraoperatively | Procedure duration | 31 | Headphones with operation noise recording | 28 | Intraoperative propofol requirement |
| PACU length of stay | |||||||||
| Bansal, 2010∗ | Abdominal, urological, or lower extremity surgery | Spinal | Choice of folk, classical, religious, soothing music | Intraoperatively | Not specified | 50 | Occlusive headphones | 50 | Intraoperative midazolam requirement |
| Binns-Turner, 2011 | Mastectomy | General | Choice of classical, easy-listening, new age, inspirational music | PreoperativelyIntraoperativelyPostoperatively | Not specified | 15 | Blank iPOD with occlusive headphones | 15 | Intraoperative opioid requirementPostoperative opioid requirementPACU length of stay |
| Blankfield, 1995∗ | Coronary artery bypass surgery | General | Dreamflight II by Herb Ernst | IntraoperativelyPostoperatively | Procedure duration and 2 × 30 min daily postoperatively | 32 | Blank tape intraoperatively and standard care postoperatively | 29 | Postoperative opioid requirementICU length of stayHospital length of stay |
| Chen, 2015∗ | Total knee replacement | Not specified | Chinese piano and violin music | PreoperativelyPostoperatively | Total 120 min | 15 | Standard care | 15 | Postoperative opioid requirement |
| Ciğerci and Özbayir, 2016∗ | Coronary artery bypass surgery | General | Choice of Turkish classical and folk music | PreoperativelyPostoperatively | 90 min before surgery, after surgery 30 min in ICU and 30 min each day | 34 | Standard care | 34 | Postoperative opioid requirement |
| Cutshall, 2011∗ | Coronary artery bypass graft and/or cardiac valve surgery | General | Choice of 4 CD's | Postoperatively | 2 × 20 min on POD 2–4, 120 min in total | 49 | Standard care with bed rest for 20 min | 51 | Postoperative opioid requirementHospital length of stay |
| Dabu-Bondoc, 2010∗ | Outpatient surgery | General | Own favorite music | Preoperatively Intraoperatively | Preoperative 30 min, procedure duration | 20 | Intraoperatively headphones with white noise | 20 | Intraoperative propofol requirementIntraoperative opioid requirementPostoperative opioid requirementPACU length of stay |
| Easter, 2010 | Elective outpatient surgery procedures | Not specified | Choice of easy-listening, country, gospel, rock | Postoperatively | During length of stay in PACU | 111 | No music | 102 | Postoperative opioid requirementPACU length of stay |
| Ebneshahidi and Mohseni, 2008∗ | Elective cesarean section surgery | General | Own favorite music | Postoperatively | 30 min in the recovery room | 38 | Headphones without music | 39 | Postoperative opioid requirement |
| Finlay, 2016 | Total knee arthroplasty | Spinal with nerve block | 32 tracks with range of genres | Postoperatively | 15 min | 72 | Headphones without music | 17 | Postoperative opioid requirement |
| Good, 1995∗ | Elective, open abdominal surgery | General | Choice of sedative nonlyrical piano, harp, synthesizer orchestral or slow jazz music | Postoperatively | 60 min during the first 2 d after surgery | 21 | Standard care | 21 | Postoperative opioid requirement |
| Good, 1999 | Elective, open, major abdominal surgery | General | Choice of taped soothing music | PreoperativelyPostoperatively | First 2 d after surgery | 151 | Standard care | 152 | Postoperative opioid requirement |
| Graversen and Sommer, 2013∗ | Laparoscopic cholecystectomy | General | Musicure using music pillow | PreoperativelyIntraoperativelyPostoperatively | Before surgery start until day care discharge | 40 | Standard care | 35 | Intraoperative propofol requirementIntraoperative opioid requirementPostoperative opioid requirementDay care unit length of stay |
| Heitz, 1992∗ | (Para)thyroidectomy or unilateral modified radical mastectomy | General | Choice of 3 instrumental classical tapes | Postoperatively | 15 min after PACU arrival until discharge | 20 | Headphones without music | 20 | Postoperative opioid requirement |
| Standard care | 20 | PACU length of stay | |||||||
| Hook, 2008∗ | Moderate or major elective surgery | General | Choice of Malay, Western, Chinese, soothing music | Preoperatively Postoperatively | 60 min before and 180 min after surgery | 51 | Standard care | 51 | Postoperative opioid requirement |
| Iblher, 2011 | Open heart surgery (coronary bypass, valvular transplant, or both combined) | General | Baroque organ, flute, string orchestra music with 60-80 bpm | Postoperatively | 60 min after ICU admission | 25 | Standard care | 25 | Postoperative opioid requirement |
