Perception of auditory stimuli during general anesthesia and its effects on patient outcomes: a systematic review and meta-analysis
Purpose Interest in implicit memory formation and unconscious auditory stimulus perception during general anesthesia has resurfaced as perioperative music has been reported to produce beneficial effects. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) evalua...
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| Veröffentlicht in: | Canadian journal of anesthesia 2021-08, Vol.68 (8), p.1231-1253 |
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| container_title | Canadian journal of anesthesia |
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| creator | Fu, Victor X. Sleurink, Karel J. Janssen, Joséphine C. Wijnhoven, Bas P. L. Jeekel, Johannes Klimek, Markus |
| description | Purpose
Interest in implicit memory formation and unconscious auditory stimulus perception during general anesthesia has resurfaced as perioperative music has been reported to produce beneficial effects. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) evaluating explicit and implicit memory formation during general anesthesia and its effects on postoperative patient outcomes and recovery.
Source
We performed a systematic literature search of Embase, Ovid Medline, and Cochrane Central from inception date until 15 October 2020. Eligible for inclusion were RCTs investigating intraoperative auditory stimulation in adult surgical patients under general anesthesia in which patients, healthcare staff, and outcome assessors were all blinded. We used random effects models for meta-analyses. This study adhered to the PRISMA guidelines and was registered in PROSPERO (CRD42020178087).
Principal findings
Fifty-three (4,200 patients) of 5,859 identified articles were included. There was evidence of implicit memory formation in seven out of 17 studies (41%) when assessed using perceptual priming tasks. Mixed results were observed on postoperative behavioural and motor response after intraoperative suggestions. Intraoperative music significantly reduced postoperative pain (standardized mean difference [SMD], -0.84; 95% confidence interval [CI], -1.1 to -0.57;
P
< 0.001;
I
2
= 0;
n
= 226) and opioid requirements (SMD, -0.29; 95% CI, -0.57 to -0.015;
P
= 0.039;
I
2
= 36;
n
= 336), while positive therapeutic suggestions did not.
Conclusion
The results of this systematic review and meta-analysis show that intraoperative auditory stimuli can be perceived and processed during clinically adequate, general anesthesia irrespective of surgical procedure severity, leading to implicit memory formation without explicit awareness. Intraoperative music can exert significant beneficial effects on postoperative pain and opioid requirements. Whether the employed intraoperative anesthesia regimen is of influence is not yet clear. |
| doi_str_mv | 10.1007/s12630-021-02015-0 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8282577</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2529943082</sourcerecordid><originalsourceid>FETCH-LOGICAL-c474t-7b19b3324a8711b5a92f0d84df41b9f8b1a620d5bbcba22b95c2b5939eabc7e3</originalsourceid><addsrcrecordid>eNp9kT1vFDEQhi0EIkfgD1AgSzQ0C2N7vWtTIKGILykSFCnoLNs7e3G0uz5sb9DV_HF8uRA-CgprLM0z73y8hDxl8JIB9K8y452ABjirD5hs4B7ZsFZ3jdK9vE82oARvOgZfT8ijnK8AQHVSPSQnogUm2k5syI8vmDzuSogLjSO16xBKTHuaS5jXKdBhTWHZ0i0umOxE7YK5XGIOtn4HGkqmOI7oa6wCO1sCLoXGtfg4Y35NLc37XHCuCU8TXgf8flM4Y7GNXey0zyE_Jg9GO2V8chtPycX7dxdnH5vzzx8-nb09b3zbt6XpHdNOCN5a1TPmpNV8hEG1w9gyp0flmO04DNI57yznTkvPndRCo3W-R3FK3hxld6ubcfB10rqS2aUw27Q30Qbzd2YJl2Ybr43iisu-rwIvbgVS_LbWQ5g5ZI_TVK8S12y45Fq3AhSv6PN_0Ku4prrvgZJMgei7A8WPlE8x54Tj3TAMzMFic7TYVIvNjcUGatGzP9e4K_nlaQXEEci7g3eYfvf-j-xPjca1eQ</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2551803762</pqid></control><display><type>article</type><title>Perception of auditory stimuli during general anesthesia and its effects on patient outcomes: a systematic review and meta-analysis</title><source>MEDLINE</source><source>SpringerLink Journals</source><creator>Fu, Victor X. ; Sleurink, Karel J. ; Janssen, Joséphine C. ; Wijnhoven, Bas P. L. ; Jeekel, Johannes ; Klimek, Markus</creator><creatorcontrib>Fu, Victor X. ; Sleurink, Karel J. ; Janssen, Joséphine C. ; Wijnhoven, Bas P. L. ; Jeekel, Johannes ; Klimek, Markus</creatorcontrib><description>Purpose
Interest in implicit memory formation and unconscious auditory stimulus perception during general anesthesia has resurfaced as perioperative music has been reported to produce beneficial effects. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) evaluating explicit and implicit memory formation during general anesthesia and its effects on postoperative patient outcomes and recovery.
