CRD Summary: This review concluded that music interventions can help reduce or control peri-operative patient anxiety and pain. Although the authors’ conclusions were suitably cautious, given the potential for bias and the heterogeneity among studies, they should be interpreted with caution.

CRD Commentary: The objectives of the review and the inclusion criteria were clear. The literature search was adequate. The authors acknowledged the potential for language and publication bias due to language restrictions and not searching for unpublished articles. The authors did not report the processes used for study selection, validity assessment or data extraction, thus the potential for reviewer error and bias could not be ruled out. Although the quality of the studies was assessed using a modified version of previously published criteria, the authors acknowledged that the quality was insufficient in a number of studies, which may affect the reliability of the conclusions. Due to the differences in methodological methods, a narrative synthesis was appropriate. However, there were also clinical differences in terms of patient surgical procedures and few patient characteristics, such as co-morbidities, were reported it was unclear how comparable patients were at baseline. Further, as some studies included interventions with music plus other components, it was unclear not only whether music alone or in combination was the most effective but also against which comparators they were most effective. Although the authors’ conclusions appeared appropriate, given the above limitations they should be interpreted with caution.