Music vs. No Music During Cesarean Delivery on Patient Satisfaction

Background:

Several studies have demonstrated that music can improve various outcomes during labor and delivery. In particular, patient satisfaction is often measured on a simple VAS scale, where 0 is no satisfaction and 10 is the highest satisfaction. However, patient satisfaction is a complex parameter to measure, and may be affected by a number of different factors. This study will be performed on the labor and delivery unit to assess patient satisfaction with a validated, reliable, 22-question survey in the setting of music or no music during the cesarean delivery.

Although "music" is an all-encompassing term that describes sound with different pitches and rhythms that comes together as a harmonious whole, not all music is the same. Using "music" for therapeutic purposes would be the equivalent of using "antibiotics" to cure an infection; it is too general of a term, and unlikely that such a general use of music would show a valid therapeutic benefit. However, a study demonstrated that specific selections of Mozart piano sonatas, which have a specific rhythm and mode, improve patient anxiety through a biochemical mechanism (changing the plasma levels of IL-6 and epinephrine). Therefore, in this study, the term "music" will specifically means the same Mozart sonatas as described in the prior study.

Objectives:

The objective of this study is to determine the effect of music on patient satisfaction and anxiety during cesarean delivery.

The hypothesis is that parturients exposed to music during cesarean delivery will have greater overall satisfaction and less anxiety.

Study Timelines:

• Participation begins at the time of consultation for cesarean delivery on the day of surgery, where the co-investigator Dr. Dahlawi will approach the participants and ask them to sign the ICF, and it ends after the post-anesthesia check on postoperative day 1. After recruitment and consent, patients will be randomized using a computer-generated randomization scheme will be used to allocate patients to one of the arms of the study.
• The two arms of the study are as follows:

• Control group: baseline hemodynamics and anxiety screen; no music
• Intervention group - Mozart: A study investigator will turn on a playlist of pre-selected Mozart music.

Inclusion criteria

• Age: 18-50 years old
• Scheduled for elective cesarean delivery
• Nulliparity
• Singleton pregnancy
• Full term fetus (≥37.0 weeks gestational age)
• Healthy fetus (no known congenital diseases at the time of surgery)
• Requesting neuraxial anesthesia for the procedure
• Able to provide informed consent

Exclusion criteria

• Patient refusal
• Prior history of extensive abdominal surgery
• Active labor
• Contraindication to neuraxial anesthesia
• Uncorrected coagulopathy
• Infection at the skin site of epidural placement
• Increased intracranial pressure
• Untreated hemodynamic instability
• Known hypersensitivity to local anesthetics (a.k.a. amide or ester allergy)
• Patients with impaired hearing
• Patient on anti-anxiolytic medication