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      Interventions with Music in PECTus excavatum treatment (IMPECT trial): a study protocol for a randomised controlled trial investigating the clinical effects of perioperative music interventions

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          Abstract

          Introduction

          Pectus excavatum repair is associated with substantial postoperative pain, despite the use of epidural analgesia and other analgesic regimens. Perioperative recorded music interventions have been shown to alleviate pain and anxiety in adults, but evidence for children and adolescents is still lacking. This study protocol describes a randomised controlled trial that evaluates the effects of recorded music interventions on postoperative pain relief in children and adolescents after pectus excavatum repair.

          Methods

          A multicentre randomised controlled trial was set up comparing the effects of perioperative recorded music interventions in addition to standard care with those of standard care only in patients undergoing a Nuss procedure for pectus excavatum repair. One hundred and seventy subjects (12–18 years of age) will be included in three centres in the Netherlands. Patient inclusion has started in November 2018, and is ongoing. The primary outcome is self-reported perceived pain measured on the visual analogue scale. Secondary outcomes are anxiety level, analgesics consumption, vital parameters such as heart rate, blood pressure and respiratory rate, length of hospital stay, postoperative complications, quality of life and cost-effectiveness.

          Ethics and dissemination

          This study is being conducted in accordance with the Declaration of Helsinki. The Medical Ethics Review Board of Erasmus University Medical Centre Rotterdam, The Netherlands, has approved this protocol. Results will be disseminated via peer-reviewed scientific journals and conference presentations.

          Trial registration number

          NL6863

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          Most cited references25

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          Meta‐analysis evaluating music interventions for anxiety and pain in surgery

          Background This study aimed to evaluate anxiety and pain following perioperative music interventions compared with control conditions in adult patients. Methods Eleven electronic databases were searched for full‐text publications of RCTs investigating the effect of music interventions on anxiety and pain during invasive surgery published between 1 January 1980 and 20 October 2016. Results and data were double‐screened and extracted independently. Random‐effects meta‐analysis was used to calculate effect sizes as standardized mean differences (MDs). Heterogeneity was investigated in subgroup analyses and metaregression analyses. The review was registered in the PROSPERO database as CRD42016024921. Results Ninety‐two RCTs (7385 patients) were included in the systematic review, of which 81 were included in the meta‐analysis. Music interventions significantly decreased anxiety (MD –0·69, 95 per cent c.i. –0·88 to –0·50; P < 0·001) and pain (MD –0·50, –0·66 to –0·34; P < 0·001) compared with controls, equivalent to a decrease of 21 mm for anxiety and 10 mm for pain on a 100‐mm visual analogue scale. Changes in outcome corrected for baseline were even larger: MD –1·41 (–1·89 to –0·94; P < 0·001) for anxiety and –0·54 (–0·93 to –0·15; P = 0·006) for pain. Music interventions provided during general anaesthesia significantly decreased pain compared with that in controls (MD –0·41, –0·64 to –0·18; P < 0·001). Metaregression analysis found no significant association between the effect of music interventions and age, sex, choice and timing of music, and type of anaesthesia. Risk of bias in the studies was moderate to high. Conclusion Music interventions significantly reduce anxiety and pain in adult surgical patients.
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            Measuring and valuing health benefits for economic evaluation in adolescence: an assessment of the practicality and validity of the child health utility 9D in the Australian adolescent population.

