Effect of music intervention on anxiety in surgical patients: Systematic review and meta-analysis of randomized controlled trials.

BACKGROUND

During the patient's surgery, they tend to experience anxiety a lot which sometimes affect their outcomes in a negative way. Music intervention which is a non-pharmacological intervention is being used increasingly to address perioperative anxiety among patients. However, the existing evidence shows varied quality of studies, intervention timing and patient characteristics. This study aimed to analysis RCT evidence on the effectiveness of music intervention in reducing anxiety among adult surgical patients.

METHODS

We searched 5 databases following PRISMA guidelines. The search scope covers the period from database creation to July 2025. Eligible studies included RCTs examining the impact of music as an approach for surgical patients. Risk of bias was assessed using the Cochrane tool. We combined standardized mean differences with a random effects model. The intervention timing, type of anesthesia, gender distribution and average age were studied in subgroup analyses. Sensitivity analyses and publication bias evaluations were done.

RESULTS

A total of 33 RCTs (n = 3793) were included and the data from 8 statistical outliers was removed, leaving 25 studies for the primary meta-analysis. Music intervention significantly reduced perioperative anxiety (SMD = -0.50, 95% CI -0.60 to -0.39, p < 0.001) with moderate heterogeneity (I2 = 33.3%). There were greater outcomes in those receiving multi-phase interventions, local/regional anesthesia, males, and older patients. Although there were no significant subgroup differences. Sensitivity analysis confirmed robustness of findings and no meaningful publication bias was detected.

CONCLUSION

Music intervention, as a safe, effective, and easy-to-implement intervention strategy, can help reduce perioperative anxiety in patients undergoing various surgeries in different clinical settings. Including music protocols in standard perioperative care may help enhance patient experience and mental well-being.