Effect of music intervention on anxiety and pain after anatomical endoscopic enucleation of the prostate: a prospective randomized controlled trial

BACKGROUND: This prospective randomized study aimed to assess the effect of self-selected music, delivered via loudspeaker, on early postoperative anxiety and pain in patients who underwent anatomical endoscopic enucleation of the prostate (AEEP) under spinal anesthesia without sedation. METHODS: Adult male patients scheduled for AEEP were randomly allocated to either a music intervention group (self-preferred music) or a control group (no music). Baseline characteristics, preoperative urethral catheter status, International Prostate Symptom Scores (IPSS), operative duration, and pre- and postoperative anxiety scores (State Anxiety Inventory, SAI) were recorded. Visual Analog Scale (VAS) was used to evaluate postoperative pain two hours after surgery. RESULTS: A total of 135 patients were analyzed (music group, n= 67; control group, n= 68). Baseline characteristics and operative times were comparable between groups (p>0.05). The music group had significantly lower postoperative SAI (32.0 ± 7.32 vs. 38.38 ± 11.28; p = 0.001) and VAS scores (1 [1-2] vs. 2 [1-3]; p = 0.001). The reduction in postoperative SAI compared to preoperative value was also greater in the music group (14 [10.00-21.00] vs. 7 [1.00-11.75]; p = 0.001). Music type had no significant impact on outcomes (p>0.05). In multivariate analysis, music intervention and preoperative catheterization were independent predictors of postoperative anxiety. CONCLUSIONS: Self-selected music intervention significantly reduced early postoperative anxiety and pain following AEEP under spinal anesthesia. Given its simplicity and non-invasive nature, music may serve as an effective adjunct for enhancing patient comfort, regardless of music genre. CLINICAL TRIAL NUMBER: NCT07255118.