The effect of preoperative classical music listening on salivary cortisol level and anxiety in pregnant women undergoing cesarean section

Purpose: Music has been used in various studies as a non-pharmacological method to reduce anxiety in patients undergoing regional anaesthesia. Studies examining the effect of music on anxiety in the literature have generally been conducted using only anxiety questionnaires. Therefore, in this study, we aimed to evaluate the effect of music on perioperative anxiety by looking at salivary cortisol levels, which is an objective marker, in patients who underwent cesarean section under regional anesthesia. Materials and Methods: Sixty female patients, whose age range was 20-42 (mean 30±6) years, who underwent cesarean section under spinal anesthesia were included in our study. The pregnant women included in the study were visited in the morning on the day of surgery and the age, height, weight, body mass index, gestational week, education level, comorbidities, medications, smoking and previous anesthesia experiences were recorded. The pregnant women were asked to fill in the STAI-S and BAI scales (STAI-S 1, BAI 1). In order to evaluate the anxiety levels of the patients, saliva samples were taken to measure the cortisol level (cortisol 1). When the patients came to the operating room, they were divided into two groups using the closed envelope method. Group M listened to 432 Hz classical music with headphones for 30 minutes in the waiting room. No intervention was made in Group K. Blood pressure, heart rate and sP02 of both groups were recorded every 15 minutes. At the end of 30 minutes, patients in both groups were asked to fill in the STAI-S and BAI scales again (STAI-S 2 and BAI 2) and a saliva sample was taken (cortisol 2). Patients in group M continued to listen to music in the operating room. Blood pressure, heart rate, and Sp02 were recorded every 15 minutes for both groups. The patients who were taken out of the postoperative recovery room were kept here for 30 minutes, during which time blood pressure, heart rate, and sP02 values were recorded; At the end of this period, the patients were asked to fill in the anxiety scales again (STAI-S 3, BAI 3) and a saliva sample was taken (cortisol 3). Results: In our study, demographic data, gestational week, smoking, educational status, chronic disease, intraoperative complications, infant APGAR scores evaluated at the first and fifth minutes were similar between the groups. STAI-S 1 and BAI 1 scores were statistically similar between the groups (p>0.005). There was a statistically significant difference between the groups between the STAI-S 2 and STAI-S 3 scores (p<0.001). There was also a statistically significant difference in BAI 2 and BAI 3 scores (p=<0.001 and p=.006). Cortisol 1 levels between the groups were statistically similar (p= 0.509). There was a significant difference between the groups in cortisol 2 levels (p= 0.033). There was no statistical difference between the groups in postoperative cortisol levels (p= 0.736). The blood pressure and heart rate values between the groups decreased in group M in the preoperative waiting room, and this difference was found to be statistically significant (p=0.001). There was a statistically positive correlation between STAI-S 1-2-3 and BAI 1-2-3. appeared to be. Conclusion: In our study, we found that the anxiety scores and salivary cortisol levels were lower in the group that was listened to music. The decrease in salivary cortisol levels supports the positive effect of music on anxiety as an objective indicator. Music; It is a simple, inexpensive, non-invasive and side-effect-free method. We think that more comprehensive clinical studies with more patients are needed in different patient populations to investigate the effect of music on anxiety. Keywords: Cesarean Section, Music, Salivary Cortisol, Anxiety