NICU music therapy is receiving global growing interest. In the United States, music therapists provide evidence-based interventions, and research and training programs have been developed. First Sounds: Rhythm, Breath & Lullaby NICU music therapy model works on infants, parents/caregivers and environment and is currently practiced in over fifteen countries. The RBL music therapists use live music and create a similar sound to the uterine auditory environment. In addition, the RBL supports for feeding/sucking, respiratory difficulties, sedation, sleep, sedation during a medical procedure, and selfregulation. Usage of Song of Kin supports bonding and attachment. Environmental Music Therapy is also provided to modulate the soundscape of the area.

Pain and anxiety is the most harmful physical and psychological manifestations are often experienced by the patients during extubation of mechanical ventilation which leads to unwanted complication. Hence the study was conducted with the aim to determine the effectiveness of nature based sound therapy on reduction on the level of pain and anxiety during extubation. Post-test only research design was adopted to conduct the study with 30 samples who met the inclusion criteria in intensive care unit and samples were randomly allocated into experimental group (n=15) and control group (n=15). Experimental group received nature based therapy 30 minutes prior to the extubation of mechanical ventilation besides control group received the routine care. Post test was conducted immediately after the extubation for both experimental and control group. Data were analyzed using SPSS statistical package. After the intervention, there was a significant difference was observed in the level of pain and anxiety at the level of p<0.001 between the experimental and control group. The study findings concluded that Music therapy has the potential effect to decrease symptoms of pain anxiety during extubation of mechanical ventilation and nature based sound therapy can be routinely practiced in the intensive care unit.