            The Child Health Utility 9D (CHU9D) is a new generic preference-based measure of health-related quality of life developed for children aged 7 to 11 years. There is increasing interest in its potential for application in adolescents, and previous research has demonstrated that it shows good construct validity here. This article further examines its practicality and validity in adolescents by comparing it with KIDSCREEN-10, a short generic measure for assessing children and adolescents' health-related quality of life and well-being. A Web-based survey, including the CHU9D, a general health question, questions on the presence of long-standing illness, disability, or medical conditions, sociodemographic variables, and KIDSCREEN-10, was administered to 961 consenting adolescents. The practicality and face and construct validity of the CHU9D were examined, and the CHU9D and KIDSCREEN-10 were compared in terms of their coverage, correlations between dimensions, and overall scores. Both measures demonstrated good practicality and validity. The strongest degree of correlation was found with the only dimension in common for the CHU9D and KIDSCREEN (sad). The lowest correlations were found between all the CHU9D dimensions and the "have you had enough time for yourself" dimension of KIDSCREEN-10. The findings from this study provide further support for the practicality and validity of the application of the CHU9D in the economic evaluation of adolescent health care and public health programs. Further research to test the psychometric performance of the CHU9D in more diverse clinical samples of adolescents is desirable including tests of reliability. Copyright © 2012 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.
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              Music therapy to reduce pain and anxiety in children with cancer undergoing lumbar puncture: a randomized clinical trial.

              A nonpharmacological method can be an alternative or complement to analgesics.The aim of this study was to evaluate if music medicine influences pain and anxiety in children undergoing lumbar punctures. A randomized clinical trial was used in 40 children (aged 7-12 years) with leukemia, followed by interviews in 20 of these participants. The participants were randomly assigned to a music group (n = 20) or control group (n = 20). The primary outcome was pain scores and the secondary was heart rate, blood pressure, respiratory rate, and oxygen saturation measured before, during, and after the procedure. Anxiety scores were measured before and after the procedure. Interviews with open-ended questions were conducted in conjunction with the completed procedures. The results showed lower pain scores and heart and respiratory rates in the music group during and after the lumbar puncture. The anxiety scores were lower in the music group both before and after the procedure. The findings from the interviews confirmed the quantity results through descriptions of a positive experience by the children, including less pain and fear.
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                Author and article information

                Journal
                BMJ Open
                BMJ Open
                bmjopen
                bmjopen
                BMJ Open
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                2044-6055
                2020
                8 July 2020
                : 10
                : 7
                : e036380
                Affiliations
                [1 ]departmentPediatric Surgery , Erasmus MC Sophia Children's Hospital , Rotterdam, Zuid-Holland, The Netherlands
                [2 ]departmentAnaesthesiology , Saint Antonius Hospital , Nieuwegein, Utrecht, The Netherlands
                [3 ]departmentAnaesthesiology , Erasmus MC Sophia Children's Hospital , Rotterdam, Zuid-Holland, The Netherlands
                [4 ]departmentPaediatric Surgery , Haga Hospital Juliana Children's Hospital , Den Haag, Zuid-Holland, The Netherlands
                [5 ]departmentAnaesthesiology , Haga Hospital Juliana Children's Hospital , Den Haag, Zuid-Holland, The Netherlands
                [6 ]departmentPaediatric Surgery , Emma Children's Hospital AMC , Amsterdam, North Holland, The Netherlands
                [7 ]departmentAnaesthesiology , Emma Children's Hospital AMC , Amsterdam, North Holland, The Netherlands
                [8 ]departmentInstitute for Medical Technology Assessment , Erasmus University Rotterdam , Rotterdam, The Netherlands
                [9 ]departmentBiostatistics , Erasmus MC , Rotterdam, Zuid-Holland, The Netherlands
                [10 ]departmentNeuroscience , Erasmus MC , Rotterdam, The Netherlands
                Author notes
                [Correspondence to ] Ryan J Billar; r.billar@ 123456erasmusmc.nl
                Author information
                http://orcid.org/0000-0002-3624-8222
                Article
                bmjopen-2019-036380
                10.1136/bmjopen-2019-036380
                7348468
                32641330
                da1cdaa1-814c-40c6-a14b-054765f67b41
                © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ.

                This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See:  https://creativecommons.org/licenses/by/4.0/.

                History
                : 13 December 2019
                : 16 March 2020
                : 11 June 2020
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100003061, Erasmus Medisch Centrum;
                Award ID: Not applicable
                Categories
                Surgery
                1506
                1737
                Protocol
                Custom metadata
                unlocked

                Medicine
                paediatric thoracic surgery,paediatric anaesthesia,pain management
                Medicine
                paediatric thoracic surgery, paediatric anaesthesia, pain management

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