Effects of Perioperative Music Interventions on Emotional Outcomes in Children and Adolescents: A Systematic Review and Meta-Analysis Integrating Developmental Psychology and Music Education Perspectives

Yuchen Wen; Jinying Han; Jiayin Gao; Jiaqi Lou; Ziyi Xiang

doi:10.1002/pan.70239

Effects of Perioperative Music Interventions on Emotional Outcomes in Children and Adolescents: A Systematic Review and Meta-Analysis Integrating Developmental Psychology and Music Education Perspectives

Paediatr Anaesth. 2026 Jun 13. doi: 10.1002/pan.70239. Online ahead of print.

Authors

Yuchen Wen¹, Jinying Han², Jiayin Gao³, Jiaqi Lou⁴, Ziyi Xiang⁵

Affiliations

¹ Department of Education, Graduate School, Anyang University, Anyang-si, Gyeonggi-do, Republic of Korea.
² College of Music and Dance, Guangzhou University, Guangzhou, Guangdong Province, People's Republic of China.
³ College of Music and Dance, Northeast Normal University, Changchun, Jilin Province, People's Republic of China.
⁴ Burn Department, Ningbo No. 2 Hospital, Ningbo, Zhejiang Province, People's Republic of China.
⁵ Institute of Pathology, Faculty of Medicine, University of Bonn, Bonn, Germany.

PMID: 42287097
DOI: 10.1002/pan.70239

Abstract

Objective: To evaluate the effects of perioperative music interventions on emotional outcomes (preoperative anxiety, postoperative fear, emergence delirium) and related physiological parameters in children and adolescents undergoing surgery, and to examine potential effect modifiers.

Methods: Nine databases were searched from inception to February 2026. Randomized controlled trials comparing music versus no-music control in pediatric surgical patients (≤ 18 years) were included. Risk of bias was assessed with RoB 2.0. Random-effects meta-analyzes were performed for preoperative anxiety, postoperative pain, heart rate, and blood pressure. Subgroup analyzes were conducted for age, music selection method, intervention timing, and surgery type. The certainty of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework.

Results: Seventeen RCTs (1871 children) were included. Music significantly reduced preoperative anxiety (SMD = -2.03; 95% CI -3.19 to -0.86; I² = 97%), postoperative pain (SMD = -0.64; 95% CI -1.01 to -0.27; I² = 62%), heart rate (MD = -12.92 bpm; 95% CI -19.07 to -6.77; I² = 88%), and mean arterial pressure (MD = -8.41 mmHg; 95% CI -10.07 to -6.76; I² = 66%). Effects on systolic blood pressure were not significant. Anxiolytic effects were significant in both children (≤ 12 years) and adolescents (≥ 13 years) with no subgroup difference. Self-selected and pre-selected music were both effective. Sensitivity analyzes confirmed robustness. GRADE assessment indicated very low to low certainty of evidence for all outcomes, primarily due to high heterogeneity, risk of bias, and imprecision.

Conclusions: Perioperative music was associated with reduced anxiety and pain, but evidence certainty was very low to low. Pending stronger evidence, music may be considered a low-risk adjunct to standard care.

Keywords: adolescent; anxiety; child; emotional regulation; music therapy; perioperative care.

Publication types

Review