Music for Pain and Anxiety in Children Undergoing Medical Procedures: A Systematic Review of Randomized Controlled Trials

doi:10.1016/j.ambp.2007.12.005

Ambulatory Pediatrics

Volume 8, Issue 2, 17 March 2008, Pages 117-128

https://doi.org/10.1016/j.ambp.2007.12.005 Get rights and content

Objective

The aim of this study was to conduct a systematic review of the efficacy of music therapy (MT) on pain and anxiety in children undergoing clinical procedures.

Methods

We searched 16 electronic databases of published and unpublished studies, subject bibliographies, reference lists of relevant articles, and trials registries. Two reviewers independently screened 4559 citations and reviewed the full manuscript of 393 studies. Nineteen studies met the inclusion criteria: randomized controlled trial, children aged 1 month to 18 years were examined, music was used as an intervention, and the study measured pain or anxiety. Music therapy was considered active if a music therapist was involved and music was used as a medium for interactive communication. Passive music therapy was defined as listening to music without the involvement of a music therapist.

Results

The 19 included trials involved 1513 subjects. The methodological quality of the studies was generally poor. Overall, MT showed a significant reduction in pain and anxiety (standardized mean difference [SMD] −0.35; 95% confidence interval [CI], −0.55 to −0.14; 9 studies; N = 704; I² = 42%). When analyzed by outcome, MT significantly reduced anxiety (SMD −0.39; 95% CI, −0.76 to −0.03; 5 studies; n = 284; I² = 52.4%) and pain (SMD −0.39; 95% CI, −0.66 to −0.11; 5 studies; N = 465; I² = 49.7%). There was no evidence of publication bias.

Conclusions

Music is effective in reducing anxiety and pain in children undergoing medical and dental procedures. Music can be considered an adjunctive therapy in clinical situations that produce pain or anxiety.

Section snippets

Search Strategy

A research librarian developed comprehensive search strategies to identify published studies in MEDLINE, Education Resources Information Center, the Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Online Computer Library Center, Articles First, Répertoire International de Littérature Musicale Abstracts of Music Literature, Computer-Assisted Information Retrieval Service System for Music, PsycINFO, Allied and Complementary Medicine Database, EMBASE, Latin

Description of Included Studies

Figure 1 shows the flow of studies through the selection process. Nineteen parallel randomized controlled trials were included, with a total of 1513 subjects undergoing a variety of procedures (Table 1). Four non-English studies were included.19, 20, 21, 22 The subjects ranged in age from 8 months to 20 years. Five studies examined active MT,7, 23, 24, 25, 26 whereas 14 studies evaluated passive MT.4, 19, 20, 21, 22, 27, 28, 29, 30, 31, 32, 33, 34, 35

The musical interventions varied across

Discussion

Our results show that music is effective in reducing anxiety and pain during clinical procedures in children and youth. The results are supported by a qualitative synthesis of all 19 relevant studies and meta-analysis of 9 of the studies. Although the data included in this review did not allow us to conduct subgroup analyses for certain variables, other research suggests that the findings may be especially relevant to important subgroups that demonstrate higher baseline pain and anxiety levels,

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Original ArticleMusic for Pain and Anxiety in Children Undergoing Medical Procedures: A Systematic Review of Randomized Controlled Trials

Objective

Methods

Results

Conclusions

Section snippets

Search Strategy

Description of Included Studies

Discussion

Ann Emerg Med

Am J Emerg Med

Control Clin Trials

J Pediatr Oncol Nurs

Am J Obstet Gynecol

Pain

Music and Soulmaking: Toward a New Theory of Music Therapy

Children's responses to immunizations: lullabies as a distraction

Issues Compr Pediatr Nurs

Music Therapy: An Introduction

Music for pain relief

Cochrane Database Syst Rev