Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2025 Aug 20;25(1):410.
doi: 10.1186/s12871-025-03120-z.

Music intervention as a strategy to reduce preoperative anxiety: an umbrella review

Ke-Lu Yang  1 , Elke Detroyer  1   2 , Ming-Ming Niu  3 , Danny Feike Hoogma  4   5 , Jin-Hui Tian  6 , Steffen Rex  4   5 , Koen Milisen  7   8
Affiliations
Meta-Analysis

Music intervention as a strategy to reduce preoperative anxiety: an umbrella review

Ke-Lu Yang et al. BMC Anesthesiol. .

Abstract

Background: Preoperative anxiety is pervasive among patients awaiting surgical procedures and is associated with an increased risk of postoperative complications. Music intervention is a promising strategy to alleviate preoperative anxiety levels and is easily implementable even in busy clinical settings. Our objective was to conduct an umbrella review of systematic reviews studying the efficacy of music intervention in reducing preoperative anxiety among adult patients.

Methods: To identify systematic reviews assessing the effects of music intervention on preoperative anxiety in adult surgical patients, we retrieved MEDLINE via PubMed, EMBASE, CINAHL, and the Cochrane Library from inception until 22 August 2024. The primary outcome was to review the overall efficacy of music intervention in reducing preoperative anxiety levels. In addition, specific details regarding the implementation of music intervention were also summarized. We assessed the quality of the included systematic reviews by using A MeaSurement Tool to Assess Systematic Reviews 2 checklist.

Results: Six eligible systematic reviews (i.e. one high-quality, four moderate-quality, and one low-quality review) analyzing 40 primary studies were included. The reporting on the intervention content and its implementation process was often unsatisfactory, with some key information missing. The pooled results on the reduction of preoperative anxiety using music intervention were statistically significant (MD = -5.20, 95%CI (-6.32, -4.07), I2 = 49%). Subgroup analyses revealed that music intervention had a more pronounced effect when the duration of the intervention was 20 min or longer and in patients younger than 60 years of age.

Conclusion: Music intervention may have a beneficial effect on reducing preoperative anxiety levels. However, to optimize the integration of music intervention into routine clinical practice, high-quality evidence and especially clearer reporting on the implementation methods are required.

Registration: PROSPERO (CRD42022333246).

Keywords: Music intervention; Preoperative anxiety; Surgery; Systematic review; Umbrella review.

PubMed Disclaimer

Conflict of interest statement

Declarations. Ethics approval and consent to participate: Not applicable. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart of literature screening. Legend: CINAHL: Cumulative Index to Nursing and Allied Health Literature; WOSCC: Web of Science Core Collection; PA: preoperative anxiety
Fig. 2
Fig. 2
Summary of interventions details of music intervention. Legend: This figure summarizes the details of the most reported content on music intervention. The most reported duration was 20 min, with a single session being the norm, and the most reported delivery method was headphone, typically administered on the day of surgery, and classical music was the most provided genre
Fig. 3
Fig. 3
Forest plot for meta-analysis of music intervention on preoperative anxiety levels Legend: a Forest plot for meta-analysis of music intervention on preoperative anxiety levels (only state subscale of State-Trait Anxiety Inventory); b Forest plot for meta-analysis of music intervention on preoperative anxiety levels (only Visual Analogue Scale)
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Ren A, Zhang N, Zhu H, Zhou K, Cao Y, Liu J. Effects of preoperative anxiety on postoperative delirium in elderly patients undergoing elective orthopedic surgery: A prospective observational cohort study. Clin Interv Aging. 2021;16:549–57. - PMC - PubMed
    1. Yang K-L, Detroyer E, Van Grootven B, Tuand K, Zhao D-N, Rex S, et al. Association between preoperative anxiety and postoperative delirium in older patients: a systematic review and meta-analysis. BMC Geriatr. 2023;23:198. - PMC - PubMed
    1. Majumdar JR, Vertosick EA, Cohen B, Assel M, Levine M, Barton-Burke M. Preoperative Anxiety in Patients Undergoing Outpatient Cancer Surgery. Asia Pac J Oncol Nurs. 2019;6:440–5. - PMC - PubMed
    1. Zeb A, Hammad AM, Baig R, Rahman S. Pre-Operative Anxiety in Patients at Tertiary Care Hospital, Peshawar. Pakistan. South Asian Res J Nurs Health Care. 2019;2:76–80.
    1. Abate SM, Chekol YA, Basu B. Global prevalence and determinants of preoperative anxiety among surgical patients: A systematic review and meta-analysis. Int J Surg Open. 2020;25:6–16.