MD DA DNB Dip DiabMD ACU Dip software based statistics PhD physiology IDRA CUGRA wwwpainfreeparthacom My salute Legendary teacher of two centuries Dr MRavishankar 16032022 ID: 931514
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Slide1
MUSIC IN PAIN
Dr. S. Parthasarathy
MD, DA, DNB,
Dip Diab.MD , (ACU)
Dip software based statistics,
PhD (physiology)
IDRA CUGRA
www.painfreepartha.com
Slide2My salute !!
Legendary teacher of two centuries--
Dr. M.Ravishankar
16-03-2022
Slide3What is pain ?
"An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage
Divide each words and
analyse
!
Slide4Complex !
Slide5WHAT IS MUSIC ?
An arrangement of sounds having melody, rhythm, and usually harmony
OR
the art of producing pleasing or expressive combinations of tones especially with melody, rhythm, and usually harmony
Slide6music medicine
music medicine, refers to a specialized area of work within music, health, and well-being taking place within medical contexts.
music has many benefits.
Slide7Uses
relieve stress
Less catecholamine and cortisol
Sedation - antianxiety
Better babies and better mothers Less premature babiesBetter mood
Less depression Analgesia
Slide8How it acts
Slide9Slide10Pain – types
Acute and chronic
Less than a week
More than 3 months
Examples !
Slide11Problems of acute pain
Anxiety
Sleeplessness
BP and pulse rate raise
Hormones release Sugar rise
Slide12Anxiety !
One study evaluated effect of music on 100 patients undergoing caesarean sections.
Authors found a highly
significant lowering of anxiety and a high patient satisfaction score in music group
as compared to control groupAnother study found a significant difference in anxiety scores of music group (who listen to music for 20 minutes pre-operatively) and control group (with no music intervention). Mean anxiety score in music group was found to be 1.76±0.59 and was 2.92±0.52 in control group (p <0.001).
Slide13Innumerable articles and publications on anxiety scores !
Syal
K, Singh D, Verma R, Kumar R, Sharma A. Effect of music therapy in relieving anxiety in patients undergoing surgery. IJARS.
2017;
6(1):1-4. Bansal G L, Kaur H, Shukla V, Harsh H K, Gupta A. Music: an effective anxiolytic during caesarean section under spinal anaesthesia. Int J Res Med Sci. 2019;7(3):676-81Sarkar D, Chakrabarty K, Bhadra B, Singh R, Mandal U, Ghosh D. Effects of music on patients undergoing caesarean section under spinal anaesthesia. Int J Recent Trends Sci Tech.
2015;13(3):633-7
Slide14Sedative.
Slide15Sedation
0.15 mg/ kg of midazolam
Music produced better sedation than midazolam in 300 patients underwent spinal anaesthesia
Slide16Sedative
Requirement of propofol used for sedation was found to be 15% lesser in music group, this was assessed by using Bi spectral index (BIS) in patients under regional anaesthesia
Propofol is less used to maintain same depth of anaesthesia
Slide17Anti emetic !
39 patients undergoing bone marrow transplant. A total of 33 patients were included in the data analysis, with 17 in the control group and 16 in the music intervention group.
music is an effective adjunct to a pharmacologic antiemetic regimen for lessening nausea and vomiting,
Slide18Sedation,
Anxiety reduction
Anti emetic !
Slide19Intraoperative
Postoperative anxiety can be reduced by intraoperative use of instrumental music in patients undergoing spinal
anesthesia
.
Listening to music during this surgical procedure may reduce intraoperative sedative drugs.
Patients expressed themselves
favorably
to the use of intraoperative music.
Slide20In almost all the studies, patient satisfaction is better with music therapy than with sedatives
A satisfied patient ?
Slide21Pain !! Reduction
The mechanism suggested by authors included release of endogenous endorphins by music, which help to lower the sedative and analgesic requirements.
Studies by authors regarding analgesic requirements have also concluded that music therapy reduced the requirement of analgesics in intra-operative and postoperative periods.
Slide22Music and anaesthesia
Perioperative music can reduce opioid and sedative medication requirement, potentially improving patient outcome and reducing medical costs as higher opioid dosage is associated with an increased risk of adverse events and chronic opioid abuse.
