Anesthesia , Analgesia, Breast Surgery
Conditions
Keywords
Intraoperative Music, Propofol Consumption, Bispectral Index, Total Intravenous Anesthesia
Brief summary
The goal of this study is to find out whether listening to music during surgery can reduce the amount of propofol, an anesthesia medicine, needed in patients having elective breast surgery. Patients who agree to take part will be randomly assigned to one of two groups. One group will listen to music of their choice through headphones during anesthesia and recovery. The other group will receive standard anesthesia care without music. All patients will receive routine anesthesia monitoring, including a monitor that helps assess the depth of anesthesia. The main outcome of the study is the total amount of propofol used during surgery. The study will also look at anesthesia depth values, use of other anesthesia medicine, blood pressure and heart rate, time spent in the recovery unit, nausea and vomiting after surgery, and patient satisfaction.
Detailed description
This is a single-center, prospective, randomized, controlled, two-arm study conducted at Bursa Uludag University Faculty of Medicine, Department of Anesthesiology and Reanimation. The study population will include adult patients scheduled for elective breast surgery under total intravenous anesthesia. After providing written informed consent, eligible participants will be randomized into two groups. The control group will receive routine anesthesia care in a standard operating room environment. The music group will receive the same anesthesia protocol and will listen to self-selected music using noise-cancelling Bluetooth headphones from immediately before anesthesia induction until discharge from the post-anesthesia care unit. All patients will undergo standard intraoperative monitoring, including electrocardiography, noninvasive blood pressure, pulse oximetry, capnography, and bispectral index monitoring. Anesthesia will be induced and maintained according to a standardized total intravenous anesthesia protocol using propofol and remifentanil. Propofol administration will be titrated to maintain the BIS value within the target range of 40-60. The primary outcome is total propofol consumption expressed as mg/kg. Secondary outcomes include intraoperative BIS values recorded at regular intervals, remifentanil consumption, heart rate and blood pressure measurements, post-anesthesia care unit length of stay, postoperative nausea and vomiting, and patient satisfaction before discharge from the post-anesthesia care unit.
Interventions
BEHAVIORALIntraoperative Music
Participants assigned to the music group will listen to self-selected music through noise-cancelling Bluetooth headphones from immediately before anesthesia induction until discharge from the post-anesthesia care unit. Music volume will be set at approximately 50-60 dB. Standard anesthesia care will be provided according to the study protocol.
Sponsors
Uludag University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
SINGLE (Outcomes Assessor)
Masking description
The anesthesia team will not be blinded to group allocation. The surgeon, post-anesthesia care unit staff, and outcome assessor will not be informed of the assigned group.
Intervention model description
Participants will be randomized into two parallel groups: intraoperative music plus standard anesthesia care or standard anesthesia care alone.
Eligibility
Sex/Gender
ALL
Age
18 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
* Age between 18 and 70 years * American Society of Anesthesiologists physical status I or II * Scheduled to undergo elective breast surgery with an estimated surgical duration of 45 to 180 minutes * Planned anesthesia technique is total intravenous anesthesia * Able to understand Turkish and communicate verbally * Able to read and write and provide written informed consent * Clinically normal hearing function and no ear, nose, or throat condition that prevents headphone use
Exclusion criteria
* Diagnosed unilateral or bilateral hearing loss or use of a hearing aid * Current psychiatric disease or regular use of psychotropic medication, including antidepressants, antipsychotics, anxiolytics, or hypnotics * Diagnosis of chronic pain syndrome or chronic use of opioids, pregabalin, or gabapentin * Neurological disease that may affect BIS interpretation, such as epilepsy, dementia, stroke sequelae, or Parkinson disease * Known allergy or contraindication to propofol, remifentanil, or rocuronium * Morbid obesity, defined as body mass index greater than 40 kg/m² * History of active alcohol or substance dependence * Pregnancy or breastfeeding * Emergency surgery or reoperation * Planned addition of regional anesthesia in the preoperative period * Refusal to participate in the study or refusal to sign the informed consent form
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Total Propofol Consumption | From anesthesia induction to the end of surgery, assessed up to 6 hours. | Total amount of propofol administered during anesthesia, normalized to body weight and expressed as mg/kg. Propofol consumption will be obtained from the target-controlled infusion pump records. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Bispectral Index Values | From anesthesia induction to the end of surgery, assessed up to 6 hours. | Bispectral index values will be recorded at 5-minute intervals during anesthesia to assess intraoperative depth of anesthesia. |
| Remifentanil Consumption | From anesthesia induction to the end of surgery, assessed up to 6 hours. | Remifentanil consumption during anesthesia will be calculated from target-controlled infusion pump records and expressed as mcg/kg/min |
| Mean Heart Rate | From anesthesia induction to the end of surgery, assessed up to 6 hours. | The mean intraoperative heart rate will be calculated using values recorded at 5-minute intervals during anesthesia and expressed as beats per minute. |
| Mean Systolic Arterial Pressure | From anesthesia induction to the end of surgery, assessed up to 6 hours. | The mean intraoperative systolic arterial pressure will be calculated using values recorded at 5-minute intervals during anesthesia and expressed as mmHg. |
| Mean Diastolic Arterial Pressure | From anesthesia induction to the end of surgery, assessed up to 6 hours. | The mean intraoperative diastolic arterial pressure will be calculated using values recorded at 5-minute intervals during anesthesia and expressed as mmHg. |
| Mean Arterial Pressure | From anesthesia induction to the end of surgery, assessed up to 6 hours. | The mean arterial pressure during anesthesia will be calculated using values recorded at 5-minute intervals and expressed as mmHg. |
| Postoperative Nausea and Vomiting | At 30 and 60 minutes after admission to the post-anesthesia care unit | The presence of postoperative nausea and vomiting will be assessed in the post-anesthesia care unit using a standard assessment form. |
| Post-Anesthesia Care Unit Length of Stay | From admission to the post-anesthesia care unit until discharge readiness from the post-anesthesia care unit, assessed up to 180 minutes. | Duration of stay in the post-anesthesia care unit will be recorded in minutes. Discharge from the post-anesthesia care unit will be based on an Aldrete score of 9 or higher |
| Patient Satisfaction | Immediately before discharge from the post-anesthesia care unit, assessed up to 180 minutes after post-anesthesia care unit admission. | Patient satisfaction will be assessed using a 0-10 visual analog scale before discharge from the post-anesthesia care unit. Higher scores indicate greater satisfaction. |
Countries
Turkey (Türkiye)
Contacts
CONTACTSelcan Akesen, MD
CONTACTGokce Kizilkale Kayikci, MD
Outcome results
None listed