Efficacy of music therapy on pain reduction during arterial blood gas analysis: an open-label randomized controlled trial

Jyoti Prakash; V. S. Ojha; Ratnadeep Biswas; Shubhasis Dan

doi:10.18203/issn.2454-2156.IntJSciRep20263678

Authors

Jyoti Prakash Department of General Medicine, AIIMS, Patna, Bihar, India
V. S. Ojha Department of General Medicine, AIIMS, Patna, Bihar, India
Ratnadeep Biswas Department of General Medicine, AIIMS, Patna, Bihar, India
Shubhasis Dan Independent Researcher, Kolkata, West Bengal, India

DOI:

https://doi.org/10.18203/issn.2454-2156.IntJSciRep20263678

Keywords:

Music therapy, Arterial blood gas, Procedural pain, Nursing, Randomized controlled trial, Nonpharmacological analgesia

Abstract

Background: Arterial blood gas (ABG) sampling is commonly associated with procedural pain and anxiety. Nonpharmacological approaches such as music therapy may attenuate pain without impacting workflow or safety. Objectives were to evaluate whether music therapy reduces pain during ABG sampling compared with standard care, and to assess effects on number of puncture attempts and procedure duration.

Methods: Open-label, parallel-group randomized controlled trial. General medicine wards of a tertiary-care teaching hospital in Eastern India (3-month enrollment). Adults (≥18 years) requiring ABG sampling who were alert or verbally responsive (AVPU A/V). Participants were randomized (SNOSE) to music therapy via headphones during ABG (intervention) or standard care (control). Primary outcome was post-procedure pain using 0-10 numerical rating scale (NRS). Secondary outcomes were number of puncture attempts and procedure duration. Analyses used independent t-test and chi-square as appropriate (α=0.05).

Results: Among 186 participants (n=92 music; n=94 control), mean NRS pain was lower with music (4.07±2.08) versus control (5.11±2.59); mean difference -1.04 (95% CI -1.72 to -0.36), p=0.003. First-attempt success was similar (77.2% vs 73.4%; p=0.280). Procedure duration distribution (<30s/ 30-60s />60s) did not differ between groups (p=0.890).

Conclusions: Music therapy significantly reduced procedural pain during ABG without affecting success or duration. This feasible, low-cost intervention can be incorporated into routine nursing practice for procedural comfort. Nurses can lead implementation of music therapy during brief invasive procedures to improve patient experience without disrupting workflow.

References

Castro D, Patil SM, Zubair M. Arterial Blood Gas. In: StatPearls. Treasure Island (FL): StatPearls Publishing. 2025.

Birnie KA, Noel M, Chambers CT, Lindsay SU, Jennifer AP. Psychological interventions for needle-related procedural pain and distress in children and adolescents. Cochrane Database Syst Rev. 2018;2018(10):CD005179.

Molleman J, Tielemans JF, Braam MJI, Berber W, Richard K. Distraction as a simple and effective method to reduce pain during local anesthesia: A randomized controlled trial. J Plast Reconstr Aesthet Surg. 2019;72:1979-85.

Ting B, Tsai CL, Hsu WT, Mei-Ling S, Ping-Tao T, Daniel TLC, et al. Music intervention for pain control in the pediatric population: A systematic review and meta-analysis. J Clin Med. 2022;11(4):991.

Hunter AR, Heiderscheit A, Galbally M, Davide G, Hiba M, Hubertus H. The effects of music-based interventions for pain and anxiety management during vaginal labour and caesarean delivery: A systematic review and narrative synthesis of randomised controlled trials. Int J Environ Res Public Health. 2023;20(23):7120.

Shabani F, Nayeri ND, Karimi R. Effects of music therapy on pain responses induced by blood sampling in premature infants: A randomized cross-over trial. Iran J Nurs Midwifery Res. 2016;21(4):391-6.

Arnold CA, Bagg MK, Harvey AR. The psychophysiology of music-based interventions and the experience of pain. Front Psychol. 2024;15:1361857.

Matheson L, Stephenson M, Huber B. Reducing pain associated with arterial punctures for blood gas analysis. Pain Manag Nurs. 2014;15(3):619-24.

Johnson AJ, Elkins GR. Effects of music and relaxation suggestions on experimental pain. Int J Clin Exp Hypn. 2020;68(2):225-45.

Lunde SJ, Vuust P, Garza-Villarreal EA, Irving K, Arne M, Lene V. Music-induced analgesia in healthy participants is associated with expected pain levels but not opioid or dopamine-dependent mechanisms. Front Pain Res (Lausanne). 2022;3:734999.

Lee JH. The effects of music on pain: A meta-analysis. J Music Ther. 2016;53(4):430-77.

Kwekkeboom KL. Music versus distraction for procedural pain and anxiety in patients with cancer. Oncol Nurs Forum. 2003;30(3):433-40.

Bernatzky G, Presch M, Anderson M, Ulmer H. Emotional foundations of music as a non-pharmacological pain management tool in modern medicine. Neurosci Biobehav Rev. 2011;35(9):1989-99.

Lunde SJ, Vuust P, Garza-Villarreal EA, Vase L. Music-induced analgesia: How does music relieve pain? Pain. 2019;160(5):989-93.

Powers JM, Ioachim G, Stroman PW. Music to my senses: fMRI evidence of music analgesia across connectivity networks spanning the brain and brainstem. Front Pain Res (Lausanne). 2022;3:878258.

Seminowicz DA, Remeniuk B, Krimmel SS. Pain-related nucleus accumbens function: Modulation by reward and sleep disruption. Pain. 2019;160(6):1196-207.

Tracey I, Mantyh PW. The cerebral signature for pain perception and its modulation. Neuron. 2007;55(3):377-91.

Özer N, Karaman Özlü Z, Arslan S. Effect of music on postoperative pain and physiologic parameters of patients after open heart surgery. Pain Manag Nurs. 2013;14(1):20-8.

Gogoularadja A, Bakshi SS. A randomized study on the efficacy of music therapy on pain and anxiety in nasal septal surgery. Int Arch Otorhinolaryngol. 2020;24(3):e232-6.

Potvin S, Grignon S, Marchand S. Human evidence of a supraspinal modulating role of dopamine on pain perception. Synapse. 2009;63(5):390-402.