Analysis of vital, facial and muscular responses to music or message in coma, vegetative state or sedated patients

Coma, vegetative state and sedation are disorders of consciousness with clinical differences where a generalized reduction or alteration occurs in the consciousness content, coupled with deficiencies in waking. OBJECTIVE: to analyze the relations between the vital signs, facial expressions and muscular tonus to the music or message stimuli in coma, vegetative state or sedated patients. METHOD: This study was a single-blinded transversal controlled clinical trial. DATA COLLECTION: two Intensive Care Units and one ward of a Public Hospital of Education and Research. PROCEDURE: patients with Glasgow Coma Scale between 3 and 8 or Ramsay Sedation Scale of 5 or 6 being randomly placed into one of the three groups (experimental music, experimental message or control). Their relatives recorded a voice message and chose a song according to the patients preference. The vital signs, eletroneurography and facial expressions of the patients were collected both in the baseline and also during the intervention. Two intervention sessions were performed on the same day. The Glasgow Outcome Scale was applied 30-40 days after the initial intervention. RESULTS: the majority of the 76 coma, vegetative state or 11 sedated patients were masculine, between the ages of 18 and 36 and had been interned for trauma. Statistically significant alterations were noted in the variables of temperature, facial expression, eletroneurography and Glasgow Outcome Scale in the analyses performed in this study, in addition to more frequent alterations in session 2, in the coma and vegetative state patients, in channel 1 of the eletroneurography (frontal muscle) and in the message experimental group with mean values and higher percentages than in the music experimental group. CONCLUSIONS: The results, in relation to the vital signs, are limited and inconclusive, which complicates any inference regarding their influence on the responses of patients with disorders of consciousness in relation to stimuli. Facial expressions and eletroneurography, seem to be the more reliable variables for evaluation of the responses of these patients; however, additional studies are suggested.