1. INTRODUCTION
The cesarean section (C-section) rate in Turkey is
51.2%1, well above the rate of 5-15% of deliveries
suggested by the World Health Organization2. Births
are a source of stress for women, and a C-section causes an increase in
stress and anxiety for patients due to the fact that it is a major
abdominal surgery and critical situations may
occur3,4. High preoperative anxiety levels have been
reported in many women who are prepared for a
C-section5. Since it is not possible for the father or
other supporter to attend a patient’s C-section in Turkey, it can be
expected that patients have higher anxiety levels due to isolation.
There may also be potential negative side effects of premedication to
deal with anxiety6. Due to the increased prevalence of
C-sections, choosing non-pharmacological, non-invasive interventions for
anxiety treatment would be advantageous for both the expectant mother
and the baby.
Compared to general anesthesia, spinal anesthesia is a more preferred
form of anesthesia because it reduces intraoperative blood loss and
causes less nausea and vomiting, less respiratory depression, and less
postoperative pain7. However, sounds originating from
the surgical environment (white noise), such as the sounds of surgical
instruments, are known to increase patient anxiety8.
This situation occurs especially more frequently for pregnant women.
Music intervention as a stress management technique is an easy-to-apply,
cost-effective, non-pharmacological, and non-invasive method that has
been used for centuries9. While it positively supports
the psychological well-being of the person, it may also improve physical
parameters such as blood pressure, heart rate, and
respiration10. It has been shown in some studies that
listening to music increases the threshold of pain during an operation
by distracting the patient’s attention11. Music is
effective in reducing pain by stimulating the autonomic nervous system
and releasing endorphins and natural opioids from the pituitary
gland12,13. It causes a decrease in blood pressure and
heart rate by reducing catecholamines14. These effects
generally vary depending on the tempo of the music; slow-paced and
intermittent music has been associated with a decrease in heart rate,
respiratory rate, and blood pressure, while fast-paced music has been
associated with an increase in these parameters6.
Music can have physiological effects on many areas of life and mental
health. It can affect tension depending on the type, and it can also be
used to create specific emotions15. The potential
therapeutic effect of music has been attributed to its ability to reduce
stress and alter arousal16.
There are studies showing that Sufi music is widely used in the
treatment of various psychiatric diseases17. Turkish
music played on traditional Sufi instruments (combined with the sounds
of water flowing from a fountain) was used throughout the times of both
the Seljuk and Ottoman Empires, from the 11th to 18th century, to treat
mental illnesses18. Sufis often engaged in music and
treated psychological disorders with music. Turkish music types used in
hospitals in Amasya, Sivas, Istanbul, and Edirne were classified and
started to be used in treatments. In addition, Farabi Musiki-ul-kebir,
the inventor of the oud instrument, studied music together with
astronomy and associated it with psychology according to its effects on
people19. However, there are currently limited studies
on C-sections and music. This study aimed to compare patients receiving
music therapy with a control group and to investigate the effects of
Sufi music on anxiety scores and vital signs of patients undergoing
C-sections for elective reasons.
During the study, we had two main goals:
1: To compare state anxiety scores before and after the operation in the
music and control groups.
2: To determine whether music causes changes in patients’ blood
pressure, heart rate, respiratory rate, or partial O2pressure level.