Efficacy of music therapy on pain reduction during arterial blood gas analysis: an open-label randomized controlled trial
DOI:
https://doi.org/10.18203/issn.2454-2156.IntJSciRep20263678Keywords:
Music therapy, Arterial blood gas, Procedural pain, Nursing, Randomized controlled trial, Nonpharmacological analgesiaAbstract
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.
Metrics
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. DOI: https://doi.org/10.1002/14651858.CD005179.pub4
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. DOI: https://doi.org/10.1016/j.bjps.2019.07.023
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. DOI: https://doi.org/10.3390/jcm11040991
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. DOI: https://doi.org/10.3390/ijerph20237120
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. DOI: https://doi.org/10.4103/1735-9066.185581
Arnold CA, Bagg MK, Harvey AR. The psychophysiology of music-based interventions and the experience of pain. Front Psychol. 2024;15:1361857. DOI: https://doi.org/10.3389/fpsyg.2024.1361857
Matheson L, Stephenson M, Huber B. Reducing pain associated with arterial punctures for blood gas analysis. Pain Manag Nurs. 2014;15(3):619-24. DOI: https://doi.org/10.1016/j.pmn.2013.06.001
Johnson AJ, Elkins GR. Effects of music and relaxation suggestions on experimental pain. Int J Clin Exp Hypn. 2020;68(2):225-45. DOI: https://doi.org/10.1080/00207144.2020.1719842
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. DOI: https://doi.org/10.3389/fpain.2022.734999
Lee JH. The effects of music on pain: A meta-analysis. J Music Ther. 2016;53(4):430-77. DOI: https://doi.org/10.1093/jmt/thw012
Kwekkeboom KL. Music versus distraction for procedural pain and anxiety in patients with cancer. Oncol Nurs Forum. 2003;30(3):433-40. DOI: https://doi.org/10.1188/03.ONF.433-440
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. DOI: https://doi.org/10.1016/j.neubiorev.2011.06.005
Lunde SJ, Vuust P, Garza-Villarreal EA, Vase L. Music-induced analgesia: How does music relieve pain? Pain. 2019;160(5):989-93. DOI: https://doi.org/10.1097/j.pain.0000000000001452
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. DOI: https://doi.org/10.3389/fpain.2022.878258
Seminowicz DA, Remeniuk B, Krimmel SS. Pain-related nucleus accumbens function: Modulation by reward and sleep disruption. Pain. 2019;160(6):1196-207. DOI: https://doi.org/10.1097/j.pain.0000000000001498
Tracey I, Mantyh PW. The cerebral signature for pain perception and its modulation. Neuron. 2007;55(3):377-91. DOI: https://doi.org/10.1016/j.neuron.2007.07.012
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. DOI: https://doi.org/10.1016/j.pmn.2010.05.002
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. DOI: https://doi.org/10.1055/s-0039-3402438
Potvin S, Grignon S, Marchand S. Human evidence of a supraspinal modulating role of dopamine on pain perception. Synapse. 2009;63(5):390-402. DOI: https://doi.org/10.1002/syn.20616
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Jyoti Prakash, V. S. Ojha, Ratnadeep Biswas, Shubhasis Dan

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.