The Effect of Live Classical Piano Music on the Vital Signs of Patients Undergoing Ophthalmic Surgery

Jorge G. Camara, MD; Joseph M. Ruszkowski, PhD; Sandra R. Worak, MD

Disclosures

Medscape J Med. 2008;10(6):149 

In This Article

Discussion

Numerous studies have reported the benefits of music on patients undergoing various types of surgery. One such benefit is the relief of anxiety. Two randomized, controlled studies, based on the State-Trait Anxiety Inventory, measured preoperative anxiety in adults undergoing outpatient surgery. The first of these studies, published by Berbel and colleagues,[13] found that music is as effective as sedatives for reducing preoperative anxiety. The second study, by Wang and coworkers[14] concluded that patients scheduled to undergo outpatient surgery who listened to music reported less anxiety than those who did not listen to music.[14]

Another published benefit of listening to music before or during surgical procedures is reduced need for sedatives.[15,16,17] Reduced stress levels were also reported in studies done by Schneider and Leardi and their coworkers.[18,19] Reduced stress was measured by decreased plasma cortisol levels and decreased intraoperative levels of natural killer lymphocytes.

There are few published reports on the effects of listening to music during ophthalmic surgery. The studies done by Bellan and Cruise and their colleagues documented the benefits of music during cataract surgery based on the patients' subjective feedback. To our knowledge, this is the first study on the effect of classical piano music on the vital signs of patients undergoing ophthalmic surgery. Furthermore, this study showed the effect of the classical piano music played live in the operating room. It was important to note that no complications occurred during or after surgery due to the presence of a piano in the OR.

Our bibliography lists numerous studies in which recorded music had an anxiolytic effect on patients. In this paper, the surgeon who was about to perform the operation played the piano. This may have added a further level of confidence in his surgical skill, which in turn may have alleviated the anxiety that is normally felt by patients about to undergo a surgical procedure. While no formal psychological testing was done in this study, the authors plan to compare recorded piano music versus live piano music in a future study.

In this study, we found a statistically significant decrease in the preoperative MAP, HR, and RR of patients exposed to live piano music. We also found a statistically significant increase in the preoperative systolic MAP, HR, and RR of patients who were not exposed to music.

This work adds to the many studies on the benefits of music during surgery. This study is unique in that the piano music used was live and played by the surgeon himself in the operating room.

The piano pieces used in this study were a classical or semiclassical genre chosen by the surgeon for their relaxing qualities. All arrangements were played in a slow to medium tempo to effect a relaxing mood. In addition, patients in both study groups were exposed to the usual operating room noise. Although music has repeatedly been shown to relax patients before, during, and after surgical procedures, only a few studies have considered the type of music used.

Ovayolu and colleagues[20] chose prerecorded Turkish classical flute music during colonoscopy.They reported decreased anxiety, pain, and dissatisfaction levels in the patients exposed to the music. A study done by Chan[21] used Chinese and Western classical music with slow beats on patients undergoing a C-clamp procedure. The study found that heart rate, respiratory rate, and pain scores were statistically reduced in the experimental group.

Certain styles of "classical" music can be interpreted as effecting a relaxing mood upon the listener. The reaction to any piece of music can vary widely among listeners. In this retrospective study, the music used had been chosen by the surgeon who played all the pieces at a tempo he considered relaxing or calming -- that is, at an "andante" (walking) tempo.

It is common for surgeons to play music during surgery. Inasmuch as studies have demonstrated the beneficial effects of music during surgery, with regard to the type of music further studies may have to be done. In this study, that the surgeon was playing the piano before the procedure leads us to speculate whether the patients' cognizance of this fact influenced the profound decrease in their vital signs upon exposure to the live classical piano music (see video).[22] This paper would have been strengthened if it were done as a prospective study; however, the piano was available in the OR only for a finite amount of time. Although having a piano in the OR may be difficult for most settings, this study reiterates the beneficial effect of classical piano music on objective parameters, such as patients' vital signs.

In conclusion, this paper suggests that listening to live classical piano music has a beneficial effect on MAP, HR, and RR on patients undergoing ophthalmic surgery.

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