<clinical_study>
  <!-- This xml conforms to an XML Schema at:
    https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
  <required_header>
    <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
    <link_text>Link to the current ClinicalTrials.gov record.</link_text>
    <url>https://clinicaltrials.gov/ct2/show/NCT02220452</url>
  </required_header>
  <id_info>
    <org_study_id>Sofia-Music</org_study_id>
    <nct_id>NCT02220452</nct_id>
  </id_info>
  <brief_title>The Effect of Intraoperative Music Listening on Sevoflurane Consumption and Recovery Parameters</brief_title>
  <official_title>The Effect of Intraoperative Music Listening on Sevoflurane Consumption and Recovery Parameters</official_title>
  <sponsors>
    <lead_sponsor>
      <agency>Aretaieion University Hospital</agency>
      <agency_class>Other</agency_class>
    </lead_sponsor>
  </sponsors>
  <source>Aretaieion University Hospital</source>
  <oversight_info>
    <has_dmc>Yes</has_dmc>
  </oversight_info>
  <brief_summary>
    <textblock>
      -  The perioperative period can be a significant source of psychological burden, anxiety&#xD;
           and fear for patients&#xD;
&#xD;
        -  Both pharmacological and non-pharmacological methods have been proposed in order to&#xD;
           alleviate perioperative stress&#xD;
&#xD;
        -  Music is one of the non-pharmacological methods which have been used in this context,&#xD;
           with favorable effects both preoperatively and postoperatively&#xD;
&#xD;
        -  The attenuation of perioperative stress through music listening is probably due to the&#xD;
           activation of emotional and cognitive processes that evoke feeling of pleasure and can&#xD;
           distract patients' attention from fear and unpleasant thoughts related to the surgical&#xD;
           procedure&#xD;
&#xD;
        -  Little information is available regarding the effect of intraoperative music listening&#xD;
           on anesthetized, unconscious patients&#xD;
&#xD;
        -  There is a notion that general anesthesia does not completely abolish auditory&#xD;
           perception and that some processing of intraoperative events can occur in unconscious&#xD;
           patients, even in the absence of postoperative recall&#xD;
&#xD;
        -  The investigators hypothesis is that intraoperative music listening can decrease&#xD;
           anesthetic requirements and reduce sevoflurane consumption in female patients subjected&#xD;
           to abdominal hysterectomy for benign disease.&#xD;
    </textblock>
  </brief_summary>
  <detailed_description>
    <textblock>
      -  The perioperative period can be a significant source of psychological burden, anxiety&#xD;
           and fear for patients&#xD;
&#xD;
        -  Both pharmacological and non-pharmacological methods have been proposed in order to&#xD;
           alleviate perioperative stress&#xD;
&#xD;
        -  Music is one of the non-pharmacological methods which have been used in this context,&#xD;
           with favorable effects both preoperatively and postoperatively&#xD;
&#xD;
        -  Listening to music during the preoperative period has proved useful as an adjunct to&#xD;
           premedication and can even be used instead of premedication. Additionally, listening to&#xD;
           music postoperatively can also be useful, since it has been related to a more favorable&#xD;
           recovery profile and possible attenuation of postoperative pain. In this context, music&#xD;
           has also been used in Intensive Care Units, with measurable effects on anxiety scales&#xD;
           and hemodynamic parameters. There are also studies investigating the use of music during&#xD;
           operations under regional anesthesia, which have shown that music listening&#xD;
           substantially decreases the need for anxiolytic administration throughout the operation&#xD;
&#xD;
        -  The attenuation of perioperative stress through music listening is probably due to the&#xD;
           activation of emotional and cognitive processes that evoke feelings of pleasure and can&#xD;
           distract patients' attention from fear and unpleasant thoughts related to the surgical&#xD;
           procedure&#xD;
&#xD;
        -  Although the favorable effects of music listening during regional anesthesia for the&#xD;
           attenuation of intraoperative stress in conscious patients are more or less expected and&#xD;
