Music can soothe us, relax us, and perhaps even heal us, but surgical teams should think twice about turning up the tunes in the operating room. According to a small new study, playing music during surgery puts an extra burden on nurses trying to understand surgeons' requests and could lead to serious complications for patients.
Playing music during surgery goes back to at least 1914, when surgeon Evan O'Neill Kane reported in the Journal of the American Medical Association on "employing a phonograph in my operating-room as a means of calming and distracting my patients from the horror of the situation." These days, patients are usually already unconscious by the time the tunes are turned on, and listening to music remains a very common relaxation technique; in one survey of anesthesiologists, 72 percent reported regularly working in operating rooms that played music.
In one exchange, an anesthetist mistook the beat of the music for a patient's pulse.
Previous research has suggested music might not be such a good tool for surgery. As one review explained, noise of any kind—even the melodic stuff—can be a distraction, even a health hazard. Still, much of that research focuses on surgeons' impressions of the pros and cons of playing music, rather than music's effects on communication, mistakes, or, for that matter, the other people working in the operating room.
Hoping for something more objective, Sharon-Marie Weldon and colleagues at Imperial College London and University College London filmed 20 operations in two operating rooms in the United Kingdom. There were 69 hours of video in all, which the researchers analyzed with an eye toward repeated requests—for example, how many times a surgeon had to ask for a"scalpel please" before being handed said scalpel—and whether playing music might increase the number of those repeated requests.
While repeated requests were not particularly common overall, they did occur more often whenever the stereo was on. Of the 3,585 requests the surgeons made while music played in the background, they repeated 63 of them, or about 1.7 percent. Just six out of 1,649 requests the researchers counted in relatively quiet operating theaters—0.3 percent—had to be repeated.
Though 1.7 percent isn't a big number, a closer analysis of the videos revealed what was at stake. In one exchange, an anesthetist mistook the beat of the music for a patient's pulse and told a consulting surgeon, "whatever you're doing ... it's very painful," when, in fact, the surgeon wasn't doing anything at all. In another, a member of the surgical team turned the music up just as the surgeon and a nurse were closing up, distracting them from a count aimed to make sure they hadn't left any instruments or surgical swabs inside the patient.
"The impact of loud music on communication seems to be clear: it hinders the nurses’ ability to hear the surgeon’s speech," Weldon and her co-authors write today in the Journal of Advanced Nursing.
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