Clinical Outcomes of Preoperative Music Medicine and Relaxation Techniques in Elderly Surgical Patients: A Randomized Controlled Trial

Abstract

Objective: This study examined the short- and long-term effects of one week of preoperative music medicine and relaxation techniques on perioperative anxiety and postoperative recovery. Materials and Methods: Patients aged ≥60 years undergoing elective surgery at a university hospital were randomized into four groups: music medicine, relaxation techniques, combined intervention, and control. Interventions were administered for seven days prior to surgery. Anxiety was assessed using the Hospital Anxiety and Depression Scale–Anxiety subscale (HADS-A) at baseline, one day before surgery, and on postoperative day 3, and months 1 and 3. Postoperative recovery was evaluated using the Quality of Recovery-35 (QoR-35) questionnaire. Data were analysed using a linear mixed model. Results: Of the 140 enrolled participants, 104 completed the study. Baseline characteristics were comparable across all groups. Compared to the control group, the relaxation group showed a significantly greater reduction in anxiety one day before surgery (mean difference: −1.25, p = 0.04), though no significant differences were found at subsequent time points. The music and combined groups exhibited nonsignificant reductions in anxiety. On postoperative day 3, the relaxation group had significantly higher QoR-35 scores than controls (mean difference: 2.34, p = 0.04), whereas the other intervention groups showed nonsignificant higher QoR-35 scores. By months 1 and 3, QoR-35 scores had slightly increased in all intervention groups, but without statistical significance compared with the control group. Conclusion: Preoperative relaxation techniques effectively reduced anxiety and improved early postoperative recovery. However, their long-term benefits, along with those of music interventions, were not evident.