以心率變異追蹤音樂對麻醉患者減壓的效果：來自臨床研究的數據
摘要
本研究的目的為探討音樂對麻醉手術期間減少壓力的影響，利用心率變異(HRV) 作為壓力相關生理變化的非侵入式測量。HRV與自律神經系統的交感和副交感神經活動有關。本研究中的 HRV 數據來自 10 名在全身麻醉 (n=5) 或脊髓麻醉 (n=5) 下接受腹部 (n=5) 或骨科骨折手術 (n=5) 的患者。在麻醉期間為病患播放放鬆的音樂。標準化的心率變異高頻（HF）百分比是依據高頻和低頻（LF）總和計算。與播放音樂之前相比，在播放音樂期間，音樂誘發出較多平均標準化高頻，且達到統計學上的顯著意義（P=0.035）。與播放音樂前的平均標準化高頻相比，在整個麻醉期間測量到的平均標準化高頻略有增加（P = 0.063）。因此，數據清楚的顯示出，手術期間播放的音樂誘發了平均標準化高頻數據的增加，從而活化了副交感神經系統並使交感神經系統降低活絡，引致放鬆的狀態。
關鍵字：心率變異，音樂對壓力的影響，麻醉患者
参考
References
Selye H. Journal of Human Stress. 1975: 1(2): 37–44.
Lazarus RS, Folkman S. In: “Stress, appraisal, and coping”. New York: Springer, 1984.
Liu MY, Li N, Li WA, Khan H. Association between psychosocial stress and hypertension: a systematic review and meta-analysis. Neurol Res. 2017; 39(6): 573-580.
Nakamura K. Central Circuit Mechanism for Psychological Stress-Induced Hyperthermia. Brain Nerve. 2015; 67(10): 1205-1214.
Suess WM, Alexander AB, Smith DD, Sweeney HW, Marion RJ. The effects of psychological stress on respiration: a preliminary study of anxiety and hyperventilation. Psychophysiology. 1980; 17(6):535-540.
Jackson CA, Sudlow CLM, Mishra GD. Psychological Distress and Risk of Myocardial Infarction and Stroke in the 45 and Up Study. Circ Cardiovasc Qual Outcomes. 2018; 11(9): e004500.
Vinkers CH, Penning R, Hellhammer J, et al. The effect of stress on core and peripheral body temperature in humans. Stress. 2013; 16(5): 520-30.
Zilberlicht A, Boms-Yonai N, Haya N, et al. Somatic and psychological triggers for bladder storage symptoms among men and women. Int Urogynecol J. 2020; 31(5) :933-937.
Yau YH, Potenza MN. Stress and eating behaviors. Minerva Endocrinol. 2013; 38(3): 255-67.
Konturek PC, Brzozowski T, Konturek SJ. Stress and the gut: pathophysiology, clinical consequences, diagnostic approach and treatment options. J Physiol Pharmacol. 2011; 62(6): 591-599.
Wong DL, Tai TC, Wong-Faull DC, et al. Epinephrine: a short- and long-term regulator of stress and development of illness: a potential new role for epinephrine in stress. Cell Mol Neurobiol. 2012; 32(5) :737-748.
Leonard BE. Stress, norepinephrine and depression. J Psychiatry Neurosci. 2001; 26 :S11-16.
Pulopulos MM, Baeken C, De Raedt R. Cortisol response to stress: The role of expectancy and anticipatory stress regulation. HormBehav. 2020; 117: 104587.
LeDoux J. Fear and the brain: Where have we been, and where are we going? Biol Psychiatry. 1998; 44 (12): 1229 –1238.
Mackersie CL, Kearney L. Autonomic Nervous System Responses to Hearing-Related Demand and Evaluative Threat. Am J Audiol. 2017; 26(3S): 373-377.
Kemper KJ, Danhauer SC. Music as therapy. South Med J. 2005; 98(3): 282-288.
de Witte M, Spruit A, van Hooren S, Moonen X, Stams GJ. Effects of music interventions on stress-related outcomes: a systematic review and two meta-analyses. Health Psychol Rev. 2020; 14(2): 294-324.
Lai HL, Li YM. The effect of music on biochemical markers and self-perceived stress among first-line nurses: a randomized controlled crossover trial. J Adv Nurs. 2011; 67(11): 2414-2424.
Peretti PO, Zweifel J. Affect of musical preference on anxiety as determined by physiological skin responses. Acta Psychiatr Belg. 1983; 83(5): 437-442.
Ko YL, Lin PC. The effect of using a relaxation tape on pulse, respiration, blood pressure and anxiety levels of surgical patients. J Clin Nurs. 2012; 21(5-6): 689-697.
Khalfa S, Bella SD, Roy M, Peretz I, Lupien SJ. Effects of relaxing music on salivary cortisol level after psychological stress. Ann N Y Acad Sci. 2003; 999:374-376.