Source
We performed a systematic literature search of Embase, Ovid Medline, and Cochrane Central from inception date until 15 October 2020. Eligible for inclusion were RCTs investigating intraoperative auditory stimulation in adult surgical patients under general anesthesia in which patients, healthcare staff, and outcome assessors were all blinded. We used random effects models for meta-analyses. This study adhered to the PRISMA guidelines and was registered in PROSPERO (CRD42020178087).
Principal findings
Fifty-three (4,200 patients) of 5,859 identified articles were included. There was evidence of implicit memory formation in seven out of 17 studies (41%) when assessed using perceptual priming tasks. Mixed results were observed on postoperative behavioural and motor response after intraoperative suggestions. Intraoperative music significantly reduced postoperative pain (standardized mean difference [SMD], -0.84; 95% confidence interval [CI], -1.1 to -0.57;
P
< 0.001;
I
2
= 0;
n
= 226) and opioid requirements (SMD, -0.29; 95% CI, -0.57 to -0.015;
P
= 0.039;
I
2
= 36;
n
= 336), while positive therapeutic suggestions did not.
Conclusion
The results of this systematic review and meta-analysis show that intraoperative auditory stimuli can be perceived and processed during clinically adequate, general anesthesia irrespective of surgical procedure severity, leading to implicit memory formation without explicit awareness. Intraoperative music can exert significant beneficial effects on postoperative pain and opioid requirements. Whether the employed intraoperative anesthesia regimen is of influence is not yet clear.</description><identifier>ISSN: 0832-610X</identifier><identifier>ISSN: 1496-8975</identifier><identifier>EISSN: 1496-8975</identifier><identifier>DOI: 10.1007/s12630-021-02015-0</identifier><identifier>PMID: 34013463</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Adult ; Analgesics, Opioid ; Anesthesia, General ; Anesthesiology ; Cardiology ; Clinical outcomes ; Critical Care Medicine ; General anesthesia ; Humans ; Intensive ; Medicine ; Medicine & Public Health ; Meta-analysis ; Narcotics ; Pain Medicine ; Pain, Postoperative ; Patients ; Pediatrics ; Perception ; Pneumology/Respiratory System ; Review /Brief Review ; Review Article/Brief Review ; Systematic review</subject><ispartof>Canadian journal of anesthesia, 2021-08, Vol.68 (8), p.1231-1253</ispartof><rights>The Author(s) 2021</rights><rights>2021. The Author(s).</rights><rights>The Author(s) 2021. This work is published under http://creativecommons.org/licenses/by-nc/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c474t-7b19b3324a8711b5a92f0d84df41b9f8b1a620d5bbcba22b95c2b5939eabc7e3</citedby><cites>FETCH-LOGICAL-c474t-7b19b3324a8711b5a92f0d84df41b9f8b1a620d5bbcba22b95c2b5939eabc7e3</cites><orcidid>0000-0002-0029-0816</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s12630-021-02015-0$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s12630-021-02015-0$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,777,781,882,27905,27906,41469,42538,51300</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34013463$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Fu, Victor X.</creatorcontrib><creatorcontrib>Sleurink, Karel J.</creatorcontrib><creatorcontrib>Janssen, Joséphine C.</creatorcontrib><creatorcontrib>Wijnhoven, Bas P. L.</creatorcontrib><creatorcontrib>Jeekel, Johannes</creatorcontrib><creatorcontrib>Klimek, Markus</creatorcontrib><title>Perception of auditory stimuli during general anesthesia and its effects on patient outcomes: a systematic review and meta-analysis</title><title>Canadian journal of anesthesia</title><addtitle>Can J Anesth/J Can Anesth</addtitle><addtitle>Can J Anaesth</addtitle><description>Purpose
Interest in implicit memory formation and unconscious auditory stimulus perception during general anesthesia has resurfaced as perioperative music has been reported to produce beneficial effects. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) evaluating explicit and implicit memory formation during general anesthesia and its effects on postoperative patient outcomes and recovery.
