Can background music improve surgical performance and patient recovery?

For many years doctors have openly used background music to help them remain relaxed and focused during surgical procedures. 

In early December 2009 The Boston Globe published a curious article about how a highly respected surgeon in a US hospital uses background music to improve in-theatre performance. 

According to the report, Dr Claudis Conrad, senior surgical resident at Massachusetts General Hospital and an accomplished pianist, uses Bach’s preludes and fugues when performing methodical steps during routine colorectal surgery and then selects techno and rap music for more urgent surgical procedures. 

Dr Conrad is seeking to scientifically investigate how music directly affects surgeons and patients and even friends and family in the waiting room. The stated objective of Dr Conrad’s latest research was to ascertain the extent to which music can improve the results of surgery. In the future he aims to find out if music can become standard protocol. 

Surgeon in chief at Mass. General, Dr. Andrew Warshaw, explained the objectives of Dr Conrad’s latest research: “What he’s looking at is the subliminal effect that could produce a positive effect on performance. . . . If I’m in some difficult operation, maybe there is some positive effect on my physiology - not even on my conscious mood - that would translate into a better surgical performance.” 

To test the effects of background music in the operating room, Dr Conrad devised computer-simulated tasks of paroscopic procedures - surgeries that involve operating through a small incision. Eight expert surgeons were tested under three different conditions: listening to Mozart during the procedure, performing the tasks in silence, and listening to a different stream of music in each ear - German folk music and death metal.

The dual ear mix increased the time it took expert surgeons to perform the procedures but did not affect their accuracy compared to those doctors working in silence. It did however impair their ability to learn a new task and when performing that task a second time with the same music their accuracy still did not improve. When Mozart was played during the surgical procedures completion time varied but the accuracy rate improved compared to those in the silence group.

Dr Conrad subsequently tried the same test on 40 participants that hadn’t received any surgical training and found Mozart to have the same beneficial effects when the procedure was repeated.

These may be preliminary small-scale studies but they suggest music may help with learning and improving performance. Dr Conrad is currently planning follow-up studies to understand how music impacts people’s ability to learn a task.

Despite the obviously common use of music in hospitals, the subject thus far not been extensively researched.

• In 1994, a study published in the Journal of the American Medical Association reported that surgeons’ accuracy and speed when performing a taxing mathematical task improved when they played their own music rather than a piece chosen by the researchers, ‘Pachelbel’s Canon’.

• In 2006 a survey of 171 doctors and nurses at three Israeli hospitals found that more than half frequently listened to music in the operating theatre and 58 percent preferred classical music. Dr. Yehuda Ullmann, a surgeon at Rambam Health Care Campus in Israel who reported results of the survey said, “It makes you more calm. Maybe some patients will think if we hear the music, we are not so concentrated on the operation details. But it’s not in fact true."

• Dr Conrad’s latest research follows an earlier study when he investigated how music benefits patients in intensive care. In 2007, he tested the effects of music on a group of 10 critically ill patients. Half the patients listened on headphones to slow movements of Mozart piano sonatas for an hour a day and half heard no music. The trial concluded that those who patients who listened to music needed less sedation, had lower blood pressure, lower heart rate, and had reduced stress hormone levels.

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