Pilot study provides foundation for understanding how music therapy improves pain after pancreatic surgery

A study from University Hospitals Connor Whole Health has found that it was feasible to conduct a live music-assisted relaxation and imagery session among patients admitted for pancreatic surgery. Participants described the music therapy intervention as beneficial and useful throughout recovery while also providing feedback to improve the intervention and data collection procedures moving forward.

The findings from this study appear in Global Advances in Integrative Medicine and Health.

Patients undergoing pancreatic surgeries, such as pancreatoduodenectomy and distal pancreatectomy, are known to have painful postoperative recoveries. Even with pharmacologic treatments, patients often experience elevated stress, pain, and anxiety following these procedures.

Despite several studies supporting music interventions’ efficacy for addressing post-operative pain, epigenomics underlying their analgesic effects remain poorly understood. No music therapy research has investigated the relationship between gene expression and acute post-surgical pain.

To investigate such mechanisms within music therapy, protocols must be refined for collecting blood samples pre- and post-intervention so that future mechanistic intervention studies can analyze blood samples for changes in gene expression among patients with acute post-surgical pain.

“Music therapy is a great addition to the holistic care of our surgical oncology patients and it is important to better understand the mechanism by which it makes such a difference,” said Richard S. Hoehn, MD, pancreatic surgeon at UH Seidman Cancer Center and co-author of the study.

This study provided valuable data to inform future work in which gene expression mechanisms underlying music therapy’s analgesic effects can be derived from blood samples taken pre- and post-intervention. All participants completed the live music therapy intervention as well as at least one measure of their symptoms during and after the post-surgical intervention. After the live music therapy intervention, patients continued to listen to a recording of the intervention throughout their surgical recovery.

Investigators also attempted to collect dried blood spots before, after, and 15 minutes after the intervention. Blood sampling success was variable (9/15 [60%] across attempts).

The researchers concluded that preliminary findings support (1) the feasibility and acceptability of a live music-assisted relaxation and imagery intervention, (2) continued use of music-assisted relaxation and imagery recordings over the course of hospitalization, and (3) electronic patient-reported outcome collection among adults recovering from pancreatic surgery.

However, design modifications are needed for future studies, such as expanding eligibility to increase recruitment rates, ensuring staff availability throughout the week, extending the music therapy intervention, and using a more robust blood collection procedure than a dried blood spot.

“This is the first study to investigate music therapy’s role among patients undergoing pancreatic surgery, a population that faces several challenges with post-operative symptom management,” said Samuel Rodgers-Melnick, MPH, LPMT, MT-BC, a researcher with UH Connor Whole Health and Principal Investigator of the study. Mr. Rodgers-Melnick is also a co-investigator for Effective Network to advance Scientific Evidence related to Mechanisms of music-Based interventions for pain and support coLlaborative Efforts (ENSEMBLE), an initiative devoted to understanding how music affects pain.

“With this pilot phase complete, we are well-positioned for future studies examining the gene expression mechanisms by which music therapy affects post-surgical pain,” he added.

“This study demonstrates our commitment to providing and studying the impact of nonpharmacologic pain management options for our patients. Reducing pain and anxiety with music therapy allows patients to begin the process of healing, which is a key focus of the care we provide,” said Kristi Artz, MD, FACLM, CCMS, Vice President of Connor Whole Health.