Effect Of Music Therapy On The Quality Of Anesthesia Of Patients Undergoing Thoracoscopic Lobectomy During Perioperative Period

Objective :The purpose of the study was to investigate the music therapy effect on the quality of general anesthesia during perioperative period by observing the changes of entropy index,hemodynamic parameters and pain levels of the patients undergoing thoracoscopic lobectomy.Methods:We prospectively studied 120 cases of ASA Grade ? and ? between 30?80 years of age from both sexes,undergoing thoracoscopic lobectomy(Including wedege resections or segment resections)under general anesthesia.These cases were chosen from April2019 to July 2019 in the Cancer Hospital and Institute of Liaoning Province.The patients were randomized into Group M(those who listened to music)and Group C(those who didn't listened to music),60 cases in each group.Both groups received the same anesthesia induction,maintenance,and postoperative analgesia,among which endotracheal intubation,invasive arterial pressure puncture and other invasive operations were completed by the author.Headphones were applied to all patients from entering into operating room to completing tracheal intubation and closing chest to leaving operating room.The music group listened to the light music “Ocean Blue”(the track was selected from the music therapy album “magical ? wave”)during the above periods,and the volume was adjusted to the appropiate level when the patient was awake.The main monitoring indexes of this experiment included entropy index(Re,Se),heart rate(HR),systolic blood pressure(SBP),diastolic blood pressure(DBP),mean arterial pressure(MAP),blood oxygen saturation(SPO2),extubation agitation score(RSS),5min pain score(NRS)after extubation,5min sedation score(Ramsy)and whether to add analgesic in PACU.The time points of data collection included T0(Entry),T1(5min after entry),T2(Intubation),T3(Operation start),T4(Chest closure),T5(Operation end),T6(Enter into PACU),T7(Extubation),T8(5min after extubation),T9(Exit).During the operation,the drug dose should be adjusted according to the surgical intensity and hemodynamic parameters,and vasoactive drugs should be applied if necessary to make the patient's intraoperative circulation stable,and the entropy index should be maintained between 40 and 60,so as to prevent the patiens from intraoperative awareness.The indexes of each group were compared to evaluated the effects of music therapy on the quality of anesthesia during perianaesthesia of thoracoscopic lobectomy.Results:In this study,120 cases of valid data were collected,including 30 cases in Group M,30 cases in Group C.There was no significant difference in general information between the two groups(P >0.05).There was no significant difference between the two groups in the anesthetic dosage,anesthesia time,bleeding volume(P >0.05).The entropy index of T1 and T2 in music group decreased compared with the control group,and the result was statistically significant(P<0.05).The number of cases of T1 point in group M significantly decreased(Re T1?T0>10)was more than that in group C,and the result was statistically significant(P<0.05).Hemodynamic parameters(SBP,DBP,MAP,HR,from T0 to T2)of the two groups showed a downward trend,among which group M showed a greater decline than group C,but the results were not statistically significant(P >0.05).RSS score in group M was lower than in group C(P<0.05).NRS score in group M was lower than in group C(P<0.05).The number of additional analgesics in PACU in group M was less than that in control group(P<0.05).Conclusion:The application of music therapy in thoracoscopic lobectomy can improve the quality of perioperative anesthesia and is an effective intervention.Preoperative application of music therapy in group M have lower entropy index,certain sedative and anti-anxiety effects than that in group C.The application of music therapy in the wake period can make the hemodynamics of extubation more stable,improve the quality of wake,and has certain auxiliary analgesic effect.