Effect of music on patients’ anxiety during lower limb arthroplasty procedures under spinal anaesthesia: a prospective randomised controlled study



music, anxiety, spinal anaesthesia, arthroplasty


Background: Perioperative anxiety is a common entity that can present as a challenge to the anaesthetist, and can also negatively affect the surgical outcome and functional recovery. The use of music in a medical setting is becoming increasingly popular. Literature indicates promising outcomes on the use of music to reduce anxiety. The aim of this study was to determine the effects of listening to music on the anxiety of patients undergoing knee and hip arthroplasty procedures under spinal anaesthesia in a South African context.

Methods: This randomised, controlled study included 58 adult patients scheduled to receive lower limb arthroplasty surgery. Patients in the intervention group (music group) received one of five genres of music via headphones. The control group did not receive music. Both groups received a standardised neuraxial anaesthetic. Patients’ anxiety in both groups was measured using a visual analogue scale for anxiety (VAS-A). Anxiety scores were measured at the preoperative visit, the morning prior to surgery, at skin incision and in the post-anaesthesia care unit.

Results: Each group contained 29 patients. There was no difference in the baseline anxiety scores recorded at the preoperative visit between the two groups (1.8 cm vs 1.9 cm; p = 0.422). The anxiety scores were significantly lower in the music group compared to the control group at skin incision (0.9 cm vs 1.9 cm; p < 0.001). The music group also experienced a greater decrease in their anxiety from prior to surgery to skin incision (1.4 cm vs 0.2 cm; p = 0.002).

Conclusion: Music is an effective, cheap, safe, non-pharmacological adjunct that can be used to reduce perioperative anxiety in patients undergoing lower limb arthroplasty procedures under spinal anaesthesia.

Level of evidence: Level 2

Author Biographies

Samantha A Ballard, University of the Witwatersrand

Department of Anaesthesiology, University of the Witwatersrand, Chris Hani Baragwanath Academic Hospital, Soweto, Johannesburg, South Africa

Gwyneth Davies

Anaesthesiologist, private practice

Maria Fourtounas

Anaesthesiologist, private practice






Arthroplasty - Knee