THE VALUE of music in reducing perioperative anxiety in patients undergoing surgery or caesarean delivery has been quantified by researchers in a 2026 systematic review and meta-analysis, which found an effectiveness similar to that of benzodiazepines.
The calculated number needed to treat (NNT) was 4, meaning that only four patients need to listen to music perioperatively for one of them to benefit from the intervention.
This translates to a reduction in perioperative anxiety by 12 mm on the Visual Analog Scale for Anxiety, or 5.7 points on the State-Trait Anxiety Index, for one patient when four are treated.
Calculating the NNT of Music Intervention
Music intervention has previously been established as an effective therapy for reducing perioperative anxiety but, until now, had not been assigned an NNT.
Hence, researchers aimed to provide the measurement to support clinicians in considering the real-world value of implementing the intervention.
They found that patients experienced a significant, moderate-to-large anxiety reduction after recorded music interventions in surgical settings.
Researchers conducted a comprehensive literature search, collating data from randomised controlled trials that analysed the effect of the intervention on perioperative anxiety (measured with any validated tool).
They subsequently calculated effectiveness, using Furukawa’s method to translate statistical evidence into the NNT for clinical application.
Effectiveness Similar to Benzodiazepines Without Potential Side-Effects
Pharmacological treatment of anxiety in surgical settings has mostly centred around the use of benzodiazepines.
In recent years, side-effects, including respiratory depression, drowsiness, and dependency, have gained increasing attention in discourse surrounding the use of the drugs in perioperative care, particularly in older populations.
The only NNT for the use of benzodiazepines is a score of 4 for their effect in the treatment of a panic disorder, researchers reported.
It follows that authors warned that no NNT for the effect of the drugs in the specific context of preoperative anxiety is known, limiting direct comparison.
Nonetheless, the clinical implications of the calculated NNT are significant, researchers highlighted, because music intervention can be seen as similarly as effective as benzodiazepines but does not carry the same side-effects (nor cost).
Authors said this could encourage clinicians to implement music intervention into daily practice.
References
Stoop JM et al. The number needed to treat for music as a medicine against perioperative anxiety: A systematic review and meta-analysis. Anesth Analg. 2026;142(4):625-634.
Mahanna-Gabrielli E et al. Pro-con debate: judicious benzodiazepine administration for preoperative anxiolysis in older patients. Anesth Analg. 2023;137:280-288.
Breilmann J et al. Benzodiazepines versus placebo for panic disorder in adults. Cochrane Database Syst Rev. 2019;DOI:10.1002/14651858.CD010677.pub2.
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