If you hate needles, music might make you feel better during a cannula insertion… but it has to be the right kind of music. Although different musical interventions have repeatedly been reported to help with pain and stress, the evidence varies widely for different types of music and it's hard to figure out what works best. To investigate, scientists played different kinds of music for patients about to undergo an intravenous cannula before an MRI — either Mozart, relaxation music, or the patients' own favorite tunes. They found that playing patients' favorite music worked best.
"Although a needle puncture is a minor procedure, the level of pain can vary significantly from person to person," said Dr Andrei Cristinel Dragnea of University Hospital Zürich, lead author of the article in Frontiers in Pain Research. "In modern medicine, the goal of treating physicians is not only to provide a successful diagnosis and therapy, but also to ensure that the procedure causes as little discomfort as possible."
"I would recommend listening to music to patients, especially patients who like music in general," said Dr Meritxell Garcia Alzamora of University Hospital Zürich, senior author of the article. "In view of our results we will increase the application of music in venous punctures performed for radiological procedures, especially in anxious or claustrophobic patients."
Sweet music?
The scientists recruited 204 patients undergoing a non-emergency MRI of the brain, spine, or head and neck. These patients' procedures called for a contrast agent inserted into their veins with a cannula, which can hurt. A quarter of them acted as a control group, meaning they listened to no music, while three other groups listened to either their favorite music, music specifically designed for relaxation, or a piece of Mozart, Sonata KV448, which several studies have found to have therapeutic properties.
Before the procedure started, patients assigned to the 'favorite music' group were asked to name an artist or song they would like to hear, and all patients were shown a visual scale that describes pain from a level of one (no pain) to 10 (worst pain of their life). This allowed the researchers to ask patients to rate their pain before and during the procedure, and then at two points afterwards — 30 seconds and two minutes later.
"From the four conditions we examined, only favorite music and Mozart showed a positive effect," said Garcia Alzamora. "Favorite music manifested a significant pain reduction effect both in patients with and without baseline pain — i.e. with preexisting pain before needle puncture. Mozart only showed significant pain relief in patients with preexisting pain."
Patients who were listening to their favorite music experienced less pain both 30 seconds and two minutes after the cannula was inserted. In a subgroup of patients who reported preexisting pain before cannulation, listening to their favorite music also reduced pain at the time of needle insertion, and listening to Mozart reduced pain two minutes after needle insertion.
Pain levels seemed to improve more two minutes after cannulation than at the earlier time points, although this data can't explain why. It could be that the initial discomfort of the cannula pulled people's attention from the music, or that the mechanisms which make music helpful for pain reduction need some time to kick in.
Relaxation music doesn't soothe
However, Mozart only seemed to work for the patients who reported being in pain before the cannulation, and the patients who listened to relaxation music or no music didn't experience any change in their pain.
"Relaxation music is usually characterized by a slow speed and low volume, and does not show noticeable dynamics," said Garcia Alzamora. "These characteristics may have contributed to the patients disregarding relaxation music, which would explain the lack of pain relief."
"The intervention — in this case the venous puncture — consisted only of a very short-term pain with a small needle, although this can be very painful for some patients," cautioned Dragnea, adding that it would be worth evaluating the benefits of music for patients undergoing procedures that are more painful and last longer. "Additionally, a technician accompanying and talking to the patient could be regarded as a confounder, as the mere presence of a person talking to you may be perceived as calming and distracting. However, all patients were exposed to the same conditions, so this confounder should not be over-interpreted."
