Do surgeons listen to music?

Music has always been an integral part of the operating room. Since the 19th century, surgeons have been known to play music during operations to help ease tension and improve focus. But does music actually help surgeons perform better, or is it simply a matter of preference? Here we explore the evidence behind surgeons listening to music while operating.

Table of Contents

The history of music in the operating room

Playing background music during surgery has been a tradition dating back over a century. In 1914, surgeon Evan O’Neill Kane brought a phonograph into the operating room and played music for his patients during their procedures. He found it helped relax the patients before anesthesia was used. Other surgeons adopted the practice of playing music and it became popular during surgeries.

Initially, live music was common in the OR. Small chamber groups would sometimes provide live ambient music as surgeons operated. Recorded music grew in popularity through the 1920s and 1930s as phonographs and records became more accessible. Radio also became a popular source of music in the OR in the 1930s and 1940s.

Music selection evolved over the decades, shifting from classical to jazz to pop music. Music volume was usually kept low and selections were primarily instrumental. The priority was on creating a calming environment for the surgical team rather than entertaining or distracting them.

Potential benefits of music during surgery

There are a number of ways that music may provide advantages in the operating room:

Improves mood – Music can have emotional and psychological benefits that uplift the surgical team.
Lowers stress – Listening to relaxing music has been shown to lower cortisol and other stress indicators.
Increases focus – Rhythmic music may help surgeons enter a mental flow state and stay focused on the task.

Enhances performance – Some studies have indicated music can improve surgical task performance and efficiency.
Drowns background noise – Music can mask distracting beeps and noises from surgical equipment.
Promotes teamwork – The shared music experience can contribute to an atmosphere of collaboration among the surgical team.

Many surgeons report that they enjoy listening to music during operations. The percentage of surgeons who say they listen to music during surgery ranges from 40% to over 90% in various surveys. Younger surgeons, in particular, show a strong preference for playing music in the OR.

Potential concerns about music in the OR

While the benefits of music are clear to many surgeons, there are also some arguments against allowing music in the operating room:

Distraction – Lyrical or attention-grabbing songs could disrupt the focus of the surgical team.

Communication – Music can make it harder for the surgical team to talk and communicate clearly.
Errors – There are anecdotal reports of music contributing to surgical errors if it causes distraction.
Infection control – Equipment like headphones may raise issues around sterilization and infection control standards.

Patient preferences – Music selection should suit patient tastes in case they can hear it under anesthesia.
Equipment issues – Music could interfere with or distract from equipment noises and alerts.

These potential downsides have made some surgeons reluctant to allow music in operations. A small minority of surgeons (around 10%) report they try to avoid music during surgery.

Rules around music in the OR

Most hospitals and surgical facilities now have policies around music use in the operating room. While exact rules vary, there are some common requirements:

Music volume must be kept to a reasonable ambient level.
Headphones or earbuds are usually prohibited for infection control reasons.

Lyrics, if allowed, must not be offensive or inappropriate.
Music players and speakers need to be appropriate for the OR environment.
The surgical team should have some level of control over selections.

Alert sounds from equipment must still be audible over music.

Surgeons or nurses may be designated to help select appropriate music playlists. Content is usually instrumental only or soft jazz/classical vocal selections. Sound levels are kept moderate to allow communication and audible alerts. The priority is on creating a pleasant environment rather than high-fidelity listening.

Evidence on music’s impact on surgical outcomes

A number of studies have tried to determine what effect, if any, music has on surgical outcomes and the performance of surgeons. Results have been mixed:

Some studies have found no significant improvement in surgical speed or quality when music is played.
Other studies have reported music improves performance on surgical simulation tasks, but results may not carry over to actual surgeries.
There is evidence music leads to lower stress and higher job satisfaction for surgeons, which could indirectly impact outcomes.

One study showed surgeons performed better suturing laparoscopic tasks with music they said was “relaxing.”
Another study found surgeon heart rate variability was better – indicating lower stress – when they listened to self-selected music.

Overall the evidence is currently inconclusive over whether music makes surgeons definitively perform better. More research is still needed comparing surgical outcomes with and without music across a wide range of procedures and surgeons.

Should surgeons be allowed to listen to music?

Based on the potential benefits and risks, these guidelines emerge for surgeons listening to music:

Music should be permitted when it benefits the surgical team and there are policies in place to prevent risks.
Volume levels should be moderate and controlled.

Headphones should be avoided and speakers preferred.
Sound alerts must remain audible over music.
Careful music selections are important, favoring gentler instrumental or classical genres.

Surgeons should be given significant control over music choices.
Patient preferences should be considered regarding music genre and volume.
Communication in the OR must be kept clear.

Rather than debate whether music fundamentally helps or harms, it may be wise to focus on implementing standards that maximize benefits while also minimizing risks and disruptions. Surgeons could also consider preferences of the whole OR team when making music choices. With reasonable guidelines in place, music can likely play a productive role in the operating room.

Alternatives to music for focus

If music is deemed inappropriate or too risky in a certain surgical scenario, there are alternatives that can provide similar benefits for the focus and calm of the surgical team:

Nature sounds or white noise to mask background noise distractions.

Guided meditation audio if played at very low volume.
Allow surgeons to listen to preferred playlists through one earbud to limit distraction.
Provide surgeons a choice of calm visual backgrounds or projections in the OR.

Install acoustic dampening tiles to limit equipment noise that music would otherwise mask.
Take occasional breaks from music to check it is not causing communication issues.

Finding the right balance is key – taking steps to maximize focus and relaxation while also keeping communication tight and medical sound alerts audible. While music can help set the desired ambience, there are viable alternatives to consider when music proves too disruptive or risky.

Key takeaways on music and surgery

Music has been played in operating rooms for over a century to help surgeons remain calm and focused.
Most surgeons enjoy listening to some music during procedures, but policies should prevent risks.
Evidence is mixed on whether music reliably improves measurable surgical outcomes.

Music volume and selection should be carefully controlled if played in the OR.
Alternatives like white noise can provide focus benefits if music is unsuitable.
More research is warranted on how music impacts different kinds of procedures and surgeons.

Like many aspects of surgery, music accompaniment must be evaluated on a case by case basis. Blanket policies banning OR music are hard to justify given its potential advantages. With some prudent safeguards, music can play on for surgeons seeking an extra element of comfort and focus at the operating table.

Conclusion

Music has been an operating room tradition for over a century, though practices around its use continue evolving. Most surgeons value music for the calming effects and mental focus it can provide during procedures. However, detractors point out risks like distraction and communication issues. Research on music’s direct impact on surgical outcomes remains limited and inconclusive. Sensible guidelines on music volume, content, and player equipment can allow the benefits of music while preventing problems. If risks appear too high in certain surgeries, alternatives like white noise or limited headphone use could also be reasonable substitutions. With judicious policies in place, the melody of music is likely to carry on playing a role during surgery for many operators.