Evidence Explorer · MS-N256 · Mind–body and music · postoperative pain and recovery · Appraised November 6, 2026
In the double-blind multicenter IMPROMPTU trial, research-selected classical music played under general anesthesia did not reduce postoperative pain, medication use, physiologic stress or recovery outcomes after esophageal or gastric cancer surgery.
Evidence at a glance
- Benefit signal: No meaningful benefit was found.
- Certainty: Low to moderate. The design was rigorous, but only 70 participants were analyzed.
- Risk context: Headphone-delivered music under anesthesia had little direct behavioral risk; it must not distract from standard anesthesia and perioperative safety.
- Cancer-control relevance: No tumor-response, recurrence or survival benefit was tested.
What was studied
Eighty-three adults undergoing curative-intent esophageal or gastric cancer surgery were randomized in a double-blind, placebo-controlled, multicenter study; 70 were analyzed (31 music, 39 control).
Noise-cancelling headphones delivered preselected classical instrumental music during general anesthesia. The primary outcome was pain on postoperative day 1; medication use, stress markers, complications and length of stay were secondary outcomes.
What the study found
Pain scores were 1.8 with music and 2.0 with control; the mean difference was −0.28 (95% CI −0.76 to 0.19; p=.236).
There were no significant differences in perioperative medication requirements, physiologic stress, complications, length of stay or recovery.
What this does not establish
The study was smaller than planned after exclusions and attrition, so modest effects remain possible. Results apply to research-selected classical music during general anesthesia, not necessarily patient-selected music before or after surgery.
A null supportive-care result says nothing about music’s personal value for comfort or anxiety outside the operating room.
Safety and practical context
Music cannot replace analgesia, anesthesia monitoring or enhanced-recovery protocols. Headphones must be managed so the clinical team retains full access to the patient and equipment.
Patient-selected music before or after surgery may have different emotional effects and should respect preferences, hearing needs and delirium risk.
Questions for the care team
- Is the goal comfort or anxiety reduction rather than a promise of faster recovery?
- Will music interfere with communication, hearing devices or monitoring?
- What evidence-based pain and enhanced-recovery plan remains in place?
Sources and identifiers
Funding and conflicts: Funding and complete conflicts were not fully verified from the accessible abstract and journal page.
Source access and dates: Primary abstract and accessible journal report were appraised. Sources checked November 6, 2026. Last literature search November 6, 2026.
Educational evidence summary, not individualized medical advice. Psychological and sleep interventions should complement—not replace—oncology, palliative, mental-health or sleep-medicine care.
