Binaural beats for anxiety and pain around surgery: a meta-analysis of 15 trials

Anxiety before and after surgery is common, and it makes blood pressure swing and pain feel worse. Xiong and colleagues pooled every randomized trial they could find, through December 2024, in which surgical patients listened to binaural beats and had their anxiety, pain or vital signs measured. Fifteen trials qualified.

Against silent or blank audio, binaural beats cut anxiety by a large margin: a standardised mean difference of about 1.4 across fourteen trials and just over a thousand patients. Postoperative pain fell too, by a moderate amount, and systolic blood pressure and heart rate dropped by a few points. Diastolic pressure did not change reliably. The more interesting comparison is against ordinary, non-beat audio, which is where most of the “it’s just the music” objection lives. There, binaural beats still came out ahead on anxiety and on pain, though the anxiety result is less certain.

The authors call binaural beats a promising non-drug option for surgical anxiety and recommend standardising protocols, because trials differed widely in the beat frequency, duration and timing they used.

Limitations. The pooled anxiety effect comes with heterogeneity above 90 percent, which means the trials disagree a great deal about how big the effect is, even if they agree on its direction. Several comparisons rest on three to six small trials. Perioperative patients are a specific, highly anxious group, and this result does not automatically transfer to everyday listening. We grade it strong on the rubric because it is a meta-analysis of randomized trials with a consistent direction of effect, and we would move it to moderate if a later review with lower heterogeneity finds smaller effects.