Evaluating music medicine with IV ketamine for pediatric forearm fracture reduction in a tertiary emergency setting

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Purpose: This study aimed to assess whether adjunctive music medicine during intravenous (IV) ketamine sedation for pediatric forearm fracture reduction can reduce the total ketamine doses required compared to ketamine alone while enhancing patient comfort.

Methods: A retrospective study was conducted on pediatric patients (1–18 years) with isolated forearm fractures who received procedural sedation with IV ketamine. The control group (n = 55) received only IV ketamine, while the intervention group (n = 90) received IV ketamine and classical music therapy (Johannes Brahms’s “Wiegenlied” Op. 49). Data collected included ketamine dosing, number of additional doses, and procedure duration. Statistical analyses included chi-square test and Wilcoxon–Mann–Whitney test.

Results: No significant differences were observed in ketamine dosing, additional doses, or procedural duration. Feedback from pediatric emergency physicians and orthopedic residents indicated that music intervention fostered a calmer environment, helping to manage patient anxiety and improving the overall experience.

Conclusion: While no significant ketamine dosing changes were observed, music medicine contributed positively. Integrating music therapy into pediatric sedation protocols can enhance emotional and physical well-being. Future research is needed to further explore and integrate music medicine into routine pediatric care as part of a holistic approach to child-centered healthcare.