The Effect of Music Therapy on Pain and Anxiety in Patients After Coronary Artery Bypass Grafting

Coronary artery disease (CAD) has remained one of the leading causes of high morbidity and mortality both in our country and worldwide over the past five years. According to global epidemiological data, cardiovascular diseases account for nearly one-third of all deaths, making them a major public health concern. CAD is characterized by atherosclerotic plaque formation and the narrowing of coronary vessels, which results in reduced myocardial oxygenation. As the disease progresses, coronary artery bypass grafting (CABG) becomes one of the most commonly used and effective treatment methods. The primary goal of CABG is to restore myocardial blood flow distal to the stenotic or occluded coronary artery by using arterial or venous grafts, thereby improving cardiac perfusion and enhancing both quality of life and overall survival.

CABG is a major surgical intervention that imposes significant psychological, physiological, social, and economic burdens on patients. In the postoperative period, patients frequently experience severe pain, anxiety, sleep disturbances, stress, depressive symptoms, hemodynamic instability, and reduced quality of life. The intensity of postoperative pain is affected by the invasiveness of the procedure, such as sternotomy, placement of chest tubes, surgical drains, and limited mobility. Moreover, undergoing a surgical procedure involving the heart-a vital organ-often triggers fear of death, a sense of loss of control, uncertainty about recovery, and concerns about postoperative complications, all of which contribute to heightened anxiety levels.

While pharmacological treatments are essential in managing postoperative pain and anxiety, they are often insufficient on their own. For this reason, non-pharmacological interventions are increasingly recommended as complementary approaches during the recovery process. Among these interventions-such as breathing exercises, relaxation techniques, massage therapy, and aromatherapy-music therapy has gained particular attention due to its demonstrated benefits.

Music therapy is a specialized, evidence-based discipline that utilizes the therapeutic elements of music within a structured patient-therapist relationship to support the individual's physical, psychological, and spiritual well-being. By employing components such as rhythm, melody, and harmony, music therapy aims to regulate emotional responses and promote healing. Studies have shown that music has significant effects on the autonomic nervous system; it activates the parasympathetic system, helping to stabilize heart rate, reduce blood pressure, regulate breathing, and decrease levels of stress-related hormones, including cortisol. Consequently, music therapy alleviates both the perception of pain and anxiety.

Furthermore, disruptions in sleep patterns prior to surgery can exacerbate anxiety and pain, while chronic stress and elevated stress hormones may negatively affect heart rate, oxygen demand, and overall cardiopulmonary stability. Previous research has demonstrated that music therapy can help regulate the mind-body-spirit connection within the endocrine and nervous systems, thereby promoting physiological balance and emotional comfort in individuals undergoing major surgical procedures such as CABG.