Furthermore, we would like to suggest cost-effectiveness studies comparing live music therapy
with recorded music. Apart from the possibly different effects of live music therapy versus
recorded music, the timing of the intervention and the effect of self-selected versus therapist
selected music deserve attention[3].
This review shows that few RCTs have been performed on effects of music in pediatric
patients undergoing surgery, but that music interventions are worthwhile to further investigate
for its clinical usefulness. State-of-the-art RCTs evaluating music interventions are difficult to
perform in particular due to the inherent performance bias and detection bias. The only way to
perform a double-blinded study is to offer recorded music through headphones to patients
under general anesthesia which would preclude evaluation of the potential beneficial effect of
music pre- and post surgery[42]. Furthermore it is impossible to blind patients for live music
therapy by a music therapist.
In conclusion, this review shows that music as a non-pharmacological adjuvant intervention
has potential in reducing pain, anxiety and distress in children undergoing surgery. Its noninvasive
nature is an advantage.