           easily interpreted, less is known regarding the effect of intraoperative music listening&#xD;
           on anesthetized, unconscious patients&#xD;
&#xD;
        -  Generally, there is a notion that general anesthesia does not completely abolish&#xD;
           auditory perception and that some processing of intraoperative events can occur in&#xD;
           unconscious patients, even in the absence of postoperative recall&#xD;
&#xD;
        -  The preservation of some form of auditory processing during general anesthesia is not&#xD;
           necessarily undesirable and can be used to the patient's benefit, since it has been&#xD;
           shown that subjecting patients to therapeutic suggestions during general anesthesia can&#xD;
           improve recovery parameters or decrease hospital stay&#xD;
&#xD;
        -  The investigators hypothesis is that intraoperative music listening can decrease&#xD;
           anesthetic requirements. Therefore, the investigators will investigate sevoflurane&#xD;
           consumption necessary to achieve a depth of anesthesia corresponding to bispectral index&#xD;
           values of 45-55. Female patients subjected to abdominal hysterectomy for benign disease&#xD;
           will be randomized to one of two groups: in the first group, audiotapes playing relaxing&#xD;
           soothing orchestral music will be placed on the patients' ears after induction of&#xD;
           general anesthesia while in the other group the same set of audiotapes will be used&#xD;
           without however playing any music&#xD;
&#xD;
        -  Sevoflurane consumption will be estimated by weighing the sevoflurane vaporizer in a&#xD;
           high-precision scale before induction and after completion of the surgical procedure.&#xD;
           Patients will also be queried regarding recall of any sounds or intraoperative events,&#xD;
           dreaming while anesthetized and they will be asked to rate their satisfaction from&#xD;
           anesthesia. Recovery parameters will also be investigated, such as postoperative nausea&#xD;
           and vomiting and the intensity of postoperative pain. To ensure homogeneity,&#xD;
           standardized analgesia will be administered in the two groups&#xD;
&#xD;
        -  Since prolactin is related to the neuroendocrine response to stress, blood will also be&#xD;
           sampled at predetermined timepoints during anesthesia, to detect potential differences&#xD;
           between the two groups&#xD;
&#xD;
        -  The clinical interest of this study lies in the fact that if a non-costly intervention&#xD;
           such as music listening during anesthesia can lead to reduced requirements of anesthetic&#xD;
           agents or to reduced need for postoperative analgesia, this theoretically can be&#xD;
           translated to a reduction in anesthetic cost. In addition, improvement in recovery&#xD;
           profile parameters could lead to a quicker discharge from the post-anesthesia care unit&#xD;
           with reduction in turnaround times and overall time optimization.&#xD;
    </textblock>
  </detailed_description>
  <overall_status>Recruiting</overall_status>
  <start_date>August 2014</start_date>
  <completion_date type="Anticipated">December 2024</completion_date>
  <primary_completion_date type="Anticipated">December 2024</primary_completion_date>
  <phase>N/A</phase>
  <study_type>Interventional</study_type>
  <has_expanded_access>No</has_expanded_access>
  <study_design_info>
    <allocation>Randomized</allocation>
    <intervention_model>Parallel Assignment</intervention_model>
    <primary_purpose>Supportive Care</primary_purpose>
    <masking>Triple (Participant, Investigator, Outcomes Assessor)</masking>
  </study_design_info>
  <primary_outcome>
    <measure>sevoflurane consumption during general anesthesia</measure>
    <time_frame>change of sevoflurane vaporizer weight from before induction to end of anesthesia, an average period of 2 hours</time_frame>
    <description>the sevoflurane vaporizer will be weighed before anesthetic induction and at the end of anesthesia and consequently sevoflurane consumption during anesthesia will be determined</description>
  </primary_outcome>
  <secondary_outcome>
    <measure>recall of postoperative events</measure>
    <time_frame>participants will be followed for the duration of stay in postanesthesia care unit, an average period of 1 hour</time_frame>
