Effects of Patient-Preferred Music on Anxiety, Pain, and Quality of Recovery After Knee Arthroplasty Under Spinal Anesthesia: A Randomized Controlled Trial.

Preoperative anxiety and pain can adversely affect recovery and satisfaction. Music is a safe, low-cost, non-pharmacological intervention that may enhance perioperative outcomes. This study evaluated the effects of patient-preferred music on anxiety, recovery, pain, satisfaction, and hemodynamics during unilateral knee arthroplasty under spinal anesthesia. In this prospective, randomized, controlled, single-blind trial, 80 patients were assigned to either a music group (Group M) or a control group (Group C). Group M listened to preferred music via headphones before and during surgery, while Group C received standard care. Anxiety (State-Trait Anxiety Inventory; state: STAI-S, trait: STAI-T), recovery (Quality of Recovery-15 [QoR-15]), pain (Numeric Rating Scale [NRS]), satisfaction, and hemodynamic parameters were measured. Minimal clinically important difference (MCID) analyses were used to assess clinical significance. Sixty-five patients (Group M: 32; Group C: 33) were analyzed. Postoperative STAI-S scores were significantly lower in Group M (p = .001), with a 6.18-point difference exceeding the MCID by 283%. QoR-15 scores were higher in Group M (p = .007), surpassing the MCID by 123%. Group M also showed lower systolic blood pressure at several perioperative points (p < .05), lower NRS pain scores at the 12th postoperative hour (p = .001), and reduced need for rescue analgesia (p = .035). Satisfaction was significantly greater in Group M (p = .001). No significant differences were found in heart rate (p > .05). Patient-preferred music significantly improved anxiety, pain, recovery quality, hemodynamic stability, and satisfaction. MCID analysis confirmed clinical relevance. Music may serve as an effective and feasible adjunct in perioperative care.