The effect of intraoperative music therapy on anesthetic agent consumption and anxiety in thoracic surgery

Aim: Thoracic surgery is a high-risk surgical field that frequently induces significant stress and anxiety due to the possibility of malignancy and the magnitude of surgical trauma. This study aimed to evaluate the effects of intraoperatively administered Classical Western music and Sufi music, delivered through over-ear headphones, on anesthetic agent consumption (propofol and desflurane), postoperative anxiety, pain, additional analgesic requirement, and hemodynamic responses in patients undergoing thoracic surgery. Materials and Methods: This prospective, randomized, single-center study included 159 patients scheduled for elective thoracic surgery under general anesthesia. Patients were assigned to three groups: control, Classical Western music, and Sufi music. The music intervention was initiated before induction and continued throughout the surgery. All patients were monitored with electrocardiography, non-invasive blood pressure, oxygen saturation, and bispectral index. Propofol dose during induction, total desflurane consumption, hemodynamic parameters, extubation and discharge times, postoperative pain, sedation, additional analgesic requirements, and anxiety levels were recorded. The State-Trait Anxiety Inventory (STAI-State) was used to assess anxiety. Results: The propofol induction dose and total desflurane consumption were significantly higher in the control group compared with the music groups (p=0.011 and p=0.013, respectively). Extubation time was shorter in the Sufi music group (p=0.003). Post-intubation systolic, diastolic, and mean arterial pressures were significantly higher in the control group than in the music groups (p=0.014, p=0.002, and p=0.003, respectively). In the postoperative period, the Sufi group had a higher incidence of bradycardia and a lower incidence of tachycardia (p=0.027 and p=0.048). No significant differences were observed among the groups regarding postoperative sedation levels and additional analgesic requirements (p>0.05). Preoperative and postoperative anxiety levels were higher in the Sufi music group (p=0.013 and p=0.017). Conclusion: Intraoperative music listening in thoracic surgery is a non-invasive and easily applicable method that supports hemodynamic stability by reducing anesthetic agent consumption and suppressing the sympathetic response to intubation. However, its superiority on postoperative anxiety and pain could not be demonstrated. Studies with larger sample sizes will strengthen the role of music in anesthesia practice. Keywords: Anesthetic consumption; Bispectral index; Hemodynamics; Music therapy; Postoperative anxiet; Pain; Thoracic surgery;