The effects of music on sedation depth and necessity during pediatric dental procedures

The Effects of Music on Sedation Depth and Necessity during Pediatric Dental Procedures The patients with dentophobia, who are generally pediatric, mental retarded, with psychiatric problems, without cooperation or over-anxious, may frequently need different levels of sedation. It is well known that music has anxiolitic and sedative effects. By listening to different kinds of music it is possible to alter various symptoms such as blood pressure, heart rate, respiration rate and endorphin levels. In addition to these, there are some evidences that listening to music, sound of nature or blocking ambient sounds during various surgery or intervention may decrease the intraoperative need for anesthetic and sedative drugs. The hypothesis of our study is that listening to music or providing sound isolation increases the depth of sedation and decreases the need for sedatives in pediatric dental patients. Following Institutional Review Board and Ethics Committee approval of Başkent University, 180 pediatric patients aged between 3-15 years, planned for elective dental intervention at Dental Clinic of Ankara Hospital of Başkent University Medicine School were included in the study, prospectively. Patients with hearing impairment, different ear anatomy, recent organ or system deficiency, severe pulmonary and/or cardiovascular problems, intolerance to propofol, airway abnormalities, substance addiction or known psychiatric or mental problems were excluded from the study. The patients were randomly assigned into 3 different groups as music (Group M), isolation (Group I) and control (Group K). The patients in the music group listened to relaxing classical music (Vivaldi's Four Seasons violin concertos) by sound isolating headphones throughout the operation. The patients in the isolation group only wore the headphones but did not listen to music. The patients in the control group were allowed to hear ambient sounds without using the headphones. During the intervention, dental procedures (tooth extraction, filling, amputation and root treatment), peripheric oxygen saturations, heart rates, respiration rates, OAA/S scores and BIS data were monitored and recorded at 5 minutes intervals. The demographic information, total propofol dosage, procedure time, any complication, need for manual or oral airway opening and the satisfaction of the operating surgeon were recorded. During the recovery of patients Modified Aldrete Score was utilized and scores were recorded at 5 minutes intervals. The patient satisfaction was questioned and evaluated by Likert Scale. The demographic variations, procedure times and intervention types were found to be similar in all the groups (p>0.05). The patients' heart beat rate, oxygen saturation, OAA/S and BIS scores, monitored during the operation, were also similar in all the groups (p>0.05). In terms of utilized propofol amount, there was no statistically significant difference in the groups, yet the least usage was in the music group (p=0.065). Need for airway manipulation was significantly less frequent in the control group (p<0.001). The waking up of the patients calmly or agitated in the recovery room and the duration to discharge readiness were found to be similar in all the groups (p>0.05). In conclusion, according to our study listening to music or providing sound isolation during the pediatric dental interventions did not affect the vital signs, sedation level of the patient, the amount of medication and the postoperative recovery, significantly. This was considered due to the deep level sedation obtained in our study. Therefore, new studies with similar methodology and providing lesser levels of sedation might reach to different results. Key words: Pediatric, dental procedures, sedation, music.