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A1267
October 21, 2008
9:00 AM - 11:00 AM
Room Hall E2-Area A,
Hemispheric Synchronized Sounds and Perioperative Analgesic Requirements
Susan M. Dabu-Bondoc, M.D., Nalini Vadivelu, M.D., Megan Weinberg, M.A., Jill E. MacLaren, Ph.D., Zeev N. Kain, M.D., M.B.A.
Anesthesiology, Yale University School of Medicine, New Haven, Connecticut
The use of hemispheric synchronized (Hemi-Sync) sounds in the operating room has been promoted to decrease anxiety, perioperative anesthetic or analgesic consumption but data is limited. 60 ambulatory patients were consented and randomized into 3 groups: treatment group had hemisync sounds (n=20), music group had music tapes of their choice (n=20), and control (placebo) group had a blank cassette tape (n=20). The intervention was applied in the preoperative area and during the surgical procedure. After a propofol-nitrous-vecuronium general anesthesia perioperative analgesic requirements were recorded. To ensure uniformity of hypnotic depth in all participants a bispectral index monitor was used. The Hemi-Sync group had a significantly reduced intraoperative analgesic consumption compared to the music (p=0.02) and control group (p = 0.04). Although pain (VAS) scores were significantly less in the Hemi-Sync group 1 hour and 24 hours after surgery, analgesic requirements were similar among the three groups throughout the 24 hour postoperative period. Time to discharge trended lower in participants who had Hemi-Sync (p=.058); incidence of nausea/vomiting, oxygen desaturation. patient recall, and patient satisfaction were similar in all groups. We conclude that the use Hemi-Sync sounds before and during general anesthesia decreases intraoperative but not postoperative analgesic requirements.[table1][table2]

Anesthesiology 2008; 109 A1267
[table 1] Baseline Characteristics
VariableHemiSync groupMusic groupControl groupP value
Age (yr)42.3 +/- 13.841.2 +/- 13.141.1 +/- 10.50.94
Education (yr)15.5 +/- 03.013.9 +/- 02.514.9 +/- 03.00.19
Sex (% male; % female)38/6245/5528/720.55
State anxiety (STAI)40.0 +/- 13.042.2 +/- 11.643.4 +/- 10.70.65
Trait anxiety (STAI)34.8 +/- 09.040.6 +/- 11.439.8 +/- 08.20.13
Prior surgery (%)25/7524/7639/610.53
Weight (kg)74.6 +/- 14.976.7 +/- 17.874.1 +/- 18.00.88
Continuous data were analyzed by one way ANOVA, categorical data by chi-square test
[table 2] Results
VariableHemisync groupMusic groupControl groupP value
Intraop Fentanyl *14.6 +/- 6.920.9 +/- 9.120.3 +/- 9.40.046
Postop (PACU) analgesic**15.0 +/ 12.914.4 +/-13.216.9 +/- 12.80.830
Postop (Home) analgesic**18.6 +/-11.628.0 +/-16.425.0 +/- 13.10.099
Total periop analgesic48.3+/- 21.862.6+/- 29.161.7+/- 24.00.144
VAS score T0 in PACU3.8 +/- 3.44.5 +/- 3.35.4 +/- 2.50.300
VAS score T10 in PACU4.0 +/- 3.33.8 +/- 2.75.2 +/- 2.30.258
VAS Score T20 in PACU3.6 +/- 2.84.5 +/- 2.44.3 +/- 2.20.520
VAS Score T30 in PACU3.5 +/- 2.03.4 +/- 1.44.1 +/- 2.40.541
VAS score T60 in PACU2.6 +/- 1.64.2 +/- 2.13.9 +/- 1.70.020
VAS score 24 hrs postop3.5 +/- 1.55.3 +/- 1.85.0 +/- 2.00.005
Discharge time120.2 +/-37.3156.6 +/-65.6162.8 +/-68.20.058
PONV0.1 +/- 0.50.2 +/- 0.40.2 +/- 0.40.608
Recall000N/A
Patient satisfaction3.9 +/- 0.24.0 +/- 0.23.9 +/- 0.40.124
Total propofol (mcg/min/kg)***0.18 +/- 0.060.17 +/- 0.040.20 +/- 0.130.43
*fentanyl requirements in mcg converted to IV morphine mg equivalents