| 60 min after sedation stop | 24 | Postoperative catecholamine requirement | |||||||
| Ignacio, 2012 | Elective spine, hip or knee surgery | General | Not specified | Postoperatively | 2 × 30 min | 12 | No music | 9 | Postoperative opioid requirement |
| Ikonomodou, 2004∗ | Laparoscopic sterilization or tubal dyeing | General | Peaceful pan flute music | PreoperativelyPostoperatively | 30 min before and after surgery | 29 | Blank compact disk | 26 | Postoperative opioid requirement |
| Johnson, 2012 | Gynaecological outpatient surgery | Not specified | Choice of soft country, classical/new age and inspirational music | PreoperativelyIntraoperativelyPostoperatively | On average 212 min | 43 | Headphones without music | 35 | Postoperative opioid requirement |
| Standard care | 41 | PACU length of stay | |||||||
| Kar, 2015∗ | Elective cardiac surgery under cardiopulmonary bypass | General | Raga therapy (Indian classical music) | Preoperatively Intraoperatively | 30 min before surgery and procedure duration | 17 | Headphones without music | 17 | Intraoperative sedative requirement Intraoperative opioid requirement |
| Kliempt, 1999 | Diverse range of surgical procedures | General | Classical music Adagio Karajan | Intraoperatively | Procedure duration | 25 | Headphones without music | 26 | Intraoperative opioid requirement |
| Koch, 1998∗ | Outpatient urological procedures | Spinal | Own favorite music | Intraoperatively | Procedure duration | 19 | Standard care | 15 | Intraoperative propofol requirementPACU length of stay |
| Koelsch, 2011∗ | Total hip arthroplasty | Spinal | Joyful instrumental music | Preoperatively Intraoperatively | 120 min beforesurgery and procedure duration | 20 | Headphones with breaking sea waves noise | 20 | Intraoperative propofol requirement |
| Kumar, 2014 | Hernia, breast, appendix and thyroid surgery | Not specified | Raga Ananda Bairavi (Indian classical music) | Preoperatively Postoperatively | At admission and POD 1–3 | 30 | Standard care | 30 | Postoperative opioid requirement |
| Laurion and Fetzer, 2003 | Gynecological, laparoscopic outpatient day surgery | General | Piano music | PreoperativelyIntraoperativelyPostoperatively | 2 times a day before surgery, procedure duration, PACU stay | 28 | Standard care | 28 | Postoperative opioid requirementPACU length of stay |
| Lepage, 2001∗ | Nononcologic, outpatient or short-stay surgery | Spinal | Choice of pop, jazz, classical, new age | PreoperativelyIntraoperativelyPostoperatively | Anesthesia induction until recovery | 25 | Standard care | 25 | Perioperative midazolam requirement |
| Liu and Petrini, 2015 | Thoracic surgery | General | Soft, melodious music 60-80 bpm | Postoperatively | 30 min daily on POD 1–3 | 56 | Standard care | 56 | Postoperative patient-controlled analgesia requirement |
| Macdonald, 2003 | Total abdominal hysterectomy | Not specified | Own favorite music | Postoperatively | 2–6 h on day of surgery | 30 | Standard care | 28 | Postoperative patient-controlled analgesia requirement |
| Masuda, 2005∗ | Orthopedic surgery | General and spinal | Choice of Noh, Gagaku, classical or Enka music | Postoperatively | 20 min | 22 | Standard care | 22 | Hospital length of stay |
| McCaffrey and Loscin, 2006 | Elective hip or knee surgery | Not specified | Choice of CD's | Postoperatively | 60 min 4 times a day | 62 | Standard care | 62 | Postoperative patient-controlled analgesia requirement |
| McRee, 2003 | ‘Low risk’ surgery | General, spinal, local and regional | Soft piano music | Preoperatively | 30 min | 13 | Standard care | 13 | Postoperative opioid requirement |
| Migneault, 2004∗ | Gynaecological surgery | General | Choice of jazz, classical, popular new-age or piano music | Intraoperatively | Procedure duration | 15 | Headphones without music | 15 | Intraoperative end-tidal isofluraneIntraoperative fentanyl requirementPostoperative opioid requirement |
| Miladinia, 2017∗ | Abdominal surgery | General | Relaxing nonlyrical music with a bpm of 60–80 | Postoperatively | 3 × 10 min sessions on day of surgery | 30 | Standard care | 30 | Postoperative opioid requirement |
| Nielsen, 2018∗ | Unspecified orthopedic, urological, gynaecological and general surgery | Epidural, spinal and local | Musicure | Intraoperatively | Procedure duration | 58 | Standard care | 44 | Intraoperative fentanyl requirementIntraoperative propofol requirement |
