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Dr. Sandeep Kumar Kar Bookmark and Share

 

Effect of Indian Classical Music (Raga Therapy) on Fentanyl, Vecuronium, Propofol requirement and cortisol levels in Cardiopulmonary bypass.

 

 

 

Methods  After obtaining clearance from Institutional Ethical Committee and written informed consent from patients, 34 patients were assigned to either Group I Music group (n= 17) and Blank CD  Group II (n= 17). The patients awareness .level and depth of anesthesia was monitored by BIS (Bispectral index) , Fentanyl and propofol infusion titrated to a BIS score of 50 and neuromuscular monitoring was done by Post tetanic count  (PTC)  in the Aductor Pollicis muscle .Vecuronium was repeated whenever a PTC count of 7 was achieved, in both the groups. Music therapy or blank CD was played by earphone, in the patient’s ear in both the groups, from 30 mins before induction to till the patient was shifted to the ICU.

 

Results We found significant decrease in the cortisol levels both after Sternotomy and after aortic crosscalmp release. In the Music group (Group I) which was 30 % less than the Blank CD group (Group II). Fentanyl, propofol and vecuronium requirement in the Music group were reduced by 30 % and 25 %and 25 % respectively, which were statistically significant (P< 0.05)

 

Discussion Music is regarded as the medicine with no side effects. Cardiopulmonary bypass is associated with immense stress response and high levels of intraoperative cortisol levels which is detrimental to the patient and involves large doses of Fentanyl, propofol and vecuronium requirement to maintain hemodynamic stability intraoperatively.By unknown mechanism s Indian classical music therapy reduced the intraoperative stress and analgesic requirement.

 

Conclusion Intraoperative Indian classical music therapy effectively reduced the intraoperative stress (as revealed by reduced levels of cortisol) and reduced the requirement of drugs (Fentanyl, Propofol and Vecuronium) during Cardiopulmonary Bypass.

 

 

 

 

 

1)    References Bagchi, Kalyan. (Ed) (2003) Music, Mind and Mental Health. New Delhi.

2)     Tony Wigram, Inge Nygaard Pedersen and Lars Ole Bonde.Jessica Kingley Publishers Philadelphia2002:  A comprehensive guide to music therapy, Theory, clinical practice Research & Training.

3)    Nisson, Rawal N, Unosson M. A comparison of intra-operative or postoperative exposure to music--a controlled trial of the effects on postoperative pain. Anaesthesia. 2003 Jul; 58(7):699-703.

4)    Yale University School of medicine 2003 Effects of music therapy.

5)    Sairam, T. V. (2004a) Medicinal Music. Chennai: Nada Centre for Music Therapy

6)    Sairam T. V. (2004b) Raga Therapy. Chennai: Nada Centre for Music Therapy

7)    Sairam, T. V. (2004c) What is Music? Chennai: Nada Centre for Music Therapy

8)    Lewis.  Anesth Analg 2004; 98:533-6

9)    N. Yapici, I. A. Tarhan, T. Kehlibar, T. Coruh, Y. Arslan, M. Yilmaz, F. Yapici, A. Ozler & Z. Aykac : Blood Cortisol Levels On Cardiopulmonary Bypass After Methylene Blue Administration . The Internet Journal of Thoracic and Cardiovascular Surgery. 2008 Volume 11 Number 2

10) Miller  7th edition Neuro muscular monitoring chapter 47

                                                                                                             

 


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12/05/2011
More by : Dr. Sandeep Kumar Kar
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