Evaluation of the effectiveness of aromatherapy and music on anxiety, perioperative pain and physiological parameters in patients undergoing extraction of impacted third molars

Randomized clinical trial with three groups: experimental 1 (91 patients) who will undergo surgical extraction of the third molar receiving musical stimulation during the surgical procedure. Experimental group 2 (91 patients) to which aromatherapy will be applied during the surgical procedure. And control group (91 patients) that will be the patients who will undergo the extraction of the third molar without receiving musical stimulation or aromatherapy during the surgical procedure. Experimental group 1 (MUSIC group): Patients who will be included in the music therapy intervention group will receive an electronic acoustic reproduction device iPod, with wireless headphones (Trust Urban). “Introduction and Allegro for harp, flute, clarinet, and string quartet” by Ravel and “Aria” by J.S. Bach are selected as the playlist to be played during the procedure, as they are considered relaxing instrumental music. This device will allow the patient to listen to music when unaccompanied, both presurgery (in the preoperative holding area) and during surgery (in the operating room), with a duration of 20 minutes each time. In the preoperative holding area, when the patient is unaccompanied, the device will be given 20 minutes before the extraction (volume of 60-70 decibels to avoid risk of acoustic damage). The basic vital signs: systolic blood pressure (SBP), diastolic blood pressure (DBP), oxygen saturation (SAT O2) and heart rate (HR), will be taken and the STAI-Y1 and STAI-Y2 questionnaire will be carried out. After 20 minutes alone and listening to music, the patient goes to the operating room where the surgery is performed while the patient uses the music player during surgery. During surgery, new basic vital signs will be taken: systolic blood pressure (SBP), diastolic blood pressure (DBP), oxygen saturation (SAT O2) and heart rate (HR) using the same tower with which they were taken in the preoperative holding area. These constants will be taken at different times during the surgical act: during the infiltration of local anesthetic (articaine with epinephrine 40/0.005mg/ml (trade name Ultracain ®)); during the osteotomy and dental section carried out with a handpiece at 40,000 revolutions with a 23 milling cutter; and after the closure of the flap and placement of local compressive gauze. 20 minutes after the surgery, the STAI-Y1, STAI-Y2 questionnaire will be passed again and new basic vital signs will be taken. And finally, a visual analog scale (VAS) will be used to indicate the perioperative pain experienced by the patient. Intervention group 2 (AROMATHERAPY GROUP): The aromatherapy will be applied using a dispenser that will contain 100% pure lavender oil essence (4 drops in 150 ml of distilled water). The procedure will be carried out in the same way as in the intervention group with music therapy (the patient will be alone for 20 minutes in the preoperative holding area receiving the aromatherapy and then they will go to the operating room, using the device during surgery). As a strategy to monitor adherence or fidelity to the intervention, the "directly observed therapy" method will be used. To do this, a health professional will fill out a check-list in which they will verify that each patient is receiving the intervention indicated according to the protocol.