    <description>a questionnaire will be used to assess the specific outcome measure</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>recall of postoperative sounds</measure>
    <time_frame>participants will be followed for the duration of stay in postanesthesia care unit, an average period of 1 hour</time_frame>
    <description>a questionnaire will be used to assess the specific outcome measure</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>occurence of postoperative nausea or vomiting</measure>
    <time_frame>participants will be followed for the duration of stay in postanesthesia care unit, an average period of 1 hour</time_frame>
    <description>a questionnaire will be used to assess the specific outcome measure</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>intensity of postoperative pain</measure>
    <time_frame>participants will be followed for the duration of stay in postanesthesia care unit, an average period of 1 hour</time_frame>
    <description>a verbal rating scale will be used to assess the specific outcome measure</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>satisfaction from anesthesia</measure>
    <time_frame>participants will be followed for the duration of stay in postanesthesia care unit, an average period of 1 hour</time_frame>
    <description>a verbal rating scale will be used to assess the specific outcome measure</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>measurement of prolactin levels</measure>
    <time_frame>during the time that patients are anesthetized, an approximate period of 2 hours</time_frame>
  </secondary_outcome>
  <other_outcome>
    <measure>sleep diary</measure>
    <time_frame>first postoperative night</time_frame>
    <description>a questionnaire will be used to assess the specific outcome measure and participants will be queried in the first postoperative morning</description>
  </other_outcome>
  <other_outcome>
    <measure>sleep diary</measure>
    <time_frame>second postoperative night</time_frame>
    <description>a questionnaire will be used to assess the specific outcome measure and participants will be queried in the second postoperative morning</description>
  </other_outcome>
  <number_of_arms>2</number_of_arms>
  <enrollment type="Anticipated">60</enrollment>
  <condition>Anesthesia</condition>
  <condition>Stress</condition>
  <condition>Music</condition>
  <condition>Auditory Perception</condition>
  <arm_group>
    <arm_group_label>music listening during anesthesia</arm_group_label>
    <arm_group_type>Experimental</arm_group_type>
    <description>In patients allocated to the music listening group, audiotapes will be placed on patients' ears, playing soothing and relaxing music throughout anesthesia</description>
  </arm_group>
  <arm_group>
    <arm_group_label>absence of music listening during anesthesia</arm_group_label>
    <arm_group_type>Active Comparator</arm_group_type>
    <description>In patients allocated to absence of music listening group, audiotapes will be placed on the patients' ears, without however playing any music</description>
  </arm_group>
  <intervention>
    <intervention_type>Other</intervention_type>
    <intervention_name>music listening during anesthesia</intervention_name>
    <description>In patients allocated to the music listening group, audiotapes will be placed on patients' ears, playing soothing and relaxing music throughout anesthesia</description>
    <arm_group_label>music listening during anesthesia</arm_group_label>
  </intervention>
  <intervention>
    <intervention_type>Other</intervention_type>
    <intervention_name>absence of music listening during anesthesia</intervention_name>
    <description>In patients allocated to absence of music listening group, audiotapes will be placed on the patients' ears, without however playing any music</description>
    <arm_group_label>absence of music listening during anesthesia</arm_group_label>
  </intervention>
  <eligibility>
    <criteria>
      <textblock>
        Inclusion Criteria:&#xD;
&#xD;
          -  adult patients, American Society of Anesthesiologists (ASA) distribution I-III,&#xD;
             scheduled for elective hysterectomy for benign disease&#xD;
&#xD;
        Exclusion Criteria:&#xD;
&#xD;
          -  hearing impairment&#xD;
&#xD;
          -  psychiatric disease (depression, dementia)&#xD;
&#xD;
          -  mental disability&#xD;
&#xD;
          -  concurrent treatment with medication known to affect anesthetic requirement, such as&#xD;