Slide23Some studies have evaluated PONV in postoperative period and found significant difference in reduction of PONV with use of music. Mechanism suggested by authors includes modulation of psychology of patients thus allaying anxiety, reducing nausea and vomiting
Slide24All are less !
Blood glucose
levels have also been estimated as indicators of stress response. Reduction in blood glucose has been seen in operative patients by some authors with use of music
recent study evaluated serum levels of
adrenaline and nor adrenaline and found that music significantly lowered epinephrine levels. Serum cortisol levels have been shown to be reduced significantly in music group as compared to control group during intra operative period
Slide25Stress reduction
Music plays an important role !
Sometimes pain therapists may be like this !
Slide26Controlled hemodynamics
Slide27Better hemodynamics
listening to slow beat music lowers the pulse rate and blood pressure, thereby improving the cardiac autonomic regulation.
Slide28Hemodynamics
In a systemic review of 23 clinical trials
music had positive effects music on blood pressure, heart rate,
respiratory rate, anxiety, and pain in coronary artery disease patients
Slide29Music
is a noninvasive and low-cost intervention that can be easily implemented in the perioperative setting, and these findings suggest that perioperative music can
reduce MAP, anxiety, and pain
among women undergoing mastectomy for breast cancer.
Slide30Labour pain
A group of pregnant women who listened to music during labor, compared to those who did not, reported less pain and required less postpartum analgesia.
Simavli
S,
Gumus
I, Kaygusuz
I, et al. Effect of Music on Labor
Pain Relief, Anxiety Level and Postpartum Analgesic Requirement: A Randomized Controlled Clinical Trial.
Gynecol
Obstet
Invest
. 2014;78(4):244–250.
Slide31This double-blind study has demonstrated that intra-operative music and music in combination with therapeutic suggestions may have some beneficial effects on postoperative recovery after hysterectomy
.
Slide32Listening to music is beneficial as an adjunct to pain medication and contributes to increased patient satisfaction.
Slide33Problems of acute pain
Anxiety
Sleeplessness
BP and pulse rate raise
Hormones release Sugar rise
Slide34Chronic pain – more than three months
Slide35Chronic pain
The results of this study implied that the inclusion of music therapy in the routine care of patients with neuropathic pain could provide nurses with an effective practice for reducing patients' pain intensity.
Slide36Slide37We found that music reduced self-reported chronic pain and depressive symptoms. We also found that music had a greater effect when the patient chose the music, compared to when the researcher chose it.
Slide38Mood regulation and depression
Slide39The improvement of positive coping skills and diminishing of avoidance as a coping skill were measured to show greater changes in music therapy participants.
Slide40listening to relaxing music alleviated the mental fatigue associated with performing an enduring cognitive-motor task.
Slide41Pain music role
Acute pain
Its other ill effects
Chronic pain
Its other ill effects
Slide42Slide43How to give it ?
music therapist will assess your needs and your strengths.
music therapist will also talk with you about any background you might have in music and your musical preferences.
Patient age and abilities
Patient interest
Musical background Listen to music – vocal or instrument If possible patient preferred music Single sitting or multiple sittings
Sometimes make you sing !
Slide44Innumerable studies in ICU
Anxiety
Depression
Sedation
Pain relief
Stress reduction So many articles ?
Slide45Side effects of music therapy
ability to incite unwanted memories.
Over stimulation
The wrong music can cause distress and heightened anxiety in Alzheimer’s patients.
The lyrics can have a huge impact on the mental state of the client the therapist is treating.
The way its sung ! In pediatrics – is it less beneficial than silence and darkness
May not be efficient !
Slide46Does insurance cover music therapy?
Slide47Bhairavi
Enna
satham
,
nann
oru
sindhu
,
Slide48Darbari kaanada
– the best sedative
kalyana
then
nila
, dekha hai pahli
baar
Slide49Mesh repair and prostate
Slide50Slide51Slide52Summary !
Slide53Slide54Whom its useful
Listen to music
atleast
it will be immense help to practicing doctors
Thank you all Long live the ISASlides are on www.painfreepartha.com