Semester

Summer

Date of Graduation

2026

Document Type

Problem/Project Report

Degree Type

DNP

College

School of Nursing

Department

Anesthesiology

Committee Chair

Laurel Miner

Committee Member

David Rosen

Committee Member

Erin Weekley

Abstract

Introduction: Excessive noise in the operating room negatively impacts patient comfort and outcomes, particularly in patients undergoing spinal anesthesia who have the potential for awareness.

Background: Research demonstrates that music therapy is a low-cost, low-risk intervention that reduces perioperative anxiety and sedative requirements. Literature supports the use of music as an adjunct to anesthesia care, especially in orthopedic populations.

Purpose: At J.W. Ruby Memorial Hospital, orthopedic procedures with regional anesthesia expose patients to high noise levels, often leading to increased anxiety, sedation use, and longer recovery times. Addressing this problem aligns with institution goals for safe, patient-centered care.

Methods: Using the Iowa Model, music therapy via headphones was implemented for patients undergoing total knee arthroplasty under spinal anesthesia. Data were collected through retrospective and prospective chart audits, measuring anxiety (V AS-A), sedation use, and post-anesthesia care unit length of stay.

Intervention: Patients in the intervention group listened to patient-selected music through headphones intraoperatively. Standard care was maintained for both groups. Staff education supported implementation.

Results: Twenty-nine patients were analyzed (15 pre-intervention, 14 intervention). Postoperative anxiety scores were significantly lower in the intervention group (0.14 vs. 1.46; p = 0.048). Sedation requirements showed no significant difference (98.07 vs. 98.93 mcg/kg/min). PACU stay trended shorter in the intervention group but was not statistically significant.

Conclusion: Music therapy significantly reduced postoperative anxiety in total knee arthroplasty patients under spinal anesthesia. As a safe, feasible, and cost-effective intervention, it holds promise for broader integration into anesthesia care.

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