Efeito da música na redução da ansiedade no perioperatório de colecistectomia por videolaparoscopia: ensaio clínico randomizado

Abstract

Introduction: Cholelithiasis is a disease caused by the presence of one or more stones in the gallbladder. The definitive treatment for this pathology is surgery. Despite the usual surgical procedures they are enhancers of states of anxiety and stress. Several non-pharmacological measures can be used to reduce perioperative anxiety. Among these, music therapy stands out as a beneficial practice for the health of the population in the control of anxiety, pain, stress and depression, in the preoperative period and in the postoperative recovery. Objective: To evaluate the effect of music therapy in reducing anxiety in patients who underwent laparoscopic cholecystectomy at a Federal University Hospital. Method: This is a randomized, uni-blind, controlled clinical trial with 106 patients. Participants were randomly allocated into two groups: a control group (CG), in which patients underwent standard admission to the unit and the application of anxiety assessment scales, and an intervention group (IG), consisting of patients who after admission standard of the unit and were submitted to the music session of their own choice during the period they remained in the preparation room until the time of referral to the operating room. Categorical and numerical variables were described by absolute and relative frequency. Data normality was tested using the Shapiro-Wilk test. Associations between categorical variables were tested using Pearson's chi-square test. The calculation of the anxiety classification score was performed based on the classification determined by the STAI (low anxiety: 20 to 40 points; medium anxiety: 40 to 60; high anxiety: 60 to 80 points). Analysis of variance for repeated measures (ANOVA) was applied to test differences before and after the intervention. The effect size of music was analyzed using Rank-Biserial correlation and Square Eta (η2), using observed differences in ANOVA. Results: The sample consisted of 106 patients, mostly female (82.24%) aged between 38 and 47 years (30.18%), mixed race (57.55%), married marital status (32.95%), non-smokers (96.23%), active social life (85.85%), non-practitioners of physical activity (50.94%) and with a body mass index indicating overweight (31.12% ). The intervention group had lower values (p<0.001) of systolic and diastolic BP compared to the control group. Statistically, the effect in reducing anxiety was large (η2 = 0.186). Conclusion: The use of music as a non-pharmacological therapy helps to reduce the anxiety levels of patients in the preoperative period of laparoscopic cholecystectomy. It should be prescribed and used as a complementary therapy to reduce perioperative anxiety.