             benzodiazepines, anticonvulsants, opioids, psychotropic drugs or alcohol&#xD;
      </textblock>
    </criteria>
    <gender>Female</gender>
    <minimum_age>18 Years</minimum_age>
    <maximum_age>70 Years</maximum_age>
    <healthy_volunteers>No</healthy_volunteers>
  </eligibility>
  <overall_official>
    <last_name>Kassiani Theodoraki, PhD, DEAA</last_name>
    <role>Principal Investigator</role>
    <affiliation>Aretaieion University Hospital</affiliation>
  </overall_official>
  <overall_contact>
    <last_name>Kassiani Theodoraki, PhD, DEAA</last_name>
    <phone>#306974634162</phone>
    <email>ktheodoraki@hotmail.com</email>
  </overall_contact>
  <location>
    <facility>
      <name>Aretaieion University Hospital</name>
      <address>
        <city>Athens</city>
        <zip>115 28</zip>
        <country>Greece</country>
      </address>
    </facility>
    <status>Recruiting</status>
    <contact>
      <last_name>Kassiani Theodoraki, PhD, DEAA</last_name>
      <phone>#306974634162</phone>
      <email>ktheodoraki@hotmail.com</email>
    </contact>
    <investigator>
      <last_name>Sofia Vasiloglou, MD</last_name>
      <role>Principal Investigator</role>
    </investigator>
  </location>
  <location_countries>
    <country>Greece</country>
  </location_countries>
  <reference>
    <citation>Bringman H, Giesecke K, Thorne A, Bringman S. Relaxing music as pre-medication before surgery: a randomised controlled trial. Acta Anaesthesiol Scand. 2009 Jul;53(6):759-64. doi: 10.1111/j.1399-6576.2009.01969.x. Epub 2009 Apr 14.</citation>
    <PMID>19388893</PMID>
  </reference>
  <reference>
    <citation>Wang SM, Kulkarni L, Dolev J, Kain ZN. Music and preoperative anxiety: a randomized, controlled study. Anesth Analg. 2002 Jun;94(6):1489-94, table of contents. doi: 10.1097/00000539-200206000-00021.</citation>
    <PMID>12032013</PMID>
  </reference>
  <reference>
    <citation>Ganidagli S, Cengiz M, Yanik M, Becerik C, Unal B. The effect of music on preoperative sedation and the bispectral index. Anesth Analg. 2005 Jul;101(1):103-6, table of contents. doi: 10.1213/01.ANE.0000150606.78987.3B.</citation>
    <PMID>15976214</PMID>
  </reference>
  <reference>
    <citation>Zhang XW, Fan Y, Manyande A, Tian YK, Yin P. Effects of music on target-controlled infusion of propofol requirements during combined spinal-epidural anaesthesia. Anaesthesia. 2005 Oct;60(10):990-4. doi: 10.1111/j.1365-2044.2005.04299.x.</citation>
    <PMID>16179044</PMID>
  </reference>
  <reference>
    <citation>Block RI, Ghoneim MM, Sum Ping ST, Ali MA. Human learning during general anaesthesia and surgery. Br J Anaesth. 1991 Feb;66(2):170-8. doi: 10.1093/bja/66.2.170.</citation>
    <PMID>1817616</PMID>
  </reference>
  <reference>
    <citation>Evans C, Richardson PH. Improved recovery and reduced postoperative stay after therapeutic suggestions during general anaesthesia. Lancet. 1988 Aug 27;2(8609):491-3. doi: 10.1016/s0140-6736(88)90131-6.</citation>
    <PMID>2900410</PMID>
  </reference>
  <reference>
    <citation>Lindh A, Carlstrom K, Eklund J, Wilking N. Serum steroids and prolactin during and after major surgical trauma. Acta Anaesthesiol Scand. 1992 Feb;36(2):119-24. doi: 10.1111/j.1399-6576.1992.tb03436.x.</citation>
    <PMID>1532279</PMID>
  </reference>
  <verification_date>February 2023</verification_date>
  <study_first_submitted>August 17, 2014</study_first_submitted>
  <study_first_submitted_qc>August 19, 2014</study_first_submitted_qc>
  <study_first_posted type="Estimate">August 20, 2014</study_first_posted>
  <last_update_submitted>February 5, 2023</last_update_submitted>
  <last_update_submitted_qc>February 5, 2023</last_update_submitted_qc>
  <last_update_posted type="Actual">February 8, 2023</last_update_posted>
  <responsible_party>
    <responsible_party_type>Principal Investigator</responsible_party_type>
    <investigator_affiliation>Aretaieion University Hospital</investigator_affiliation>
    <investigator_full_name>Dr Kassiani Theodoraki</investigator_full_name>
    <investigator_title>Associate Professor in Anaesthesiology</investigator_title>
  </responsible_party>
  <intervention_browse>
    <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
    <mesh_term>Anesthetics</mesh_term>
  </intervention_browse>
  <!-- Results have not yet been posted for this study                                          -->
</clinical_study>


