Background music in surgery assessed

Surgeons have long earned a reputation as a terse crowd bent on perfection. Yet the stereotype of this stern bunch operating in a silent and sterile environment has been disputed with the results of a recent UK study. Ninety percent of surgeons surveyed in England reported listening to music while in surgery, and nearly half preferred that music to be rock.

Two studies in the United States have already examined the performance of surgeons while listening to music.  In 2008, Surgical Endoscopy found that trainees did not perform as well when attempting a difficult operation for the first time.  However, a 1994 study published in JAMA by researchers from SUNY Buffalo examined the performance of fifty male surgeons between the ages of 31 and 61.  Each was required to perform complex arithmetic while listening to a sound track of their choice, and again while listening to Classical music (Pachelbel's Canon in D Major). Variables measured in the study included heart rate, blood pressure, pulse and performance accuracy.

Oddly enough, surgeon performance on the task, as well as improved vital signs, such as decreased blood pressure, were better when listening to music, particularly if it was self-selected as opposed to Classical.  Researchers believe that listening to music of one's selection may indeed lead to improved performance, particularly as it may decrease stress. It also has the added incentive of being used as a "benchmark" for the amount of time remaining in procedures with a narrow time window, such as removing a tumor, according to a surgeon interviewed for the study.

Charles Limb, an Associate Professor of Otolaryngology at the Hopkins School of Medicine, finds that music played in the background at a low volume helps to improve his clarity. "The music is something in the background to help improve the sonic quality of the room," Limb wrote in an e-mail to the Newsletter.  "The OR is a noisy place full of monitors, drills, buzzing, talking.  Sometimes a little music makes it a better working environment. But it's different for all surgeons."

While some may be concerned about the distractions of music in this environment, it may come as a relief that only one-fourth of respondents felt that it hindered communication during a case.  Quarrels over what to play and the volume of the music were more common.  And, thankfully, music was silenced at the first sign of struggle during a case. Limb pointed out that there are numerous considerations to take into account when deciding whether or not to play music, such as the surgical situation, as well as "making sure the music improves team performance rather than detracts." He often finds music to be helpful for trainees to get past basic anxiety that they may have.

Music may also be beneficial for patients undergoing surgery.  A 2008 study found that those who listened to it while waiting for general anesthesia to take effect prior to surgery required only half as much anesthesia and had shorter recovery times.

While playing music during a case has become common among surgical teams (nearly three-quarters surveyed said they regularly worked in operatories which typically played music), the verdict is still out as to what type of music is best to play in terms of decreasing stress and improving performance.