Thoma MV, La Marca R, Brönnimann R, et al. The effect of music on the human stress response. PLoS One. 2013; 8(8): e70156.
Bradt J, Dileo C, Magill L, Teague A. Music interventions for improving psychological and physical outcomes in cancer patients. Cochrane Database Syst Rev. 2016; (8): CD006911.
Umbrello M, Sorrenti T, Mistraletti G, et al. Music therapy reduces stress and anxiety in critically ill patients: a systematic review of randomized clinical trials. Minerva Anestesiol Actions. 2019; 85(8) :886-898.
Nilsson U, Rawal N, Uneståhl LE, Zetterberg C, Unosson M. Improved recovery after music and therapeutic suggestions during general anaesthesia: a double-blind randomised controlled trial. Acta Anaesthesiol Scand. 2001; 45(7): 812-817.
Nilsson U, Unosson M, Rawal N. Stress reduction and analgesia in patients exposed to calming music postoperatively: a randomized controlled trial. Eur J Anaesthesiol. 2005; 22(2): 96-102.
Matsota P, Christodoulopoulou T, Smyrnioti ME, et al. Music's use for anesthesia and analgesia. Altern Complement Med. 2013; 19(4): 298-307.
Migneault B, Girard F, Albert C, et al. The effect of music on the neurohormonal stress response to surgery under general anesthesia. Anesth Analg. 2004; 98(2): 527–532.
Sztajzel J. Heart rate variability: a noninvasive electrocardiographic method to measure the autonomic nervous system. Swiss Med Wkly. 2004; 134(35-36): 514-522.
Delaney JP, Brodie DA. Effects of short-term psychological stress on the time and frequency domains of heart-rate variability. Percept Mot Skills. 2000; 91(2):515-524.
Hernando D, Roca S, Sancho J, et al. Validation of the Apple Watch for Heart Rate Variability Measurements during Relax and Mental Stress in Healthy Subjects. Sensors (Basel). 2018; 18(8): 2619.
Brandes V. Music as Medicine: incorporating scalable music-based interventions into standard medical practice In: “Music that works”. Hass and Brandes (Eds). SprongWienNewYork, 2009.
Chuang CY, Han WR, Li PC, Song MY, Young ST. Effect of long-term music therapy intervention on autonomic function in anthracycline-treated breast cancer patients. Integr Cancer Ther. 2011; 10(4): 312-316.
Akselrod S, Gordon D, Ubel FA, Power spectrum analysis of heart rate fluctuation: a quantitative probe of beat to beat cardiovascular control. Science. 213: 220–222, 1981.
Peng Z, Fangfang S, Anqiong Z, Fang W, Guohui L. Music Therapy on Heart Rate Variability. 3rd International conference on Biomedical Engineering and Informatics, 2010.
a Mazzeo AT, Monaca EL, Leo RD, Vita G, Santamaria LB. Heart rate variability: a diagnostic and prognostic tool in anesthesia and intensive care. Acta Anaesthesiol Scand. 2011; 55(7): 797-811.
Malik M. Heart rate variability: standards of measurement, physiological interpretation and clinical use. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Circulation. 1996; 93(5): 1043-1065.
Verkuil B, Brosschot, JF, Tollenaar MS, Lane RD, Thayer JF. Prolonged Non-metabolic Heart Rate Variability Reduction as a Physiological Marker of Psychological Stress in Daily Life. Annals of Behavioral Medicine. 2016; 50(5): 704–714.
Kim HC, Cheon EJ, Bai DS, Lee YH, Koo BH. Stress and Heart Rate Variability: A Meta-Analysis and Review of the Literature. Psychiatry Investig. 2018; 15(3): 235–245.
Bailón R, Enk R, Koelsch S, et al. A method for continuously assessing the autonomic response to music-induced emotions through HRV analysis. Medical & Biological Engineering & Computing. 2010; 48(5): 423–433.
Wang Y, Dong Y, Li Y. Perioperative Psychological and Music Interventions in Elderly Patients Undergoing Spinal Anesthesia: Effect on Anxiety, Heart Rate Variability, and Postoperative Pain. Anesthesiology Yonsei Medical Journal 2014; 55(4): 1101-1105.
Miyata K, Odanaka H, Nitta Y, et al. Music before Dental Surgery Suppresses Sympathetic Activity Derived from Preoperative Anxiety: A Randomized Controlled Trial. JDR Clin Trans Res. 2016; 1(2): 153-162.
Cotoia A, Dibello F, Moscatelli F, et al. Effects of Tibetan Music on Neuroendocrine and Autonomic Functions in Patients Waiting for Surgery: A Randomized, Controlled Study Anesthesiol Res Pract. 2018; 2018:9683780
