The Effect of Holy Quran Voice on Pain and Hemodynamic Indices after Cardiac Surgery: A Randomized Clinical Trial

Document Type : Original Article


1 Nursing department, Nursing faculty, Shahed university, Tehran, Iran

2 Faculty of Midwifery and Nursing, Shahed University, PO Box 1591715314, Tehran, Iran

3 Dept. of General Surgery, School of Medicine, Ahvaz Jundishapur University of Medical sciences, Ahvaz, Iran.


Background and objectives: Pain is a common complication after heart surgery that can cause problems for the patient. This study aimed to investigate the effect of Holy Quran voice on pain and hemodynamic indices after cardiac surgery.
Subjects and Methods: This single-blind randomized clinical trial was performed on heart surgery patients admitted to Golestan Hospital in Ahvaz in 2018. In the intervention group, after extubation, two times each day, for ten minutes, the voice of the Quran was broadcast. For the control group, the usual care was continued. Data collection tools consisted of demographic and clinical and visual analog scale (VAS) as well as hemodynamic indices including systolic blood pressure, diastolic blood pressure, and heart rate. Data were analyzed by SPSS software version 22 using Chi-square, independent t-test and repeated ANOVA test.
Results: There was no significant difference between qualitative and quantitative variables between the two groups, so the two groups were similar.
Repeated ANOVA test showed that the use of Holy Quran voice was effective in reducing the pain intensity of patients (P <0.001). Also, the results showed the positive effect of Holy Quran voice on systolic blood pressure (P <0.001) and no significant effect on diastolic pressure and heart rate.
Conclusion: The results of the study showed that the Holy Quran voice is effective in reducing pain and systolic blood pressure in patients after open-heart surgery. Therefore, this method can be used as non-invasive nursing care.


