The Impact of Music Therapy on Alleviating Pain in Preterm Neonates during Painful Medical Procedures: A Quasi-Experimental Research Study

Document Type : Original Article


1 Department of Pediatric Nursing, Shri. Vinoba bhave College of Nursing. DNH & DD

2 Department of Pediatrics, Shri. Vinoba bhave Civil Hospital, Namo Meri Silvassa, India


Background: Preterm neonates routinely undergo many painful procedures in the neonatal intensive care unit. Due to their nonverbal state, these neonates are unable to express their pain, resulting in underestimation and insufficient pain relief. Neglecting pain may lead to complications affecting neurodevelopment and causing permanent injuries to the brain. Music therapy provides sensory stimulation to preterm neonates, resulting in improved physiological and behavioral responses and reduced pain perception. To assess the impact of music therapy on alleviating pain in preterm neonates during painful medical procedures. The study utilized a quasi-experimental research design with a two-group post-test-only approach.
Methods: In the present study, a total of 60 preterm neonates were divided equally into a control group and an experimental group (30 participants per group). The intervention and control groups were matched before the intervention. The experimental group received music therapy during painful procedures, while the control group received routine care during the same procedures. The Neonatal Pain Agitation and Sedation Scale (NPASS Tool) was used to measure pain levels during painful procedures.
Results: The intensity of pain in both groups was the same before the intervention. In this study, the mean±SD values of intra-test pain level were 8.63±0.56 and 2.96±0.89 in the control and experimental groups, respectively. Moreover, the mean±SD values of the post-test pain level in the control and experimental groups were 7.53±0.89 and 1.1±0.88, respectively. The obtained t-test value in the intra-test was obtained at 29.57 (P<0.05), thereby stating that music therapy was effective in the reduction of pain levels among preterm neonates during painful procedures. 
Conclusion: This study has important implications for healthcare professionals who care for infants and should prompt the integration of music therapy into routine care for this vulnerable population.


  1. Centers for Disease Control and Prevention. November 1, 2022; Avai URL:https://
  2. Baik-Schneditz N, Pichler G, Schwaberger B, Mileder L, Avian A, Urlesberger B. Peripheral Intravenous Access in Preterm Neonates during Postnatal Stabilization: Feasibility and Safety. Front Pediatr. 2017; 10(5):171-3.
  3. Kaur H, Negi V, Sharma M, Mahajan G. Study of pain response in neonates during venipuncture with a view to analyse utility of topical anaesthetic agent for alleviating pain. Med J Armed Forces India. 2019;75(2):140-145.
  4. Campbell-Yeo M, Eriksson M, Benoit B. Assessment and Management of Pain in Preterm Infants: A Practice Update. Children (Basel). 2022;9(2):244-61.
  5. Jain A, Upadhyay K, Lakhkar B. Music therapy in neonates for procedural pain. J Datta Meghe Inst Med Sci Univ 2019;14(Suppl 2):S83-6.
  6. National Library of Medicine. Improving the Quality of Care Through Pain Assessment and Management; 2008 Apr, Chapter 17; Available URL:
  7. El Geziry A, Toble Y, Al Kadhi F, Pervaiz M, Al Nobani M. Non-pharmacological pain management. Pain management in special circumstances. 2018:1–14.
  8. Rachael F. Music Therapy as an Intervention for Pain Perception. 2018. Thesis for: Master Music Therapy.
  9. Yue W, Han X, Luo J, Zeng Z, Yang M. Effect of music therapy on preterm infants in neonatal intensive care unit: Systematic review and meta-analysis
    of randomized controlled trials. J Adv Nurs. 2021;77(2):635-652.
  10. Calderon-Noy G, Gilboa A. Music Therapy with Neonatal Intensive Care Unit-Discharged Mother-Infant Dyads: Developing a Method for Nurturing Communicative Parental Efficacy (CoPE with Music). Int J Environ Res Public Health. 2021;18(16):8553.
  11. Hillman BA, Tabrizi MN, Gauda EB, Carson KA, Aucott SW. The Neonatal Pain, Agitation and Sedation Scale and the bedside nurse's assessment of neonates. J Perinatol. 2015;35(2):128-31.
  12. Ragasivamalini S, Ragupathy, N. Effect of music therapy intervention in pain reduction during venepuncture in neonates. Int J Contemp Pediatr. 2019;6(4):1529-32
  13. Shabani F, Nayeri ND, Karimi R, Zarei K, Chehrazi M. Effects of music therapy on pain responses induced by blood sampling in premature infants: A randomized cross-over trial. Iran J Nurs Midwifery Res. 2016;21(4):391-6.
  14. Chen Y, Li Y, Sun J, Han D, Feng S, Zhang X. The Effect of Maternal Voice on Venipuncture Induced Pain in Neonates: A Randomized Study. Pain Manag Nurs. 2021;22(5):668-73.
  15. Polkki T, Korhonen A. The effectiveness of music on pain among preterm infants in the NICU: a systematic review. JBI Database Syst Rev Implement Rep. 2014;12(4):354-373.
  16. Qiu J, Jiang YF, Li F, Tong QH, Rong H, Cheng R. Effect of combined music and touch intervention on
    pain response and β-endorphin and cortisol concentrations in late preterm infants. BMC Pediatr. 2017;17(1):1-7.