- Cosmetic Surgery
- Minor Ops
Monday, November 5, 2018
Music can have positive effects on humans, with reactions to music dependent on individual preferences, current mood and emotions. Comprehensive research and data analysis has showed that listening to music before, during and/or after surgery can help improve patient experience, with reduced anxiety and pain and analgesia requirements.
The work I led at Oxford University Hospitals in the department of plastic surgery examined anxiety levels and respiratory rates in 96 patients undergoing surgery whilst awake i.e. under local anaesthetic. Half of the patients had classical music being played in the background, whilst the other half experienced surgery without music. All patients were happy to have music played and be part of the study. The music group reported lower anxiety levels and were found to have lower breathing rates (i.e. a favourable outcome from both a psychological and physiological perspective).This work published in the Annals of the Royal College of Surgeons of England in 2012 received worldwide media attention and since then there have been numerous other studies undertaken by different research groups in various surgical specialties, to further elucidate the effects of music on the patient journey.
It has been reported that classical music may provide its benefits via its calming effect. It is also known that patient choice is very important, as music familiarity and fondness has a strong ability to reduce anxiety levels.
It seems obvious that if music is to be played, it should be done so at an appropriate level whereby the patient and/or surgical team can hear it without any impediment to communication. At times when heightened communication is essential, such as at the start of surgery or at critical parts of more complex surgery, music should be turned down or eliminated as necessary to allow for maximal concentration. The aim is to perform a surgical procedure meticulously and most importantly safely. When a patient and/or surgical team request music to be played, it should only be played when the overall team consensus is happy with this decision. When under local anaesthetic (i.e. whilst awake) it is crucial to ask the patient if he or she has a preference for music or no music, and if music is desired, if there is a preferred type. Music can indeed be a useful modality to distract away from negative stimuli of a surgical procedure, producing positive thoughts and memorable ambience. Nevertheless, there are patients, surgeons, and theatre staff who do not like the notion of music in theatres and prefer a more silent theatre with equipment, machinery and surgical "sounds" audible in the background only, and this should be respected.
It is interesting to note that there is data to suggest that music may reduce operative times and improve surgical procedural quality. However, the recent work in this area assessed surgical trainees in skin closure on simulated models (not actual surgery on patients) and so this cannot be extrapolated into the real world per se. Nevertheless, it provides food for thought on the potential benefits enjoyable music can bring to the psychomotor and technical skills domain, which warrants further study.
As we all know, the fundamental tenet of ethical medical practice is primum non nocere (first do no harm). If through the use of music we are able to improve the patient journey and reduce patient anxiety, it seems prudent to routinely offer it to our patients and teams, so that those who enjoy it may also benefit from it.