Evaluation of a web app-based music intervention on pain during wound closure in the emergency department: The EMERGENCE randomized controlled trial

Abstract

Background: Wound suturing in emergency departments is a potentially stressful and painful experience for patients. Web app-based music intervention is known as an effective adjuvant treatment for the management of physical pain and anxiety in various medical fields. Only two studies have assessed the effectiveness of music listening on pain and anxiety during wound suturing. However, they found conflicting results and did not evaluate the point of view of healthcare professionals. This article details a prospective, randomized, open-label, multicenter study to evaluate the effect of a web app-based music intervention on pain and anxiety during sutures in the emergency room.

Methods: This was an interventional prospective, randomized, open-label, multi-center trial. The primary outcome is the comparison of maximal pain Visual Analogue Scale (VAS) with or without web app-based music intervention (application Music Care®) during the wound closure.

Results: Between June 2022 and February 2023, 170 patients were included. There was no significant difference between the two groups regarding the pain during suturing in this population. The mean pain VAS was 2.1 ± 2.7 cm (cm) in the music group versus 2.6 ± 2.6 cm in the control group (p= 0.197). However, the music group showed significantly lower values of respiratory rate (p = 0.002) and anxiety score (p = 0.042). Finally, satisfaction scores were significantly improved in the music group for the patient (p= 0.0002) and the physician (p < 0.0001).

Conclusion: In this population, which demonstrated an average light maximal pain intensity, we showed no significant difference regarding the pain intensity during wound suturing. However, it does suggest that web app-based music intervention could reduce peri-procedural anxiety, but the robustness of this finding is not demonstrated yet. Nevertheless, it highlights the need for additional studies on this subject to identify its role in the optimal management of procedural pain and the improvement of the patient and practitioner experience.

Trial registration: ClinicalTrials.gov n° NCT05388591 (https://clinicaltrials.gov/study/NCT05388591?term=NCT05388591&rank=1).

Keywords: Anxiety; Emergency; Music care; Musicotherapy; Pain; Wound closure.