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This randomized controlled trial investigates the effects of music played during liver donor surgery on hemodynamic parameters and cortisol levels. Ninety participants were divided into three groups: music, silence (with headphones but no sound), and a control group with no intervention. The study aimed to evaluate whether music can reduce stress-related physiological responses during surgery.
This study was designed to evaluate the effects of music played during surgery on liver transplant donors. The research included 90 adult participants who underwent live liver donation surgeries. Participants were randomly assigned to one of three groups: music group (headphones with music), silence group (headphones without sound), and a control group (no headphones). Music intervention lasted for 30 minutes during the operation.
The primary objective was to examine whether intraoperative music exposure could reduce physiological stress, measured via cortisol levels. Secondary outcomes included changes in hemodynamic parameters such as systolic and diastolic blood pressure, pulse rate, oxygen saturation, and respiratory rate. Measurements were taken before and after the surgery.
The study was conducted at İnönü University Liver Transplant Institute, with ethical approval granted by the Malatya Clinical Research Ethics Committee (Approval No: 2021/52). The findings suggest that music may be an effective supportive intervention for reducing surgical stress.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Music Group | Experimental | Participants in this group listened to a playlist composed of music pieces they selected prior to surgery, consisting of approximately 5-6 tracks. The music was played continuously for 30 minutes during the surgery through Bluetooth headphones. The sound level was set at 65 decibels. |
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| Silence Group | Sham Comparator | Participants in this group wore headphones during the surgery, but no music was played. The headphones were used to block ambient operating room sounds. This group was used to control for the effect of wearing headphones without auditory stimulation. |
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| Control Group | No Intervention | Participants in this group did not receive any intervention. No headphones were worn, and no music or auditory stimulus was provided during the surgery. This group served as the control to compare the effects of music and silence interventions. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Music Listening Intervention | Behavioral | Participants listened to a playlist of 5-6 music tracks they personally selected before surgery. The music was played continuously for 30 minutes through Bluetooth headphones during liver transplantation. Volume was kept at 65 decibels. |
| Measure | Description | Time Frame |
|---|---|---|
| Change in Serum Cortisol Levels During the Intraoperative Period | Serum cortisol levels were measured at two intraoperative time points: (1) immediately before anesthesia induction and (2) at the 30th minute of surgery. Blood samples were drawn from the radial artery, centrifuged, stored at -80°C, and later analyzed using the ELISA method. The difference between the two measurements was calculated to evaluate the physiological impact of the interventions. | Intraoperative (from pre-induction to the 30th minute of surgery) |
| Measure | Description | Time Frame |
|---|---|---|
| Change in Systolic Blood Pressure During the Intraoperative Period | Systolic blood pressure was measured at two intraoperative time points: (1) immediately before anesthesia induction and (2) at the 30th minute of surgery. The difference between the two values was used to assess the hemodynamic effect of music and silence interventions compared to standard care. | Intraoperative (from pre-induction to the 30th minute of surgery) |
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Inclusion Criteria:
Undergoing elective surgery as a liver donor
No physical or mental condition preventing listening to music
Willing to participate voluntarily and signing the informed consent form
Exclusion Criteria:
Participants for whom the study could not be continued due to technical reasons during surgery
Participants who did not comply with the study protocol or had incomplete records
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| Name | Affiliation | Role |
|---|---|---|
| Meral ÖZKAN, Prof. Dr. | Inonu University Faculty of Nursing | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Turgut Özal Medical Center, Liver Transplantation Institute | Malatya | Malatya | 44280 | Turkey (Türkiye) |
Individual participant data (IPD) will not be shared because this study did not include a plan for data sharing in the ethical approval and informed consent process. Participant confidentiality and data protection are prioritized.
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This study employed a parallel assignment interventional model. Participants were randomly divided into three groups: (1) the music group, which received classical music intervention during surgery, (2) the silence group, which used noise-canceling headphones without music, and (3) the control group, which received no intervention. All participants were liver transplant donors. The hemodynamic values and cortisol levels of participants were measured and compared before, during, and after surgery to evaluate the physiological effects of music exposure.
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| Silence with Headphones | Behavioral | Participants wore Bluetooth headphones during the surgery, but no audio was played. This intervention was designed to control for the effect of wearing headphones and isolating ambient operating room sounds. |
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| Change in Diastolic Blood Pressure During the Intraoperative Period | Diastolic blood pressure was measured at two intraoperative time points: (1) immediately before anesthesia induction and (2) at the 30th minute of surgery. Blood pressure was monitored continuously using a non-invasive automated device. The difference between the two values was analyzed to assess the effects of music and silence interventions on intraoperative hemodynamic response. | Intraoperative (from pre-induction to the 30th minute of surgery) |
| Change in Heart Rate During the Intraoperative Period | Heart rate was recorded at two intraoperative time points: (1) immediately before anesthesia induction and (2) at the 30th minute of surgery. Monitoring was performed using standard intraoperative ECG. The difference between the two values was analyzed to evaluate the effect of music and silence interventions on autonomic cardiac response during surgery. | Intraoperative (from pre-induction to the 30th minute of surgery), |
| Change in Respiratory Rate During the Intraoperative Period | Respiratory rate was recorded at two intraoperative time points: (1) immediately before anesthesia induction and (2) at the 30th minute of surgery. Monitoring was conducted using standard intraoperative vital sign monitoring systems. The difference between the two values was analyzed to evaluate the effect of music and silence interventions on respiratory function. | Intraoperative (from pre-induction to the 30th minute of surgery) |
| Change in Peripheral Oxygen Saturation (SpO₂) During the Intraoperative Period | Peripheral oxygen saturation (SpO₂) was measured at two intraoperative time points: (1) immediately before anesthesia induction and (2) at the 30th minute of surgery. Measurements were taken using standard pulse oximetry. The difference between the two values was used to assess the impact of music and silence interventions on tissue oxygenation during surgery. | Intraoperative (from pre-induction to the 30th minute of surgery) |