Perioperative music listening as a non-pharmacological adjunct in enhanced recovery after total knee arthroplasty under neuraxial anaesthesia: A systematic review and meta-analysis (2026)

Type of publication:

Systematic review

Author(s):

Chall, Kramer; Komperla, Siddharth; *Abdelaal, Ali; Seeruthun, Ravish.

Citation:

Journal of Perioperative Practice. 17504589261490336, 2026 Oct 26.

Abstract:

INTRODUCTION: Patients undergoing total knee arthroplasty under neuraxial anaesthesia remain awake within a stressful operative environment. Music listening is a low-cost, non-pharmacological intervention that may reduce anxiety and pain.

METHODS: We searched PubMed, MEDLINE, Embase and Cochrane Central Register of Controlled Trials from inception to April 2026. Standardised mean differences were pooled using random-effects models; risk of bias was assessed with Cochrane Risk of Bias 2.

RESULTS: Eight randomised controlled trials (440 participants) were included. Music listening significantly reduced postoperative anxiety (standardised mean difference = -0.95; 95% confidence intervals: -1.34 to -0.55) and postoperative pain at 24 h (standardised mean difference = -0.81; 95% confidence interval: -1.23 to -0.39) and was associated with reduced opioid consumption, lower intraoperative sedation requirements, fewer conversions from neuraxial to general anaesthesia and higher patient satisfaction. Subgroup analysis suggests that a proportion of the benefit may be attributable to noise isolation from headphones alone rather than to music.

CONCLUSION: Low-certainty evidence suggests music may be an optional, low-cost adjunct within enhanced recovery after surgery pathways for total knee arthroplasty. Further research is needed to refine optimal intervention protocols and validate benefits in larger multicentre trials.

DOI: 10.1177/17504589261490336