Effects of perioperative music-based interventions on psychological and physiological outcomes in breast cancer surgery patients: a systematic review and meta-analysis

Objective This study aimed to systematically evaluate the effects of perioperative music-based interventions on psychological and physiological outcomes in patients undergoing breast cancer surgery. Methods CNKI, Wanfang, VIP, SinoMed, PubMed, Web of Science, and the Cochrane Library were searched for randomized controlled trials (RCTs) published up to October 2025. Two reviewers independently screened the studies, extracted data, and assessed methodological quality using the Cochrane risk-of-bias tool (RoB 1.0). A meta-analysis was conducted using RevMan 5.4 software. Effect sizes were expressed as mean differences (MD) or standardized mean differences (SMD) with 95% confidence intervals (CIs). Random-effects models were used when substantial heterogeneity was present, and sensitivity and subgroup analyses were conducted to explore robustness and potential sources of heterogeneity. Results A total of 18 RCTs involving 1,728 patients were included. The results showed that music-based interventions significantly improved postoperative anxiety (SMD = 0.99, 95% CI: 0.48–1.49, I ² = 91%, p = 0.0001), depression (SMD = 0.66, 95% CI: 0.44–0.88, I ² = 0%, p < 0.00001), and pain (SMD = 0.64, 95% CI: 0.31–0.97, I ² = 65%, P = 0.0001). In addition, music-based interventions significantly reduced systolic blood pressure (MD = 14.17, 95% CI: 5.66–22.67, I ² = 56%, P = 0.001), diastolic blood pressure (MD = 7.14, 95% CI: 0.48–13.79, I ² = 84%, p = 0.04), and heart rate (MD = 4.75, 95% CI: 1.02–8.48, I ² = 77%, P = 0.01). Subgroup analyses revealed that the effects on psychological and physiological outcomes differed by intervention timing and music playback mode. Conclusion Perioperative music-based interventions appear to be an effective, safe, and low-cost non-pharmacological approach for alleviating psychological distress, reducing pain, and stabilizing certain physiological stress indicators in patients undergoing breast cancer surgery. Further high-quality studies are needed to optimize intervention protocols and facilitate the standardized clinical application of music-based interventions in breast cancer rehabilitation. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/view/CRD420251235397 , identifier CRD420251235397.