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Meta-Analysis
. 2020 Oct 9;15(1):465.
doi: 10.1186/s13018-020-01995-x.

The effect of musical interventions in improving short-term pain outcomes following total knee replacement: a meta-analysis and systematic review

Rongguo Yu  1 , Youguang Zhuo  1 , Eryou Feng  1 , Wulian Wang  1 , Wentao Lin  1 , Feitai Lin  1 , Zhanglai Li  1 , Liqiong Lin  1 , Lili Xiao  1 , Haiyang Wang  1 , Yuting Huang  1 , Chunlin Wu  1 , Yiyuan Zhang  2
Affiliations
Meta-Analysis

The effect of musical interventions in improving short-term pain outcomes following total knee replacement: a meta-analysis and systematic review

Rongguo Yu et al. J Orthop Surg Res. .

Abstract

Background: A growing number of patients continue to receive total knee replacement (TKR) surgery. Nevertheless, such surgeries result in moderate to severe postoperative pain and difficulty in managing it. Musical interventions are regarded as a type of multimodal analgesia, achieving beneficial results in other clinical treatments. This study aims to evaluate the effect of musical interventions in improving short-term pain outcomes following TKR in order to determine a more reasonable and standard way of delivering musical intervention.

Methods: A systematic search was conducted to identify available and relevant randomized controlled trials (RCTs) regarding musical interventions compared against non-musical interventions in patients treated with TKR in Embase, MEDLINE, Cochrane Library, Web of Science, CNKI, and Wanfang Med Online up to 8 January 2020. The authors independently assessed study eligibility and risk of bias and collected the outcomes of interest to analyze. The statistical analysis was conducted using the Review Manager (RevMan) version 5.30 software.

Results: Eight RCTs comprised of 555 patients satisfied the inclusion criteria and were enrolled in the present study. The results showed no significant difference between the music and control groups in pain of the visual analog scale (VAS), during postoperative recovery room, back to the ward after surgery; anxiety degree of VAS; heart rate; respiratory rate; oxygen saturation; blood pressure, systolic blood pressure, and diastolic blood pressure. Nevertheless, significant differences were observed between the two groups in average increase in continuous passive motion (CPM) angles and LF/HF ratio (one kind index of heart rate variability).

Conclusions: Musical interventions fail to demonstrate an obvious effect in improving short-term pain outcomes following TKR. A reasonable standardization of musical interventions, including musical type, outcome measures used, outcomes measured, duration, timing and headphones or players, may improve pain outcomes with certain advantages and should be further explored after TKR.

Keywords: Knee surgery; Meta-analysis; Music interventions; Music therapy; Pain; Systematic-review; TKA; TKR; Total knee replacement.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
The PRISMA flow diagram detailing our literature search
Fig. 2
Fig. 2
The risk of bias summary of the included studies. (+ represents yes; – represents no; ? represents not clear)
Fig. 3
Fig. 3
The risk of bias graph of the included studies.
Fig. 4
Fig. 4
A forest plot diagram showing the pain severity
Fig. 5
Fig. 5
A forest plot diagram showing the anxiety degree
Fig. 6
Fig. 6
A forest plot diagram showing the average increase in CPM angles
Fig. 7
Fig. 7
A forest plot diagram showing the heart rate
Fig. 8
Fig. 8
A forest plot diagram showing the blood pressure
Fig. 9
Fig. 9
A forest plot diagram showing the respiratory rate
Fig. 10
Fig. 10
A forest plot diagram showing the oxygen saturation
Fig. 11
Fig. 11
A forest plot diagram showing the LF/HF ratio
See this image and copyright information in PMC

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