Available online 24 March 2024

Author links open overlay panel, , , , , , Highlights•

Our study is a randomized, controlled clinical trial presents the largest cohort, contributing significantly to the literature on pain and anxiety during thyroid biopsy.

•

Our study shows music consistently reduces pain and anxiety during thyroid FNAB.

•

Implementing music as a cost-effective measure during thyroid biopsy is recommended.

Clinical Relevance: Our study investigates the influence of music on patient experience during thyroid biopsies, indicating that music can significantly reduce anxiety and enhance overall satisfaction with the procedure.

ABSTRACTIntroduction

High-resolution ultrasonography devices have led to the increased detection of thyroid nodules and the need for fine-needle aspiration biopsy (FNAB). However, FNAB is an invasive procedure that can cause discomfort and pain. Music therapy has been used for centuries to alleviate pain, and our clinical trial was conducted to investigate its impact on pain scores during thyroid FNAB.

Materials and methods

We conducted a randomized, controlled clinical trial, including adult patients undergoing thyroid FNAB. We evaluated the non-pharmacological intervention of listening to music before and during thyroid FNAB. We used a slow, non-lyrical, flowing melody with a tempo of 60 to 80 beats per minute as a therapeutic intervention for managing anxiety and pain. It had low tones, minimal percussion, and a volume of around 60 decibels. The Beck Anxiety Inventory and Visual Pain Scale were used.

Results

The study included 529 patients assigned to either the music group (n=258, 48.7%) or the control group (n=271, 51.2%). The patients were categorized into subgroups based on either a single nodule (73.63%) or multiple nodules (24.18%). When all patients or single nodule and multiple data are examined separately, the intervention group showed statistically significantly lower pain scores than the control group.

Conclusion

Our study is among the first on this topic and the largest in the available literature to demonstrate that listening to music during FNAB significantly reduces pain and anxiety. Music therapy is an effective, safe, and noninvasive intervention that can improve patient care and reduce distress and pain.

Section snippetsINTRODUCTION

In recent years, there has been an increase in the detection of thyroid nodules due to the availability of high-resolution ultrasonography devices. While palpation can identify thyroid nodules in about 4-8% of the general population, ultrasound has raised this detection rate to 19-67% (1, 2, 3). As a result, it has become crucial to utilize fine-needle aspiration biopsy (FNAB) to evaluate thyroid nodules. FNAB is typically an outpatient procedure without sedation or anesthesia, making it safe

Inclusion and exclusion criteria for participants

The study included patients of both sexes undergoing elective thyroid FNAB, 18 years old or older.

Exclusion criteria1)

Unwilling to participate

2)

Hearing or mental impairment

3)

Psychiatric disorders/anti-psychotic drug use for any reason

4)

Substance abuse

Patients who met the study criteria and agreed to participate were given details about the study and signed a free informed consent form.

Study design

The study described is a single-centered, 1:1 allocated, randomized, controlled clinical trial conducted at the Endocrinology and

RESULTS

The study included 562 patients from January 2022 to May 2022. After randomization, 12 patients were excluded from the study because they did not accept informed consent. A total of 550 patients, 450 women and 100 men, were included in the study (Figure 1). These patients were assigned to either the music group (n=265, 48.2%) or the control group (n=285, 51.8%). The average age of the patients was 43.60 ± 10.610 [SD], ranging from 19 to 77 years (Table 1). Seven people in the intervention group

DISCUSSION

US-guided FNAB for thyroid nodules is a procedure that is considered safe, reliable, and cost-effective. However, some patients may experience pain and discomfort during the procedure due to the necessary skin and subcutaneous tissue penetration. Measuring pain is challenging as it relies on subjective assessment, and pain scales are commonly used to quantify the perceived intensity of pain. In our study, 57% of patients experienced moderate to severe pain, while 43% experienced no pain or mild

Uncited reference

4, 5.

REFERENCES (43)M.C. FratesManagement of thyroid nodules detected at US: Society of Radiologists in Ultrasound consensus conference statement

Radiology

(2005)

F. PaciniEuropean consensus for the management of patients with differentiated thyroid carcinoma of the follicular epithelium

Eur J Endocrinol

(2006)

D.S. CooperRevised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer

Thyroid

(2009)

U. NilssonThe anxiety- and pain-reducing effects of music interventions: a systematic review

AORN J

(2008)

A. GursoyThe analgesic efficacy of lidocaine/prilocaine (EMLA) cream during fine-needle aspiration biopsy of thyroid nodules

Clin Endocrinol (Oxf)

(2007 May)

The Joanna Briggs Institute Best Practice Information Sheet: music as an intervention in hospitals

Nurs Health Sci

(2011)

É.V. de AndradeEffect of listening to music on anxiety, pain, and cardiorespiratory parameters in cardiac surgery: study protocol for a randomized clinical trial

Trials

(2022 Apr 11)

G. RussEuropean Thyroid Association Guidelines for Ultrasound Malignancy Risk Stratification of Thyroid Nodules in Adults: The EU-TIRADS

Eur Thyroid J

(2017 Sep)

Beck, A. T., et al. (1988). Beck Anxiety Inventory [Database record]. APA PsycTests....M. CouperEvaluating the effectiveness of visual analog scales: A web experiment

Soc Sci Comput Rev

(2006)

D.W. KimUltrasonography-guided fine-needle aspiration cytology for thyroid nodules: an emphasis on one-sampling and biopsy techniques

Diagn Cytopathol

(2012)

View full text

© 2024 Published by Elsevier Inc. on behalf of the AACE.