| Nilsson, 2001∗ | Elective abdominal hysterectomy | General | Relaxing, calming music with sea waves sound | Intraoperatively | Procedure duration | 30 | Headphones with operation noise recording | 28 | Postoperative opioid requirement Hospital length of stay |
| Nilsson, 2003a∗ | Daycare surgery: varicose veins, open inguinal hernia repair | General | Soft, relaxing and calming classical music | Postoperatively | PACU arrival until patient chose to stop | 62 | Headphones without music | 63 | Postoperative opioid requirement |
| Nilsson, 2003b∗ | Daycare surgery: varicose veins, open inguinal hernia repair | General | Soft instrumental new-age synthesizer music | Intraoperatively | Procedure duration | 51 | Headphones without music | 49 | Postoperative opioid requirement |
| Postoperatively | 1 h after PACU arrival | 51 | |||||||
| Nilsson, 2005∗ | Open hernia repair (Lichtenstein) | General | Soft, new-age synthesizer | Intraoperatively | Procedure duration | 25 | Headphones without music | 25 | Postoperative opioid requirement |
| Postoperatively | 1 h after PACU arrival | 25 | |||||||
| Nilsson, 2009a | Coronary artery bypass graft and/or aortic valve replacement | General | MusiCure using music pillow | Postoperatively | 30 min on POD1 | 20 | Standard care | 20 | Postoperative opioid requirement |
| Nilsson, 2009b∗ | Coronary artery bypass graft or aortic valve replacement | General | Soft, relaxing, new age style music using music pillow | Postoperatively | 30 min on POD1 | 28 | Standard care | 30 | Postoperative opioid requirement |
| Reza, 2007∗ | Elective caesean section | General | Soft, instrumental, Spanish style guitar music | Intraoperatively | Procedure duration | 50 | White music | 50 | Postoperative opioid requirement |
| Santhna, 2015 | Total knee replacement surgery | Not specified | Choice of soothing and relaxing nonlyrical piano or violin music | Postoperatively | 60 min, 4 times a day | 20 | Standard care | 20 | Postoperative opioid requirement |
| Schwartz, 2009∗ | Coronary artery bypass graft surgery | General | Light piano music | Postoperatively | Patient's choice in ICU | 35 | Standard care | 32 | ICU length of stayHospital costs |
| Sen, 2009a∗ | Local urological procedures | Propofol PCS with local infiltration | Own favorite music | Intraoperatively | Procedure duration | 30 | Earphones without music | 30 | Intraoperative propofol requirement |
| Sen, 2009b∗ | Elective caesarian section | General | Own favorite music | Preoperatively | 60 min | 50 | Headphones without music | 50 | Postoperative opioid requirement |
| Sen, 2010∗ | Elective caesarian section | General | Own favorite music | Postoperatively | 60 min | 35 | No music | 35 | Postoperative opioid requirement |
| Szmuk, 2008 | Laparoscopic hernia or cholecystectomy | General | Choice of pop-rock, classical or Israeli music | Intraoperatively | Procedure duration | 20 | Headphones without music | 20 | Intraoperative end-tidal sevoflurane Postoperative opioid requirement |
| Tse, 2005 | Endoscopic sinus surgery or tubinectomy | Not specified | Choice of Chinese, Western or own favorite music | Postoperatively | 2 × 30 min after surgery and on POD1 | 27 | Standard care | 30 | Postoperative analgesic medication requirement |
| Vaajoki, 2012 | Elective major abdominal midline incision surgery | General | Choice of 2000 popular music songs | Postoperatively | Total of 7 × 30 min | 83 | Standard care | 85 | Postoperative opioid requirementHospital length of stay |
| Zhang, 2005∗ | Total abdominal hysterectomy | General with spinal or epidural | Own favorite music | Intraoperatively | Procedure duration | 55 | Headphones without music | 55 | Intraoperative propofol requirement |
| Zhou, 2011∗ | Radical mastectomy | General | Choice of 202 songs | Postoperatively | 2 × 30 min daily | 60 | Standard care | 60 | Hospital length of stay |
| Zimmerman, 1996 | Coronary artery bypass graft surgery | General | Choice of 5 soothing music tapes | Postoperatively | 30 min daily during POD1-3 | 32 | Scheduled rest of 30 min | 32 | Postoperative opioid requirement |
| Hospital length of stay |
∗
Denotes study included in meta-analysis.
CD indicates compact disk; ICU, intensive care unit; Min, minutes; N, number of patients; PACU, post-anesthesia care unit; PCS, patient-controlled sedation; POD, postoperative day; d, days; h, hours.