Preoperative Music Intervention for Anxiety in Hip and Knee Arthroplasty

Trial statusRecruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age18+
SponsorColumbia University

About this trial

Many patients feel anxious before joint replacement surgery. This anxiety is common - affecting roughly 1 in 3 patients - and research has shown that patients who are more anxious before surgery tend to have more pain afterward and may need more pain medication during recovery. Listening to music before medical procedures has been shown to reduce anxiety in many types of surgery. In fact, a recent analysis of 20 studies found that music works about as well as anti-anxiety medication for calming patients before surgery, with about 1 in 4 patients experiencing a meaningful benefit. However, almost all of this research has been done in other types of surgery. No study has specifically tested whether letting patients listen to their own preferred music before hip or knee replacement surgery reduces their anxiety.

This study will randomly assign 52 patients scheduled for hip or knee replacement surgery to one of two groups: one group will listen to music of their choice through noise-cancelling headphones while waiting for surgery (for at least 20 minutes), and the other group will receive the usual preoperative care without music. Patients will fill out a brief 6-question anxiety survey when they arrive in the preoperative area and again just before being taken to the operating room. The study will also ask patients about their pain, anxiety, and overall experience after surgery, and will review their medical charts to see how much sedation and pain medication was used during the procedure. If music is shown to reduce anxiety in this setting, it could be easily adopted by any hospital at very low cost, offering patients a simple, drug-free way to feel calmer before their surgery.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

Adults 18 years or older undergoing primary THA, TKA, or UKA for osteoarthritis

Planned spinal/regional anesthesia

Willingness to undergo randomization

Ability to provide informed consent in English

Disqualifiers

Chronic opioid use prior to surgery

Revision TJA

Primary diagnosis other than osteoarthritis (e.g., fracture, posttraumatic arthritis, AVN)

Hearing impairment precluding music listening

Trial design

Design model

Parallel

Treatments tested in this trial

  • Music via Headphones

    Other intervention

    Patient-selected music will be played through their headphones

Treatment groups

52 Participants
are divided into 2 treatment groups
Group A: Music InterventionExperimental treatment 1 intervention
Group B: Control groupNo intervention 0 interventions

Trial outcomes

Primary outcomes

1

Change in State Anxiety Score as Measured by the Six-Item Short Form of the Spielberger State-Trait Anxiety Inventory (STAI-6)

The STAI-6 is a validated 6-item short form of the state anxiety subscale of the Spielberger State-Trait Anxiety Inventory. Each item is scored from 1 to 4, for a raw total of 6 to 24. The raw total is prorated to the full-scale equivalent (multiplied by 20/6), giving a score range of 20 to 80. Higher scores indicate greater anxiety (worse outcome). The outcome is the change in prorated score from arrival in the preoperative holding area (T1) to immediately before transport to the operating room (T2).

Time frame
Day of surgery: from arrival in the preoperative holding area to immediately before transport to the operating room (approximately 20 minutes to 2 hours)

Secondary outcomes

1

Postoperative Anxiety Measured by Numeric Rating Scale (NRS)

Self-reported anxiety on an 11-point numeric rating scale from 0 (no anxiety) to 10 (worst anxiety imaginable). Higher scores indicate greater anxiety (worse outcome).

Time frame
Postoperatively in the post-anesthesia care unit (PACU), within 24 hours after surgery
2

Postoperative Pain Measured by Numeric Rating Scale (NRS)

Self-reported pain on an 11-point numeric rating scale from 0 (no pain) to 10 (worst pain imaginable). Higher scores indicate greater pain (worse outcome).

Time frame
Postoperatively in the PACU, within 24 hours after surgery
3

Global Surgical Experience Measured by Numeric Rating Scale (NRS)

Patient-reported overall satisfaction with the perioperative experience on an 11-point numeric rating scale from 0 (worst possible experience) to 10 (best possible experience). Higher scores indicate a better experience (better outcome).

Time frame
Postoperatively, within 24 hours after surgery
4

Intraoperative Sensory Recall

Proportion of participants reporting recall of intraoperative sensory experiences (e.g., sounds, conversations, sensations), assessed with a structured postoperative questionnaire. Responses are recorded as yes/no for each sensory domain. Reported recall is considered a worse outcome.

Time frame
Postoperatively, within 24 hours after surgery

Other outcomes

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