Classical music could become a routine part of surgery, after a study found it   helped to relax patients under local anaesthetic.

Surgeons believe playing a little knife music might benefit patients so much   that they recover sooner from their operations.

“This small scale work is the first time an attempt has been made to   measure the impact music has in this specific group of patients and hints at the need for bigger multi-centre research to establish whether this should become part of standard practice.”

In the study, published in the journal Annals of the Royal College of   Surgeons, 96 patients undergoing minor surgery were randomly assigned   either music or silence. All were awake during their procedures, which   included routine removal of skin lesions and cleansing of upper limb wounds after accidents.

The half played music reported lower anxiety levels and lower breathing rates than the others.

The medics did not evaluate whether Beethoven was better for patients than Bach.

Having surgery is a dangerous thing, but sometimes not having surgery is more dangerous.  If you’ve been told that you need to have surgery, there are certain risks you will want to be aware of:

Anesthesia reactions:

Most problems that arise during surgery are the result of the surgery, not the sedation for the procedure. While uncommon, there are very serious complications that can occur if a patient has a reaction to the anesthesia drugs.

Most problems associated with anesthesia are related to the process of intubation, or inserting the breathing tube.  Aspiration, or breathing food or fluid into the lungs, can be a problem, during surgery. Some patients also experience an increased heart rate or elevated blood pressure during the process.

The problem of anesthesia awareness has been discussed a great deal in the media, but waking during surgery or being awake throughout the surgery, is a very rare when anesthesia is provided by an anesthesiologist or a certified registered nurse anesthetist (CRNA).

Malignant hyperthermia, a reaction to anesthesia that causes the patient’s temperature to rise rapidly, is life threatening.  A patient who has had malignant hyperthermia in the past has a significant increase in risk and should discuss the issue with their surgeon and anesthesia provider. (information can be found on http://surgery.about.com/od/beforesurgery/a/RisksSurgery.htm)

How can music help?  When patients have begun relaxing before their procedure with slow, familiar, favorite   music, it is only natural that their bodies and muscles are not as tense and therefore the patient can be put to sleep more easily and with less anesthesia.  When the music is continued, through cordless headphones, througout the surgery, the patient’s body stays relaxed and music with a steady, slow pulse, synchronizes the heartrate and breathing.   Again, because the body is staying relaxed with the slow, steady music, less anesthesia is needed and the patient wakes up soon, still listening to the music through headphones, and requires less pain medication.

Several studies are in process right now, around the U.S. and doctors, hospitals, and patients are quite excited about the possibilities of a safer and a kinder procedure.  The headphones that I have programmed with the ideal music for surgery are available now and can be overnighted to you if you need them quickly.  If you have financial constraints, let me know and I will work with you to be able to get them.  One day, music and headphones will be available in hospitals around the world.  Don’t wait!

 I would say that this is a moderately controversial subject.  Here’s why:  if the patient and surgeon are both going to benefit from music being played in the operating room, then the music will have to be delivered ambiently to the doctor and through headphones to the patient.  Why?  Because the surgeon needs to hear more lively and energizing music, while the patient needs to hear calming and soothing music that will keep them relaxed and keep their blood pressure, heartrate and breathing slow and steady.

Luckily, this is quite possible!  Less than a year ago I was invited to do a Grand Rounds presentationat the Cleveland Clinic Florida on the use of music as an adjunct to anesthesia.  Most of the studies we looked at talked about music in the OR being played through speakers on the wall or an iPod being played through speakers.  Although this usually benefits the OR staff, it does nothing for the well-being of the patient and completely disregards the concept of rhythmic entrainment.

The more recent studies look at the benefits of patients listening to their own favorite music through headphones.  Now this has been taken a step further:  wireless, cordless headphones are now available, pre-programmed with the ideal, slow, steady, soothing music that has been proven to slow down and keep steady the heartbeat and breathing.  Rhythmic entrainment is a phenomenon that has been acknowledged for over three hundred years!  It is this phenomenon that causes us to clap our hands, snap our fingers, or get up and dance spontaneously when favorite music comes on!  The reverse is also true, therefore, when a patient arrives at the hospital to have surgery, popping on some cordless headphones, pre-programmed with calm, slow, steady and soothing music, is an ideal way to begin the sedation process.  Oftentimes, less medication will be required as a direct result of this musical intervention.

