Normalization of hypertensive responses during ambulatory surgical stress by perioperative music

Objective: The purpose of this study was to determine whether cognitive app raisals of stress level and hypertensive responses to ambulatory ophthalmic surgery can be ameliorated by patient-selected music. Methods: We studied 40 elderly individuals requiring ophthalmic surgery, 20 in an experimental group (mean age, 74 years) and 20 in a control group (mean age, 77 years). All patients had an established resting blood pressure < 140/90 mm Hg. In t he experimental group self-selected music was provided by headphones throug hout the preoperative, surgical, and postoperative periods. In the control group patients had neither headphones nor music. All patients received simi lar (weight-determined) doses of alfentanil and midazolam during surgery. H eart rate, blood pressure, and patient-reported stress and coping levels we re the dependent variables. Results: In both groups, blood pressure values were normal (approximately 129/82 mm Hg) during screening examinations 1 we ek before surgery. On the day of surgery both groups displayed increased pr eoperative blood pressures (approximately 159/92 mm Hg) associated with inc reases in heart rate (by approximately 17 beats/min). Intraoperative blood pressures in the experimental group returned quickly to screening baseline values, whereas the control group experienced persistent elevations in intr aoperative blood pressure similar to preoperative levels. Over the course o f the surgical experience, patients with music reported significant reducti ons in perceived stress and increases in coping abilities (p < .001), where as those without music did not. Conclusions: The perceived stress of ambula tory surgery in geriatric patients is associated with a clinical hypertensi ve response that is ameliorated by self-selected perioperative music, which also decreases perceived stress and increases patients' sense of personal control and well-being.