download date: ClinicalTrials.gov processed this data on September 20, 2023
link text: Link to the current ClinicalTrials.gov record.
url: https://clinicaltrials.gov/ct2/show/NCT02220452
org study id: Sofia-Music
nct id: NCT02220452
lead sponsor: 
has dmc: Yes
-  The perioperative period can be a significant source of psychological burden, anxiety
           and fear for patients

        -  Both pharmacological and non-pharmacological methods have been proposed in order to
           alleviate perioperative stress

        -  Music is one of the non-pharmacological methods which have been used in this context,
           with favorable effects both preoperatively and postoperatively

        -  The attenuation of perioperative stress through music listening is probably due to the
           activation of emotional and cognitive processes that evoke feeling of pleasure and can
           distract patients' attention from fear and unpleasant thoughts related to the surgical
           procedure

        -  Little information is available regarding the effect of intraoperative music listening
           on anesthetized, unconscious patients

        -  There is a notion that general anesthesia does not completely abolish auditory
           perception and that some processing of intraoperative events can occur in unconscious
           patients, even in the absence of postoperative recall

        -  The investigators hypothesis is that intraoperative music listening can decrease
           anesthetic requirements and reduce sevoflurane consumption in female patients subjected
           to abdominal hysterectomy for benign disease.
-  The perioperative period can be a significant source of psychological burden, anxiety
           and fear for patients

        -  Both pharmacological and non-pharmacological methods have been proposed in order to
           alleviate perioperative stress

        -  Music is one of the non-pharmacological methods which have been used in this context,
           with favorable effects both preoperatively and postoperatively

        -  Listening to music during the preoperative period has proved useful as an adjunct to
           premedication and can even be used instead of premedication. Additionally, listening to
           music postoperatively can also be useful, since it has been related to a more favorable
           recovery profile and possible attenuation of postoperative pain. In this context, music
           has also been used in Intensive Care Units, with measurable effects on anxiety scales
           and hemodynamic parameters. There are also studies investigating the use of music during
           operations under regional anesthesia, which have shown that music listening
           substantially decreases the need for anxiolytic administration throughout the operation

        -  The attenuation of perioperative stress through music listening is probably due to the
           activation of emotional and cognitive processes that evoke feelings of pleasure and can
           distract patients' attention from fear and unpleasant thoughts related to the surgical
           procedure

        -  Although the favorable effects of music listening during regional anesthesia for the
           attenuation of intraoperative stress in conscious patients are more or less expected and
           easily interpreted, less is known regarding the effect of intraoperative music listening
           on anesthetized, unconscious patients

        -  Generally, there is a notion that general anesthesia does not completely abolish
           auditory perception and that some processing of intraoperative events can occur in
           unconscious patients, even in the absence of postoperative recall

        -  The preservation of some form of auditory processing during general anesthesia is not
           necessarily undesirable and can be used to the patient's benefit, since it has been
           shown that subjecting patients to therapeutic suggestions during general anesthesia can
           improve recovery parameters or decrease hospital stay

        -  The investigators hypothesis is that intraoperative music listening can decrease
           anesthetic requirements. Therefore, the investigators will investigate sevoflurane
           consumption necessary to achieve a depth of anesthesia corresponding to bispectral index
           values of 45-55. Female patients subjected to abdominal hysterectomy for benign disease
           will be randomized to one of two groups: in the first group, audiotapes playing relaxing
           soothing orchestral music will be placed on the patients' ears after induction of
           general anesthesia while in the other group the same set of audiotapes will be used
           without however playing any music

        -  Sevoflurane consumption will be estimated by weighing the sevoflurane vaporizer in a
           high-precision scale before induction and after completion of the surgical procedure.
           Patients will also be queried regarding recall of any sounds or intraoperative events,
           dreaming while anesthetized and they will be asked to rate their satisfaction from
           anesthesia. Recovery parameters will also be investigated, such as postoperative nausea
           and vomiting and the intensity of postoperative pain. To ensure homogeneity,
           standardized analgesia will be administered in the two groups

        -  Since prolactin is related to the neuroendocrine response to stress, blood will also be
           sampled at predetermined timepoints during anesthesia, to detect potential differences
           between the two groups