1-Vilite B, Strike E, Rutka K, Leibuss R. Pain management in intensive care unit patients after cardiac surgery with sternotomy approach. Acta medica Lituanica. 2019;26(1):51-63.
2-            Ogut S, Sucu Dag G. Pain Characteristics and Pain Interference Among Patients Undergoing Open Cardiac Surgery. Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses. 2019.
3-Zubrzycki M, Liebold A, Skrabal C, Reinelt H, Ziegler M, Perdas E, et al. Assessment and pathophysiology of pain in cardiac surgery. Journal of pain research. 2018;11:1599-611.
4-Fakhr-Movahedi A, Ebrahimian A, Mirmohammadkhani M, Ghasemi S. Relationship between chest pain severity and physiological indexes in patients with coronary artery disease. Tehran University Medical Journal. 2016:140-5.
5-            Bastani F, Momenabadi H, Safdari M-T, Haghani H. The effect of acupressure on pain severity of chest tube removal in patients with open heart surgery in intensive care unit. Daneshvar Medicine. 2012;20(101):1-12.
6-Zolfaghari M, Ajri Khameslou M, Zaherimogadam M, Ajri Khameslou E, Farokhnezhad P. The effect of preferred music on physiological parameters of pain in. Advances in Nursing & Midwifery. 2015;24(86):1-8.
7-            Mazloum sR, Abbasi Teshnizi M, Kianinejad A, Gandomkar F. Effect of applying Ice bag on pain intensity associated with chest tube removal after cardiac surgery. Quarterly of Horizon of Medical Sciences. 2012;18(3):109-14.
8-Fayaz MK, Abel RJ, Pugh SC, Hall JE, Djaiani G, Mecklenburgh JS. Opioid-sparing effects of diclofenac and paracetamol lead to improved outcomes after cardiac surgery. Journal of cardiothoracic and vascular anesthesia. 2004;18(6):742-7.
9-Cattabriga I, Pacini D, Lamazza G, Talarico F, Di Bartolomeo R, Grillone G, et al. Intravenous paracetamol as adjunctive treatment for postoperative pain after cardiac surgery: a double blind randomized controlled trial. European Journal of Cardio-thoracic surgery. 2007;32(3):527-31.
10-Seirafi M, Kalate AM, Peimani J. The effect of predictability and sense of control over the pain of cardiac surgery patient. Journal of nurse and physician within war. 2015;3(8): 34-40..
11-Micah S, Barolia R, Parpio Y, Kumar S, Sharif H. Factors Associated with Postoperative Pain among Patients after Cardiac Surgery in the Tertiary Care Teaching Hospital of Karachi, Pakistan. Pain research and treatment. 2019;2019:9657109.
12-Liu H, Gao X, Hou Y. Effects of mindfulness-based stress reduction combined with music therapy on pain, anxiety, and sleep quality in patients with osteosarcoma. Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999). 2019.
13-Ogba FN, Ede MO, Onyishi CN, Agu PU, Ikechukwu-Ilomuanya AB, Igbo JN, et al. Effectiveness of music therapy with relaxation technique on stress management as measured by perceived stress scale. Medicine (Baltimore). 2019; 98(15):e15107.
14-Bashiri M, Akçalı D, Coşkun D, Cindoruk M, Dikmen A, Çifdalöz BU. Evaluation of pain and patient satisfaction by music therapy in patients with endoscopy/colonoscopy. Turk J Gastroenterol. 2018;29(5):574-9.
15-Ikonomidou E, Rehnström A, Naesh O. Effect of music on vital signs and postoperative pain. AORN journal. 2004;80(2):269-78.
16-Grafton-Clarke C, Grace L, Harky A. Music therapy following cardiac surgery-is it an effective method to reduce pain and anxiety? Interactive cardiovascular and thoracic surgery. 2018;28(5):722-7.
17-Majidi S. Recitation Effect of Holy Quran on Anxiety of Patients Before Undergoing Coronary Artery Angiography. Journal of Guilan University of Medical Sciences. 2004;13(49):61-7.
18-Chlan LL, Weinert CR, Heiderscheit A, Tracy MF, Skaar DJ, Guttormson JL, et al. Effects of patient-directed music intervention on anxiety and sedative exposure in critically ill patients receiving mechanical ventilatory support: a randomized clinical trial. Jama. 2013;309(22):2335-44.
19-Allameh T, JabalAmeli M, Lorestani K, Akbari M. The Efficacy of Quran Sound on Anxiety and Pain of Patients under Cesarean Section with Regional Anesthesia: A Randomized Case-Controlled Clinical Trial. Journal of Isfahan Medical School. 2013;31(235).
20-Rezvani Amin M, Siratinayer M, Abadi A, Moradyan T. Correlation between Visual Analogue Scale and Short form of McGill Questionnaire in Patients with Chronic Low Back Pain. Qom Univ Med Sci J. 2012;6(1):31-4.
21-Mousavi Fs, Golmakani N. Comparison and correlation between visual analogue scale and different dimensions of the short form of McGill pain questionnaire in post cesarean pain evaluation. Journal of Nursing and Midwifery Urmia University of Medical Sciences. 2018;16(9):622-30.
22-Yaghoubinia F, Navidian A, Nasiruddin TM, Sheikh S. Effect of music on pain intensity in patients with loss of consciousness in intensive care unit. Medical - Surgical Nursing Journal. 2016;4(4):40-47.
23-Ko SY, Leung DY, Wong EM. Effects of easy listening music intervention on satisfaction, anxiety, and pain in patients undergoing colonoscopy: a pilot randomized controlled trial. Clin Interv Aging. 2019;14:977-86.
24-Korhan EA, Uyar M, Eyigör C, Yönt GH, Çelik S, Khorshıd L. The effects of music therapy on pain in patients with neuropathic pain. Pain Management Nursing. 2014;15(1):306-14.
25-Dehcheshmeh FS, Rafiei H. Complementary and alternative therapies to relieve labor pain: A comparative study between music therapy and Hoku point ice massage. Complementary therapies in clinical practice. 2015;21(4):229-32.
26-Krishnaswamy P, Nair S. Effect of music therapy on pain and anxiety levels of cancer patients: A pilot study. Indian journal of palliative care. 2016;22(3):307.
27-Farzin AF, Zare M, Mousavi Garmaroodi SM, Behnam VH, Talebi S. Comparative Study of the Effect of Allah’s Recitation and Rhythmic Breathing on postoperative pain in Orthopedic Patients. Anesthesiology and Pain. 2018;9(1):68-78.
28- Nasiri M, Fayazi S, Khodadadi Karimvand H. The Effect of Reciting the Word “Allah” on Vital Signs and SpO2 of Patients After Coronary Artery Bypass Graft Surgery: A Randomized Clinical Trial. Jundishapur J Chronic Dis Care. 2015;4(2):e60300.
29-Esmaeili M, Ardestani N, Karamkhani M. Investigating the visual-oral effect of Quran verses on the intensity of labor pain among prim-parous patients. Journal of Research on Religion & Health. 2019;5(1):112-22.
30- Sen H, Yanarateş O, Sızlan A, Kılıç E, Ozkan S, Dağlı G. The efficiency and duration of the analgesic effects of musical therapy on postoperative pain. Agri: Agri (Algoloji) Dernegi'nin Yayin organidir= The journal of the Turkish Society of Algology. 2010;22(4):145-50.
31-Stern I, Greenberg MS. Clinical assessment of patients with orofacial pain and temporomandibular disorders. Dental Clinics. 2013;57(3):393-404.
32-Emami Zeydi A, Jafari H, Khani S, Esmaeili R, Gholipour Baradari A. The Effect of Music on the Vital Signs and SpO2 of Patients after Open Heart Surgery: A Randomized Clinical Trial. Journal of Mazandaran University of Medical Sciences. 2011;21(82):73-82.
33-Han L, Li JP, Sit JW, Chung L, Jiao ZY, Ma WG. Effects of music intervention on physiological stress response and anxiety level of mechanically ventilated patients in China: a randomised controlled trial. Journal of clinical nursing. 2010;19(7‐8):978-87.
34-Özer N, Özlü ZK, Arslan S, Günes N. Effect of music on postoperative pain and physiologic parameters of patients after open heart surgery. Pain Management Nursing. 2013;14(1):20-8.
35-Zarurati M, Pishgooie S, Farsi Z, Karbaschi K. The effect of music therapy on comfort Level and some vital signs of patients undergoing hemodialysis. Military Caring Sciences. 2017;3(4):221-32. Military Caring Sciences. 2017;3(4):221-32.
36-Sendelbach SE, Halm MA, Doran KA, Miller EH, Gaillard P. Effects of music therapy on physiological and psychological outcomes for patients undergoing cardiac surgery. Journal of cardiovascular nursing. 2006;21(3):194-200.
37-Nilsson U. The anxiety-and pain-reducing effects of music interventions: a systematic review. AORN journal. 2008;87(4):780-807.