Do Surgeons Actually Play Music During Surgery? The Surprising Harmony in the Operating Room

According to a 2017 survey by Spotify and Figure 1, nearly 90% of surgeons play music in the operating room, showing that the question, "Do surgeons actually play music during surgery?" is met with a resounding yes. This long-standing practice is a fixture in modern healthcare, though the reasons and consequences are more complex than many realize.

Quick Summary

Music is a common fixture in operating rooms, used to reduce staff stress, improve concentration, and enhance teamwork. Studies show it can positively affect surgical performance, though volume and genre must be managed carefully.

Key Points

• Common Practice: Many surgeons listen to music during operations, with some surveys indicating nearly 90% of them do.

• Boosts Focus and Mood: Music can help reduce stress, increase concentration, and improve morale among the entire surgical team.

• Benefits Patient Relaxation: For patients undergoing local anesthesia, music can reduce anxiety and pain perception, potentially decreasing the need for sedatives.

• Risk of Miscommunication: Excessive volume or inappropriate genre can hinder communication, potentially prolonging surgery and increasing staff frustration.

• Shared Decision: The best practice is for the entire OR team to agree on the music choice, volume, and when to turn it off, treating it like a variable that needs careful management.

• Genre Variation: Musical preferences are diverse, with rock, pop, and classical being popular choices, but the specific emotional effect is highly individual.

The Rationale Behind the Rhythm: Why Music is Played

The practice of playing music in the operating room has a long history, dating back to 1914 when a surgeon first used a gramophone to help calm patients. Today, the motivations are multi-faceted and rooted in the physiological and psychological effects of sound on both patients and the medical team. Music can act as a tool to manage stress, improve focus, and enhance communication—but only when used thoughtfully.

Boosting Surgeon and Staff Morale

One of the most immediate and widely cited benefits of playing music in the OR is its positive effect on the surgical team's morale. The high-stakes, stressful environment of surgery can take a significant toll on medical professionals. Background music offers a low-cost, effective way to mitigate this stress. Research indicates that music helps relax staff and elevates their mood, which can foster a more harmonious and supportive atmosphere.

Improving Focus and Performance

For many surgeons, the right music can aid concentration by helping them enter a state of "flow," a term for intense focus and immersion in a task. Studies on simulated surgeries have shown that listening to preferred music can improve surgical performance, including increased speed and accuracy in certain tasks. This effect is often genre-dependent and highly personalized, as individuals react differently to various types of music.

Calming the Patient

While many procedures occur under general anesthesia, music still benefits patients undergoing local anesthesia or in pre-operative and recovery stages. Calming melodies have been shown to reduce a patient's anxiety and pain perception, sometimes more effectively than standard anti-anxiety medication. This reduces overall stress and contributes to a more positive surgical experience.

Masking Operating Room Noise

The OR is a noisy place, filled with the beeping of monitors and the clang of instruments. These sounds can be distracting and anxiety-inducing for staff and conscious patients alike. Music can help mask this "white noise," providing a more consistent and predictable auditory environment. By filling the soundscape with a familiar melody, surgeons can better filter out less important sounds, helping them maintain their focus on the task at hand.

What Kind of Music is on the OR Playlist?

Surgeons' musical tastes vary widely, with popular genres often reflecting individual preferences and regional trends. What one surgeon finds calming, another may find distracting. A 2017 survey conducted by Spotify and Figure 1 revealed a diverse musical landscape in operating rooms around the world.

• Rock: A favorite among nearly half of surveyed surgeons, rock music provides a high-energy backdrop for demanding procedures. Surgeons reported that rock from their youth creates a calm and focused environment by invoking nostalgia.
• Pop: Pop music is another highly popular choice, with its upbeat tone and easy-to-listen-to nature helping to keep the OR team energetic.
• Classical: Often played at a low-to-medium volume, classical music is favored for its relaxing and stimulating effects, which can improve accuracy and speed.
• Jazz: Preferred by some surgeons, genres like smooth and Latin jazz are also common choices.
• Hip-hop and EDM: Faster-paced, rhythmic music is sometimes chosen to maintain a high energy level and has shown beneficial effects in robotic surgery training scenarios.

Weighing the Risks: The Potential Downsides

While music can offer many benefits, its use in the operating room is not without risks. The primary concern is the potential for distraction and impaired communication, which could compromise patient safety.

Impaired Communication

Studies have shown a correlation between playing music and an increase in communication errors. One analysis of 20 surgeries found that surgeons were five times more likely to have to repeat a request when music was playing. This miscommunication not only adds to the operative time but can also increase stress and frustration among the staff. This is particularly true with loud music, which can literally mask critical speech.

