The Surgical Soundtrack: The Effects of Music in the OR

Bret S. Stetka, MD

Disclosures

February 06, 2017

What Are Surgeons Listening To?

Most surgeons credit playing music in the OR as a means of relaxing while operating. But this doesn't necessarily mean streaming Enya or some equally meditative minstrel. Surgeons' musical taste appears to run the genre gamut, from pop and classical to hip hop and heavy metal.

Dr Brenin, who I distinctly remember, while on my own medical school surgery rotation, resecting tumors to Talking Heads, recalls a renowned cardiac surgeon who operated to loud hard rock. An orthopedic surgeon I recently spoke with claims to perform just fine with Metallica blaring in the background. And still another told me he works best to Prince and Michael Jackson.

Dr Marx's HSS colleague, Dr Stephen Fealy, also an orthopedic surgeon, is a strong advocate for music in the OR and carefully considers his tune selection depending on the time of day. "I might start the day off with some Jack Johnson or some reggae. Then by afternoon I might want something with a little more energy, like the Ramones. The day would be interminable without music," he says.

Dr Fealy kids that traditionally it is the surgeon who makes the decisions on song selection, but he's willing to cede to the rest of the surgical team if they have requests. Dr Marx adds, "I just want everyone [in the OR] to be comfortable with all aspects of the environment, including the music. I have almost 2000 songs on my phone, with a wide variety ranging from rap to pop to classic artists like Elvis and Frank Sinatra. I hit the 'shuffle' button, and if someone doesn't like the music, I tell them to wait 5 minutes!"

But not all specialties agree.

A 1997 survey[12] published in Anesthesia queried 200 anesthesiologists on their thoughts about music in the OR. Seventy-two percent reported regularly working in operating theaters in which music was played, but 26% of this sample felt that music reduced their vigilance and impaired their communication with other staff. In addition, 51% of anesthesiologists who worked in ORs in which music was played said that the music is distracting when anesthesia-related problems arise.

"It is critical that all of the stakeholders—the patients, the surgeons, the nursing staff, the anesthesia personnel—have a say in what, when, and how the music is to be played," says Dr Katz, a self-professed opera lover. As an example, he cites that there are stages of surgery when it is critical for certain members of the team to be relaxed, such as anesthesiologists during anesthetic induction.

One thing most surgeons and surgical team members can agree on is that in many cases, music is helpful to patients. In surgical cases in which patients are awake, self-selected music has been shown to relax them. Music even appears to decrease intraoperative sedative requirements in certain procedures.[13,14] And much like Dr Evan O'Neil Kane realized over a century ago in a Pennsylvania OR, research continues to show that listening to music before and after undergoing surgery can reduce anxiety and possibly even pain.[15]

But when it comes to the surgeons, music in the OR—like so many things—seems to be simply a matter of taste.

"If you can operate better with the music cranked up, then I'm all for it," says Dr Brenin. "If that doesn't work for you or members of the team, then turn it off!"

Do you operate to music? Why or why not? If you do, what do you like to play? Tell us in the comments section.

Follow Bret Stetka on Twitter @BretStetka

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