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How music lowers pain, anxiety after surgery

columns Updated: Sep 24, 2015 16:50 IST
Sanchita Sharma
Sanchita Sharma
Hindustan Times

A new study has found that while music doesn't hasten recovery or shorten the length of hospital stay, it works so well as a pain-reliever that patients needed fewer prescription painkillers to manage their post-operative pain. (Shutterstock Photo)

Listening to music before, during and after surgery lowers patients' pain and anxiety even if they are unconscious under general anaesthesia, concluded researchers after reviewing 72 studies on the effect of music on recovery after surgery. The study, which was reported in The Lancet earlier this week, found that while music didn't hasten recovery or shorten the length of hospital stay, it worked so well as a pain-reliever that patients needed fewer prescription painkillers to manage their post-operative pain.

Music also made patients more satisfied with the treatment and care they were given, compare to patients in routine care, those given headphones with no music, those unexposed to music, and those exposed to white noise. The choice of music and when it was played made no difference to the outcome, but the physical and psychological benefits maxed when patients, not doctors and other medical staff, chose the music.

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"Pre-recorded music through headphones, musical pillows, or background sound systems can be a non-invasive, safe, and inexpensive intervention compared with pharmaceuticals, and can be delivered easily and successfully in a medical setting," wrote researchers from Queen Mary University of London in the medical journal, The Lancet.

No additional cost
These benefits come at no extra costs. "Music is a simple and cheap intervention, which reduces transient discomforts for many patients undergoing surgery," Paul Glasziou from Bond University in Queensland, Australia, wrote in an accompanying commentary. "A drug with similar effects might generate substantial marketing."

Studies in the past have shown that music in the operating theatre (OT), if not too loud or distracting, enhances surgeon performance and lowers patient anxiety, more so in awake procedures when patients are aware of their surroundings. In its Christmas issue last year, The BMJ reported that 62-72% surgeries were done in OTs wafting with music, and 80% of the surgical staff said it improved communication between the team, lowered anxiety and improved efficiency by increasing task focus on the task at hand.

Critics of melody argue that music can potentially distract surgeons by taking up cognitive bandwidth and lowering alertness, but this is far from true. Music has a tremendously relaxing effect on the mind and body, and works by slowing the pulse and heart rate, lowering blood pressure and the levels of stress hormones. Since listening arrests attention, it prevents the mind from wandering and calms emotions. It helps people identify and express the feelings associated with stress.

Rehab mantra
So powerful is this effect that music therapy is increasingly being made part of rehab and the stress associated with trauma and surgery. Music therapy uses biofeedback, guided imagery, and other established techniques to treat people with stress-related disorders, post-traumatic stress and post-surgical stress. It's usually used in combination with biofeedback techniques to lowers tension as it triggers the relaxation response more effectively than verbal stimuli. This is probably because unlike verbal commands, the sound of music is processed in nonverbal areas of the brain, which makes people react it it far from spontaneously that they would to verbal instructions and stimuli.

Read: Tihar begins music therapy to fight inmates’ depression

Most surgeons in India play music in the OT while operating, with the playlist almost always being chosen by the surgeon leading the surgery. Vintage Bollywood, classical instrumental music and ghazals are the most popular genres among surgeons in India, but you occasionally also hear jazz wafting out of OTs.

One of the favourite stories narrated by a well-known cardiac surgeon in Delhi who plays Jazz is about a patient complaining he hated jazz just before slipping under anaesthesia. The surgeon immediately summoned the patient's family to borrow his playlist, which was played while his heart was being fixed. When the patient woke up to ghazals in post-recovery, the first words he uttered after a triple bypass was that it was a great coincidence that the hospital was playing his favourite songs!

Music do's and don'ts
While there are no structured studies to understand which beats move surgeons in India to do their best in the OT, The BMJ study suggests that popular numbers such as Stayin' Alive (Bee Gees), Smooth Operator (Sade), Comfortably Numb (Pink Floyd) and Wake Me Up Befor you Go-Go (Wham) do wonders for surgical morale, while the numbers best avoided are Another One Bites the Dust (Queen), Everybody Hurts (REM), and Scar Tissue (Red Hot Chilli Peppers), with researcher's suggesting the last one be banned in the OTs plastic and reconstructive surgeons.

Carrying your playlist with you if you're undergoing surgery is a win-win situation, unless of course you listen to Punk, which has the potential of outraging conservative OT staff much to your peril.