Music reduces pain perception in healthy newborns: A comparison between different music tracks and recoded heartbeat
Introduction
Several studies have proven that listening to music, voices and heartbeats can positively affect physiological indicators, feeding, length of stay, and pain outcomes for newborn babies [[1], [2], [3], [4], [5], [6], [7], [8], [9], [10]]. Listening to music and to parent-preferred lullabies can be used to objectively determine the effects of these interventions on the heart rate, oxygen saturation (O2Sat), nutritive sucking and caloric intake of premature newborns [4,5,8,10]. Music may also improve oxygen saturation in preterm infants undergoing endotracheal suctioning [11] and also reduce stress and pain in children undergoing painful medical procedures, such as intravenous injections, lumbar punctures and dental procedures [[12], [13], [14]].
Although the available literature suggests that the presence of harmonic and rhythmic sound can positively affect neonatal neurobehavioral development and reduce parental stress during neonatal intensive care unit (NICU) stays [[1], [2], [3]], the heterogeneity of study populations, interventions and outcomes precludes definitive conclusions on the efficacy of music for specific indications [1].
To date, the main criticisms from published works relates to a lack of categorisation of the impact that various types of music, different genres or variables within the music have on physiological outcomes.
This study evaluated the effects of three music interventions (compared to no intervention) on physiological parameters and pain perception in healthy newborns undergoing painful medical procedures. A comparison between the effects of each musical intervention was conducted in order to investigate the optimal characteristics of the sound stimuli to be used with healthy newborns, to avoid the risk of hyperstimulation and to best reduce procedural pain perception and stress.
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Participants
The study was conducted in the Neonatal Intensive Care Unit of the University Hospital of Brescia, Italy.
Eighty full-term healthy infants were enrolled during a 15 month period, with Apgar score of 8 or above, breathing spontaneously and hemodynamically stable. We verified that all infants recruited to this study had normal brainstem auditory responses (a routine procedure in all infants who are discharged from our NICU). The exclusion criteria were congenital malformations, mechanical
Results
No significant differences were found at baseline in the clinical characteristics of the subjects, nor in all the selected outcome measures (Table 1).
Between T0 and T3 the mean heart rate varied from 112.35 to 110.7 bpm in the first group (Mozart's Sonata for two pianos K.448), from 119.8 to 110.8 bpm in the second group (Beethoven's Moonlight Sonata) and from 111.8 to 105.6 in the third group (heartbeat sound recordings). By contrast, the average heart rate varied from 124.2 to 128.75 in the
Discussion
There is a growing interest in the management of stress and pain in hospitalized children, and neonates constitute a population group that might benefit from the application of standardized protocols of music therapy to provide stress reduction and analgesia [2]. According to the previous literature, although there is preliminary evidence of the therapeutic benefits of music, studies investigating the effects of music in early life have produced equivocal results, probably due to the variation
Conflict of interest statement
None declared.
Acknowledgements
We are grateful to Dr. Antonella Gasparoni for her precious assistance and to all the NICU nurses for their valuable help in performing the treatment of the children included in this study.
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