Dr Ramesh Singh Bhandari
Music has been considered as a universal language rising above all the barriers. From way back, listening music has been known to improve mental well- being as well as boosting physical health. Moreover, from making a person happier to improving performance, lowering the stress level and depression, strengthening learning and memory, many benefits have found to be associated with listening music.
For many, it is not unusual to think that operating room is a sober place where any kind of distracting noise should be avoided. With the noise in operating theatres, there is a worry that it might interfere team member’s focus and affect on performance level. Contrary to this, listening music in operating rooms specially while operating is a very common phenomenon preferred by many surgical staffs. It’s a very common practice done by many surgeons around the world to carry their own handy music playing gadgets to play on while operating. In fact, these days, many modern operating rooms around the world have their inbuilt music systems. Besides simply liking the music by operating room staffs, significant association between listening music and its effects and outcomes have been described by various research findings. While playing music in operating room is very common, the kind of music and the level of volume preferred could vary among the individual staffs.
Listening music can also help the patients undergoing surgeries under anesthesia. Some reports revealed that patients who preferred to listening soothing music while being put to sleep and during surgery required less amount of drugs and also recovered more quickly afterwards. Music is known to reduce the amount of pain and anxiety medication needed. However, most of these findings are based on observational questionnaire based studies.
A write up published in “The Guardian”, September 2011, based on the survey done in UK, reported that 90% of surgeons in UK put music on the theatre sound system during operative procedures. Most of them responded that music helped in creating harmonious and a very calm atmosphere. Interestingly, some of them added that music also helped them from getting bored. This would particularly apply for the supporting staffs not directly engaged in the procedure and specially while on long operating procedures. The survey was conducted based on questionnaires asking if they listened to music during operations, how did the music affect them and if they had any suggestions for music that surgeons could try.
It is generally assumed that the working condition of operating room is very stressful one. There are diverse group of people working with in the room. A good communication among the staff and a very calm environment is expected to have very efficient, precise and quick response in operating rooms. Back in 2006, a study done by Yohuda Ullmann and published in Journal “Injury”, again based on the questionnaire based study on doctors and nurses concluded that music had positive effect in the staffs working in the operating rooms.
Besides listening to music, the kind of music preferred and the level of volume have been associated with the professional roles and specialties in operating rooms. A study published in journal “Surgery” in 2016, looked into this issue. A multi-centric cross sectional study was done in 672 participants. The conclusion of this survey was that musical preferences and perceptions of the effect of music in operating room do differ among the specialties and professional status. The researchers assumed that this finding could help in optimizing the operating room environment.
Although, most of the evidence is showing positive correlation between music and its effect on operating staffs in operating rooms, there are some reports, which suggest that music could potentially be a safety hazard. A systemic review published in 2015 in journal “AANA” analyzed 27 relevant articles. In the contrary to the beneficial effects demonstrated by many others in the past, this analysis revealed that music actually contributed to overall stress of the environment and interfered with the communication in the operating rooms. The contradictory finding in this finding could have been due to wide variation in the choices and interest of the staffs for the music in the operating rooms. It might also could have been due to stressful types of surgeries or procedures being carried out predominantly. It has been seen that during very stressful steps and situations, even those surgeons who would otherwise preferred listening music also asked to stop the ongoing background music temporarily. The above review concluded that if music is played in the operating rooms, it must be done very judiciously and also the consent and safety of all stakeholders must taken into consideration.
Studies to find the association between the playing music and its effect on the efficiency of the operating staffs are still being carried out although very infrequently and major randomized trials in this subject are in very limited numbers. The latest evidence has recently been published in International journal of Surgery, January 2020. It is a systematic review titled on “ Influence of music on the surgical task performance”. As there have been some contradictory findings reported in the past about the effect of playing music in operating room, this systematic review tried to analyze the available evidences till date and come out with some relevant conclusions. Total 18 studies were finally selected for the analysis. Among them, 6 studies fulfilled the criteria of high quality papers while 8 studies were considered moderate quality. Among them, five studies could provide both strong and moderate scientific evidence for a positive effect of music on surgeon's task performance. On the other hand, strong scientific evidence for a negative effect of music on surgeon's task performance was also demonstrated by two high-quality studies. However, when overall analysis was made, the positive effect of music on the surgical task performance was significantly higher in comparison to its negative effects. So, the significant outcome of this study was to demonstrate positive effects of music on surgeon’s task performance overriding its negative effect. When looked into the different elements of music and its effects, it was found that playing classical music at a low to medium volume could improve the surgical task performance by increasing both accuracy and speed of performing procedures. A very important note from this analysis however was that playing a loud or high-beat type of music in the operating theatres could have very distracting effectand which always needs to be taken into consideration while discussing the effects of music on surgeons task performance.
Thus, music is and will be loved by everyone as a universal language. Since the long time, it’s been believed that most of the surgeons enjoyed listening music, especially during procedures. Many great surgeons in the past had expressed their love for music. Many said,they would have been a musician if they hadn’t been a surgeon. Besides surgeons, other staffs in operating room do have varying interest in listening music while in operating rooms. Overall, the evidence available till date is strongly showing the positive effects of playing music in operating rooms and surgeons task performance. However, the type and volume of music make an important elements of music played in the operating rooms, which always needs to be considered to avoid creating a stressful and distracting environment as the patients safety always stands at first priority.
-(Dr Bhandari is Professor of Gastrointestinal, Hepatopancreatobiliary and Liver Transplant in TUTH).