Music-STAR trial: study protocol for a randomised controlled trial to assess the impact of live and recorded music-based interventions on preoperative stress, mood, pain and biomarkers in neurosurgical patients

Introduction: Neurosurgical patients commonly experience significant preoperative anxiety, which can negatively impact surgical outcomes and recovery trajectories. Music, as a powerful neurophysiological modulator of the human stress response, offers a non-pharmacological, non-invasive and cost-effective approach to anxiolysis by stabilising the hypothalamic-pituitary-adrenal axis and autonomic nervous system. The goal of this study is to evaluate the effects of live and recorded music on preoperative stress, serum-level and plasma-level biomarkers, perceived pain, anxiety and mood states in neurosurgical cancer patients.