Source
We performed a systematic literature search of Embase, Ovid Medline, and Cochrane Central from inception date until 15 October 2020. Eligible for inclusion were RCTs investigating intraoperative auditory stimulation in adult surgical patients under general anesthesia in which patients, healthcare staff, and outcome assessors were all blinded. We used random effects models for meta-analyses. This study adhered to the PRISMA guidelines and was registered in PROSPERO (CRD42020178087).
Principal findings
Fifty-three (4,200 patients) of 5,859 identified articles were included. There was evidence of implicit memory formation in seven out of 17 studies (41%) when assessed using perceptual priming tasks. Mixed results were observed on postoperative behavioural and motor response after intraoperative suggestions. Intraoperative music significantly reduced postoperative pain (standardized mean difference [SMD], -0.84; 95% confidence interval [CI], -1.1 to -0.57;
P
< 0.001;
I
2
= 0;
n
= 226) and opioid requirements (SMD, -0.29; 95% CI, -0.57 to -0.015;
P
= 0.039;
I
2
= 36;
n
= 336), while positive therapeutic suggestions did not.
Conclusion
The results of this systematic review and meta-analysis show that intraoperative auditory stimuli can be perceived and processed during clinically adequate, general anesthesia irrespective of surgical procedure severity, leading to implicit memory formation without explicit awareness. Intraoperative music can exert significant beneficial effects on postoperative pain and opioid requirements. Whether the employed intraoperative anesthesia regimen is of influence is not yet clear.</description><subject>Adult</subject><subject>Analgesics, Opioid</subject><subject>Anesthesia, General</subject><subject>Anesthesiology</subject><subject>Cardiology</subject><subject>Clinical outcomes</subject><subject>Critical Care Medicine</subject><subject>General anesthesia</subject><subject>Humans</subject><subject>Intensive</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Meta-analysis</subject><subject>Narcotics</subject><subject>Pain Medicine</subject><subject>Pain, Postoperative</subject><subject>Patients</subject><subject>Pediatrics</subject><subject>Perception</subject><subject>Pneumology/Respiratory System</subject><subject>Review /Brief Review</subject><subject>Review Article/Brief Review</subject><subject>Systematic review</subject><issn>0832-610X</issn><issn>1496-8975</issn><issn>1496-8975</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNp9kT1vFDEQhi0EIkfgD1AgSzQ0C2N7vWtTIKGILykSFCnoLNs7e3G0uz5sb9DV_HF8uRA-CgprLM0z73y8hDxl8JIB9K8y452ABjirD5hs4B7ZsFZ3jdK9vE82oARvOgZfT8ijnK8AQHVSPSQnogUm2k5syI8vmDzuSogLjSO16xBKTHuaS5jXKdBhTWHZ0i0umOxE7YK5XGIOtn4HGkqmOI7oa6wCO1sCLoXGtfg4Y35NLc37XHCuCU8TXgf8flM4Y7GNXey0zyE_Jg9GO2V8chtPycX7dxdnH5vzzx8-nb09b3zbt6XpHdNOCN5a1TPmpNV8hEG1w9gyp0flmO04DNI57yznTkvPndRCo3W-R3FK3hxld6ubcfB10rqS2aUw27Q30Qbzd2YJl2Ybr43iisu-rwIvbgVS_LbWQ5g5ZI_TVK8S12y45Fq3AhSv6PN_0Ku4prrvgZJMgei7A8WPlE8x54Tj3TAMzMFic7TYVIvNjcUGatGzP9e4K_nlaQXEEci7g3eYfvf-j-xPjca1eQ</recordid><startdate>20210801</startdate><enddate>20210801</enddate><creator>Fu, Victor X.</creator><creator>Sleurink, Karel J.</creator><creator>Janssen, Joséphine C.</creator><creator>Wijnhoven, Bas P. L.</creator><creator>Jeekel, Johannes</creator><creator>Klimek, Markus</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8FQ</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-0029-0816</orcidid></search><sort><creationdate>20210801</creationdate><title>Perception of auditory stimuli during general anesthesia and its effects on patient outcomes: a systematic review and meta-analysis</title><author>Fu, Victor X. ; Sleurink, Karel J. ; Janssen, Joséphine C. ; Wijnhoven, Bas P. L. ; Jeekel, Johannes ; Klimek, Markus</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c474t-7b19b3324a8711b5a92f0d84df41b9f8b1a620d5bbcba22b95c2b5939eabc7e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adult</topic><topic>Analgesics, Opioid</topic><topic>Anesthesia, General</topic><topic>Anesthesiology</topic><topic>Cardiology</topic><topic>Clinical outcomes</topic><topic>Critical Care Medicine</topic><topic>General anesthesia</topic><topic>Humans</topic><topic>Intensive</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Meta-analysis</topic><topic>Narcotics</topic><topic>Pain Medicine</topic><topic>Pain, Postoperative</topic><topic>Patients</topic><topic>Pediatrics</topic><topic>Perception</topic><topic>Pneumology/Respiratory System</topic><topic>Review /Brief Review</topic><topic>Review Article/Brief Review</topic><topic>Systematic review</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Fu, Victor X.