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The best music for surgery - and who should be allowed to choose it

Surgeons operate better when they listen to music, and tunes can help patients relax. But to nurses, it's a nightmare. So much for working in harmony, says Sophie Morris

Sophie Morris
Thursday 20 August 2015 11:57 BST
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The first cut is the deepest: in ‘Trainwreck’ – as in real life – operations are performed with a musical backing
The first cut is the deepest: in ‘Trainwreck’ – as in real life – operations are performed with a musical backing (Universal)

You're a surgeon with one of the most sought-after jobs in surgery: a sports specialist with America's best-known basketball players on your books, including LeBron James and half of the Mets. These are powerful men with pay packets that make most Premier League football teams look like the Little League, and they've entrusted the future of their career to you. You're fresh, alert and pumped, ready to repair that cruciate ligament to face hundreds more tackles. What music do you crank up as you're pulling on your scrubs?

For Bill Hader in Trainwreck, the Judd Apatow film starring Amy Schumer which came out last week, it's Billy Joel's "Uptown Girl". Because it's his favourite song, Hader's character Aaron explains.

Loving this lame track turns out to be the surgeon's only weak point. And we should praise him instead of snarking at his taste in music, as journalist Amy Schumer does when watching him operate (after a quick vomit). After all, according to research from the University of Texas revealed last week, surgeons perform better when listening to their favourite songs.

The study looked at the performance of 15 plastic surgeons, who were asked to stitch incisions on pigs' feet (chosen for their similarity to human skin). It was found that those surgeons stitching to their favourite tunes were better and faster than those operating without music, with the procedure taking 10 per cent less time than usual for senior residents and 8 per cent less time for junior residents.

But what about everyone else in the operating theatre? If the surgeon has chosen to blast out Billy Joel, and worse, is humming along too, how can other members of the team focus, or even hear basic instructions clearly? A separate report, published earlier this month in the Journal of Advanced Nursing, found that music could be disruptive. When it was playing, nurses were five times more likely to request that surgeons – who had typically chosen the music and the volume – repeat their instructions. In some cases, dance and drum and bass were blasted out at levels that exceeded World Health Organisation regulations for noise in the workplace. The study was fairly small and researchers filmed 20 operations at two hospitals, but music was played during 16 of the 20 procedures, which suggests that it is popular across the board. Lead author Sharon-Marie Welden said the study "identified serious patient safety issues that cannot be ignored".

Which research is more important? One says that surgeons perform better with music, the second that it distracts the other surgical staff. And here's another study from last week, this one from The Lancet, which says that listening to music before and after surgery can reduce pain and anxiety in patients, and that it even has an effect on those under a general anaesthetic.

The study of 7,000 patients found that pain levels measured on a scale of one to 10 dropped by two points where music was used. It has been noted that if time was spent marketing this cheap and effective alternative to medication, a lot of money could be saved.

Mr Hazim Sadideen, a specialist registrar in plastic and reconstructive surgery at Queen Elizabeth Hospital Birmingham, speaks to me ahead of a perineal reconstruction. He explains that it's "a combined major case with our general surgical colleagues, with several handovers of care. We may listen to music at some point if there is a consensus to do so, but our focus is patient safety and optimal efficiency."

Sadideen led a study into reducing anxiety in minor operations, where patients were awake on the operating table; he found that music could reduce anxiety and recovery time in these cases. "It's very important to involve the patient," he says. "I talk to them and explain what is happening [when they are awake], and for some of them music – we used classical music in the study I led – can distract them from negative stimuli associated with surgery, towards more pleasant thoughts, especially if it is familiar music."

What remains to be seen, then, is how to reach a consensus on the type of music played during surgery, and whether people who like Billy Joel should even be allowed to attend medical school.

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