The Effect of Music on Pain During Drain Removal

This research was conducted as a randomized controlled experimental study to examine the effect of music listening during drain removal on pain in patients undergoing total knee arthroplasty. The study was carried out between March 19, 2024, and October 15, 2025, in the orthopedics and traumatology clinic of a state hospital in Türkiye. Written permission was obtained from the Clinical Research Ethics Committee of a state university in Türkiye to conduct the research (Decision No: 2023-KAEK-30). The sample size was calculated using the group*time interaction (mixed ANOVA) module in repeated measures in the G-Power Version 3.1.9.6 program (Franz Faul, Germany). It was determined that a minimum of 44 patients (22 in each group) were required to determine the change before, after, and at 15 minutes in the intervention and control groups with 95% power, 0.05 type I error, and at least f=0.25 (moderate) effect size. To increase the power of the study, a total of 60 patients were included, with 30 in the intervention group and 30 in the control group. The study sample consisted of patients who volunteered and provided written consent. Patients who met the inclusion criteria and agreed to participate in the study were randomly assigned to the intervention and control groups. In the randomization process, participants were given sealed envelopes containing the names of the intervention and control groups, and the patient was asked to choose between the two envelopes. The patients were assigned to either the intervention or control group according to their choice. First, the researcher had the patients complete a "Patient Demographic Characteristic Form" containing sociodemographic characteristics (age, gender, marital status, education level, etc.) and the VAS pain scale through face-to-face interviews. The patients' drains were removed by their physician on the second postoperative day according to the procedure. Patients undergoing total knee arthroplasty received routine pain relief treatment with paracetamol vial 2*1 (intravenous) (08:00-20:00) and dexketoprofen ampoule 2*1 (intravenous) (12:00-24:00). Drain removal was performed after the patients received their paracetamol vial (intravenous) treatment in the morning. Fifteen minutes before drain removal in the intervention group, the researcher played the Acemaşiran maqam of Turkish Classical Music, MP3 through headphones, prepared by the group of Turkish Music Research and Promotion (TÜMATA), which is known in the literature (Özdemir et al., 2019; Çelebi et al., 2020) to have positive effects on pain and physiological parameters and provides relaxation. The ear headphones were disinfected with a 70% alcohol solution before being used between patients. Music was listened for a total of 30 minutes, continuing before 15 minutes and after 15 minutes of drain removal (Yarahmadi et al., 2018). Pain levels were assessed again using the VAS pain scale immediately after, and 15 minutes after drain removal. Patients in the control group received no intervention. Pain levels in the control group were also assessed using the VAS pain scale 15 minutes before, immediately after, and 15 minutes after drain removal. Pain assessment of all patients was performed by another nurse independent of the study to avoid bias.