        -  The clinical interest of this study lies in the fact that if a non-costly intervention
           such as music listening during anesthesia can lead to reduced requirements of anesthetic
           agents or to reduced need for postoperative analgesia, this theoretically can be
           translated to a reduction in anesthetic cost. In addition, improvement in recovery
           profile parameters could lead to a quicker discharge from the post-anesthesia care unit
           with reduction in turnaround times and overall time optimization.
allocation: Randomized
intervention model: Parallel Assignment
primary purpose: Supportive Care
masking: Triple (Participant, Investigator, Outcomes Assessor)
measure: sevoflurane consumption during general anesthesia
time frame: change of sevoflurane vaporizer weight from before induction to end of anesthesia, an average period of 2 hours
description: the sevoflurane vaporizer will be weighed before anesthetic induction and at the end of anesthesia and consequently sevoflurane consumption during anesthesia will be determined
measure: recall of postoperative events
time frame: participants will be followed for the duration of stay in postanesthesia care unit, an average period of 1 hour
description: a questionnaire will be used to assess the specific outcome measure
measure: recall of postoperative sounds
time frame: participants will be followed for the duration of stay in postanesthesia care unit, an average period of 1 hour
description: a questionnaire will be used to assess the specific outcome measure
measure: occurence of postoperative nausea or vomiting
time frame: participants will be followed for the duration of stay in postanesthesia care unit, an average period of 1 hour
description: a questionnaire will be used to assess the specific outcome measure
measure: intensity of postoperative pain
time frame: participants will be followed for the duration of stay in postanesthesia care unit, an average period of 1 hour
description: a verbal rating scale will be used to assess the specific outcome measure
measure: satisfaction from anesthesia
time frame: participants will be followed for the duration of stay in postanesthesia care unit, an average period of 1 hour
description: a verbal rating scale will be used to assess the specific outcome measure
measure: measurement of prolactin levels
time frame: during the time that patients are anesthetized, an approximate period of 2 hours
measure: sleep diary
time frame: first postoperative night
description: a questionnaire will be used to assess the specific outcome measure and participants will be queried in the first postoperative morning
measure: sleep diary
time frame: second postoperative night
description: a questionnaire will be used to assess the specific outcome measure and participants will be queried in the second postoperative morning
arm group label: music listening during anesthesia
arm group type: Experimental
description: In patients allocated to the music listening group, audiotapes will be placed on patients' ears, playing soothing and relaxing music throughout anesthesia
arm group label: absence of music listening during anesthesia
arm group type: Active Comparator
description: In patients allocated to absence of music listening group, audiotapes will be placed on the patients' ears, without however playing any music
intervention type: Other
intervention name: music listening during anesthesia
description: In patients allocated to the music listening group, audiotapes will be placed on patients' ears, playing soothing and relaxing music throughout anesthesia
arm group label: music listening during anesthesia
intervention type: Other
intervention name: absence of music listening during anesthesia
description: In patients allocated to absence of music listening group, audiotapes will be placed on the patients' ears, without however playing any music
arm group label: absence of music listening during anesthesia
criteria: 
gender: Female
minimum age: 18 Years
maximum age: 70 Years
healthy volunteers: No
last name: Kassiani Theodoraki, PhD, DEAA
role: Principal Investigator
affiliation: Aretaieion University Hospital
last name: Kassiani Theodoraki, PhD, DEAA
phone: #306974634162
email: ktheodoraki@hotmail.com
facility: 
status: Recruiting
contact: 
investigator: 
country: Greece
citation: Bringman H, Giesecke K, Thorne A, Bringman S. Relaxing music as pre-medication before surgery: a randomised controlled trial. Acta Anaesthesiol Scand. 2009 Jul;53(6):759-64. doi: 10.1111/j.1399-6576.2009.01969.x. Epub 2009 Apr 14.
PMID: 19388893
citation: Wang SM, Kulkarni L, Dolev J, Kain ZN. Music and preoperative anxiety: a randomized, controlled study. Anesth Analg. 2002 Jun;94(6):1489-94, table of contents. doi: 10.1097/00000539-200206000-00021.
PMID: 12032013
citation: Ganidagli S, Cengiz M, Yanik M, Becerik C, Unal B. The effect of music on preoperative sedation and the bispectral index. Anesth Analg. 2005 Jul;101(1):103-6, table of contents. doi: 10.1213/01.ANE.0000150606.78987.3B.
PMID: 15976214
citation: Zhang XW, Fan Y, Manyande A, Tian YK, Yin P. Effects of music on target-controlled infusion of propofol requirements during combined spinal-epidural anaesthesia. Anaesthesia. 2005 Oct;60(10):990-4. doi: 10.1111/j.1365-2044.2005.04299.x.
PMID: 16179044
citation: Block RI, Ghoneim MM, Sum Ping ST, Ali MA. Human learning during general anaesthesia and surgery. Br J Anaesth. 1991 Feb;66(2):170-8. doi: 10.1093/bja/66.2.170.
PMID: 1817616
citation: Evans C, Richardson PH. Improved recovery and reduced postoperative stay after therapeutic suggestions during general anaesthesia. Lancet. 1988 Aug 27;2(8609):491-3. doi: 10.1016/s0140-6736(88)90131-6.
PMID: 2900410
citation: Lindh A, Carlstrom K, Eklund J, Wilking N. Serum steroids and prolactin during and after major surgical trauma. Acta Anaesthesiol Scand. 1992 Feb;36(2):119-24. doi: 10.1111/j.1399-6576.1992.tb03436.x.
PMID: 1532279
responsible party type: Principal Investigator
investigator affiliation: Aretaieion University Hospital
investigator full name: Dr Kassiani Theodoraki
investigator title: Associate Professor in Anaesthesiology
mesh term: Anesthetics