Genre and Volume Distraction

The wrong musical choice or improper volume can disrupt the delicate balance of the OR. Certain genres, particularly loud or high-beat music, have been noted to have a negative or distracting effect. Furthermore, music disliked by any team member, such as the anesthetist or nurses, can be a major source of distraction.

Potential Safety Concerns

Some research has even linked excessive noise levels in the operating room (which can include loud music) to an increased risk of surgical-site infections (SSI), possibly by acting as a surrogate marker for a stressful or chaotic environment. While the music itself isn't the direct cause, it can be part of a larger picture of noise pollution that negatively impacts the surgical team's performance. In critical situations, the music should be turned off to allow for complete concentration and clear communication.

Finding the Right Balance: A Comparison

Aspect	Music in OR	Silence in OR
Staff Mood	Can improve morale, reduce stress, and elevate mood, contributing to a better team atmosphere.	May feel more tense or monotonous to some staff, potentially increasing perceived stress levels.
Surgical Focus	Can enhance concentration by aiding entry into a state of flow and masking other environmental noise.	May be beneficial for individuals who prefer a quiet environment for intense concentration.
Patient Anxiety	Can significantly reduce anxiety and pain perception for awake patients, requiring less medication.	Offers no anxiolytic or analgesic benefit for the patient, relying entirely on medication.
Communication	Risks hindering audibility and requiring repeated requests, potentially adding operative time and increasing team frustration.	Ensures maximal clarity for verbal instructions and communication, reducing the risk of misinterpretation.
Arousal Level	Can be fine-tuned to keep arousal at an optimal level for performance; volume and genre selection are key.	May lead to lower arousal and potential fatigue during long or routine procedures.

The Future of Music in Surgery

Recent systematic reviews underscore that the beneficial effects of music often outweigh the negative ones, but only when used appropriately. The key is finding the right balance. Medical teams are increasingly aware of the need for a shared decision-making process regarding music, including genre and volume. Some experts now view music in the OR like a drug, requiring careful consideration of the "dosing" to maximize positive effects while mitigating risks. As research continues to refine this understanding, the role of music will likely become even more strategic in enhancing the operating room environment.

Conclusion

In short, the answer to whether surgeons actually play music during surgery is a definite yes, and it is a practice with deep roots and a growing body of scientific evidence. Music can be a powerful tool for reducing stress, improving focus, and calming patients and staff alike. However, the benefits are not universal and depend heavily on careful management of volume, genre, and the team's preferences. When the soundtrack is chosen with care and consideration for all team members, music serves as a unique element of healthcare that promotes a more relaxed and focused environment for everyone involved, contributing to better patient outcomes. For more insight on this topic, a systematic review on the influence of music on surgical performance can be found at ScienceDirect.

Frequently Asked Questions

Is it distracting for a surgeon to listen to music during surgery?

While it might seem distracting, many experienced surgeons report that music actually enhances their concentration and helps them enter a state of 'flow,' allowing them to tune out other less important background noise. However, studies suggest that loud or unfamiliar music can indeed be a distraction, particularly for novice surgeons or other team members.

What genres of music are most common in the operating room?

A 2017 survey involving hundreds of surgeons found that popular genres include rock, pop, and classical music. Some surgeons also favor jazz or R&B, while others prefer more rhythmic genres like hip-hop or EDM to maintain a high energy level.

Do patients get to choose the music during their surgery?

If the patient is awake during the procedure, such as under local anesthesia, they often get the first choice of music. If the patient has no preference or is under general anesthesia, the choice typically defaults to the surgical team.

Can music improve surgical performance?

Yes, some studies indicate music can improve aspects of surgical performance. Research has shown that listening to preferred music can increase the speed and quality of tasks like wound closure, particularly for more experienced surgeons.

Does music in the OR have any effect on patient safety?

The research on this is mixed, but loud music can potentially compromise safety by impairing communication among the surgical team. It's crucial for the team to manage the volume and genre to ensure critical information can be heard clearly at all times.

Has music always been used during surgery?

The use of music in surgery dates back over a century. In 1914, surgeon Evan O'Neill Kane began playing music on a gramophone to calm his patients, a practice that became more common later in the 20th century.

How is the music controlled in the operating room?

The choice and control of music typically rest with the surgeon, though it is increasingly seen as a shared decision among the entire surgical team. In critical moments, the music is usually turned down or off to ensure complete focus.