Does Music Ease Pain

Critical care patients often experience significant pain and anxiety. These symptoms may be rooted existentially as patients endure fear and uncertainty, but disease and treatment sources are other common offenders, as are noxious environmental stimuli. Unrelieved pain induces a generalized sympathetic response (increasing heart rate, blood pressure, respiratory rate, and peripheral resistance), disturbs sleep and appetite patterns, and heightens anxiety. Anxiety can also increase the perception of pain. Thus, these symptoms often go hand in hand, interfering with the healing process. On any given day, nurses exert considerable time and energy employing interventions to enhance comfort and ultimately, the patient’s experience. Some of these are dependent functions—namely, administering pharmacological agents—whereas many others are nonpharmacological approaches within autonomous nursing practice such as therapeutic listening, emotional support, family presence, repositioning, distraction, or integrative therapies. The purpose of this clinical review is to explore an integrative therapy, the use of music, for symptom management in the acute/critically ill population. Music listening interventions can be used to reduce stress/ anxiety, pain, depression, and feelings of isolation; foster relaxation; improve mood and movement; facilitate expression of emotion; provide meaningful stimuli; alleviate boredom by offering diversion; and buffer noise. Although music may have many applications in the clinical setting, this review addresses the following PICO question: How effective are music interventions at reducing pain and/or anxiety in critically ill patients? A regular feature of the American Journal of Critical Care, Clinical Evidence Review unveils available scientific evidence to answer questions faced in contemporary clinical practice. It is intended to support, refute, or shed light on health care practices where little evidence exists. To send an eLetter or to contribute to an online discussion about this article, visit www.ajcconline.org and click “Respond to This Article” on either the full-text or PDF view of the article. We welcome letters regarding this feature and encourage the submission of questions for future review.