Preoperative and perioperative music to reduce anxiety during first-time phacoemulsification cataract surgery in the high-volume setting: randomized controlled trial.

PURPOSE To determine if preoperative and perioperative music exposure reduced patient self-rated anxiety and physiologic indicators of stress during first-time phacoemulsification cataract surgery in the high-volume setting. SETTING Aravind Eye Care System, Pondicherry, India. DESIGN Prospective single-masked randomized controlled trial. METHODS Patients were provided music before and during first-time phacoemulsification in one group and patients underwent surgery without music in another group. Measurements of blood pressure, heart rate, respiration rate, and a Likert-scale anxiety rating were collected at preoperative, perioperative, and postoperative time points. RESULTS 165 patients (aged 53-65) were provided music via a portable MP3 player before and during first-time phacoemulsification, and 165 patients underwent surgery without music. Systolic and diastolic blood pressures were significantly lower in the music intervention group at the postoperative time point, with similar physiologic measures between groups during the perioperative time points. In the preoperative period before music exposure, 62 patients (38%) in the music group reported being very or extremely anxious. After 10 minutes of music exposure, only 7 patients (4%) reported this anxiety level. In the perioperative period, 80 patients (48%) in the intervention group reported feeling not at all or a little anxious, compared to 50 patients (30%) of the control group. In the postoperative period, 139 (84%) music group patients felt not at all or a little anxious after surgery compared with 92 patients (56%) in the control group. CONCLUSION Marked reductions in self-reported anxiety before, during, and after surgery when exposed to music and a significant decrease in postoperative blood pressure showed music can be an inexpensive and effective solution to improve the patient experience of cataract surgery in the high-volume setting.