</creatorcontrib><creatorcontrib>Sleurink, Karel J.</creatorcontrib><creatorcontrib>Janssen, Joséphine C.</creatorcontrib><creatorcontrib>Wijnhoven, Bas P. L.</creatorcontrib><creatorcontrib>Jeekel, Johannes</creatorcontrib><creatorcontrib>Klimek, Markus</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Canadian Business & Current Affairs Database</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Canadian journal of anesthesia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Fu, Victor X.</au><au>Sleurink, Karel J.</au><au>Janssen, Joséphine C.</au><au>Wijnhoven, Bas P. L.</au><au>Jeekel, Johannes</au><au>Klimek, Markus</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Perception of auditory stimuli during general anesthesia and its effects on patient outcomes: a systematic review and meta-analysis</atitle><jtitle>Canadian journal of anesthesia</jtitle><stitle>Can J Anesth/J Can Anesth</stitle><addtitle>Can J Anaesth</addtitle><date>2021-08-01</date><risdate>2021</risdate><volume>68</volume><issue>8</issue><spage>1231</spage><epage>1253</epage><pages>1231-1253</pages><issn>0832-610X</issn><issn>1496-8975</issn><eissn>1496-8975</eissn><abstract>Purpose
Interest in implicit memory formation and unconscious auditory stimulus perception during general anesthesia has resurfaced as perioperative music has been reported to produce beneficial effects. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) evaluating explicit and implicit memory formation during general anesthesia and its effects on postoperative patient outcomes and recovery.
Source
We performed a systematic literature search of Embase, Ovid Medline, and Cochrane Central from inception date until 15 October 2020. Eligible for inclusion were RCTs investigating intraoperative auditory stimulation in adult surgical patients under general anesthesia in which patients, healthcare staff, and outcome assessors were all blinded. We used random effects models for meta-analyses. This study adhered to the PRISMA guidelines and was registered in PROSPERO (CRD42020178087).
Principal findings
Fifty-three (4,200 patients) of 5,859 identified articles were included. There was evidence of implicit memory formation in seven out of 17 studies (41%) when assessed using perceptual priming tasks. Mixed results were observed on postoperative behavioural and motor response after intraoperative suggestions. Intraoperative music significantly reduced postoperative pain (standardized mean difference [SMD], -0.84; 95% confidence interval [CI], -1.1 to -0.57;
P
< 0.001;
I
2
= 0;
n
= 226) and opioid requirements (SMD, -0.29; 95% CI, -0.57 to -0.015;
P
= 0.039;
I
2
= 36;
n
= 336), while positive therapeutic suggestions did not.
Conclusion
The results of this systematic review and meta-analysis show that intraoperative auditory stimuli can be perceived and processed during clinically adequate, general anesthesia irrespective of surgical procedure severity, leading to implicit memory formation without explicit awareness. Intraoperative music can exert significant beneficial effects on postoperative pain and opioid requirements. Whether the employed intraoperative anesthesia regimen is of influence is not yet clear.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>34013463</pmid><doi>10.1007/s12630-021-02015-0</doi><tpages>23</tpages><orcidid>https://orcid.org/0000-0002-0029-0816</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0832-610X |
| ispartof | Canadian journal of anesthesia, 2021-08, Vol.68 (8), p.1231-1253 |
| issn | 0832-610X 1496-8975 1496-8975 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8282577 |
| source | MEDLINE; SpringerLink Journals |
| subjects | Adult Analgesics, Opioid Anesthesia, General Anesthesiology Cardiology Clinical outcomes Critical Care Medicine General anesthesia Humans Intensive Medicine Medicine & Public Health Meta-analysis Narcotics Pain Medicine Pain, Postoperative Patients Pediatrics Perception Pneumology/Respiratory System Review /Brief Review Review Article/Brief Review Systematic review |
| title | Perception of auditory stimuli during general anesthesia and its effects on patient outcomes: a systematic review and meta-analysis |
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