Julie Beatty

Scholarly Project Advisor: Marilyn Prasun PhD, CCNS, CNL, CHFN, FAHA.

Affiliated Organization where the project occurred: Carle Foundation Hospital in Champaign Urbana, IL.

Any Funding you received for the Project: Mennonite Graduate Student Grant.

External Dissemination of the Project (Podium or Poster): Clinical Inquiry Conference, Carle Foundation hospital (Poster presentation), 12/9/22 via zoom sponsored by Carle Foundation Hospital Champaign Urbana, IL.

Publication: Reference in AMA format.

Introduction/Problem

Total knee replacement (TKR) surgery is a common orthopedic procedure. Postoperative pain and agitation are common experiences following TKR surgery. Pain and agitation can lead to many adverse effects including tachycardia, hypertension, myocardial infarction, deep vein thrombosis, atelectasis, and psychological well-being (Çengel & Andsoy, 2022; Koras & Karabulut, 2019). Research suggests the use of music in addition to standard care may reduce agitation, pain, and opioid use.

Methods

Richmond agitation sedation scale (RASS), pain scores, and opioid use were obtained on baseline patients (n = 50). A classical music piece was then loaded on an MP3 devices. Total knee replacement patients above the age of 18 with no history of dementia, disorientation or hearing loss were approached in the preoperative area and offered the use of music upon awakening in the post anesthesia care unit (PACU) (n = 40). If accepted, music was applied immediately upon arrival to PACU. PACU nurses then documented the (RASS), pain scale, and opioid use.

Findings

Patients listening to music immediately postoperatively demonstrated less agitation, lower perception of pain, and decreased use of opioids. Music patients showed statistically significantly lower RASS scores than the baseline group receiving usual care (p < .001). A reduction in pain scores was also exhibited in the music group versus the baseline group (p = 0.00). Decreased opioid use was present in the music group versus the baseline as well (p = 0.05).

Practice Implications

Music is a non-pharmacologic approach that can improve patient's outcomes and should be offered to TKR patients. Nurses are in an optimal position to consider and implement music. Larger samples of patients undergoing of procedures should be considered for future projects.