If surgery is in your future, please consider your alternatives.  Feel free to contact me directly if I can help you!

 For as long as humans have pounded drums and plucked strings, listening to music has affected people’s sense of well-being, lifting their spirits and — as new research shows — calming their nerves. Literally. According to a study at Cleveland Clinic, music can slow the neuronal firings deep within the brain during surgery designed to treat Parkinson’s patients.

The seeds of this study were planted about two years ago, when a patient named Damir Janigro was being prepped for spinal surgery. Janigro, who is also a neuroscientist at the clinic, lay captive to the nerve-racking din of the operating room and in his frazzled state thought about how dentists often give their patients earphones to help ease anxiety. (See the top 10 medical breakthroughs of 2008.)

If people getting root canals merited a musical intervention, he thought, why not people undergoing brain surgery? Patients with conditions such as epilepsy, brain tumors, severe depression, and obsessive-compulsive and motor disorders like Parkinson’s have to be awake for surgical procedures that often take several hours. Janigro and his team decided to use that wakeful period to determine whether music made the subjects’ experience in the operating room less stressful.

He will present his findings on Oct. 30 as part of a symposium in New York City on music and the brain. The son of a world-renowned cellist, Janigro specializes in studying epilepsy and is associated with Cleveland Clinic’s Arts and Medicine Institute, which is working to advance our understanding of how music can do such things as help decrease pain and blood pressure and improve movement in Parkinson’s patients.

The medical community has long been interested in how the brain is affected by music. Historically, however, most research was linked to the cortex, the brain’s outer layer, which is associated with functions like memory, consciousness and abstract thought.

In those studies, neurosurgical patients, wide awake with their cortex exposed, listened to certain sounds and music. While their neural activity was being recorded, they told researchers how those selections made them feel.

Janigro wanted to perform similar studies on motor centers deep within the brain. Because music is often associated with movement — like tapping one’s feet — he theorized that music could be used to modify the activity of thalamic and subthalamic neurons, which are located in the same area where a neuronal pacemaker is implanted during deep-brain stimulation.

In Janigro’s study, more than a dozen neurosurgical patients, predominantly with Parkinson’s, listened to three musical selections — rhythmic music with no discernible melody (by Gyorgi Ligeti, of Stanley Kubrick–movie fame), melodic music with undefined rhythm (by Aaron Jay Kernis, a Pulitzer Prize winner) and something in between (Ludwig van Beethoven). In the later stages of the research, to prevent familiarity from swaying the subjects’ responses, music was specifically composed for the study by students from the Cleveland Institute of Music.

In the end, patients almost unanimously said the purely melodic offerings were the most soothing. But the recordings of their brain activity were eye-opening. (Read “The Year in Medicine 2008: From A to Z.”)

Listening to melodic music decreased the activity of individual neurons in the deep brain, says Janigro, adding that the physical responses to the calming music ranged from patients’ closing their eyes to falling asleep. Some patients even settled into a nice round of snoring. And when lead neurosurgeon Ali Rezai needed patients to perform an action, such as lifting a limb, during the procedures, he simply removed their earphones and relayed instructions. Once the music resumed, patients returned to their snoozing.

These are very desirable results, says Janigro. With the right music, he says, patients can be more relaxed in the operating room. And that relaxation may mean not only that procedures involve less medication — to control blood pressure, which increases with stress — but perhaps that patients have quicker recovery times and shorter hospital stays.

Janigro anticipates that following institutional approval, music will be used during certain neurosurgical procedures at the clinic as early as 2010. He hopes other hospitals will soon follow Cleveland’s lead. “This type of surgery can be a traumatizing experience, and using music can decrease anxiety,” he notes.

And you can’t beat the cost.

With health-care expenditures through the roof, this patient benefit is practically free, says Janigro, who used his own iPod and that of a colleague’s to pump in the music for the study. “The clinic doesn’t have a budget for iPods yet, but soon I think we will. It’s a no-brainer,” he says. “There’s nothing more calming than sleep.”

from “Time” Magazine, 10/23/2009

 This is a question that I get more and more these days.  As people around the country and around the world, find out about our ready-to-go, pre-programmed surgical headphones, they want to know that the research is there and that nationally-known, reputable hospitals are already using them.

Well, good news!  They are already being used at the Mayo Clinic in Minnesota and the Cleveland Clinic in both Ohio and Florida.  Individuals have purchased them and used them here in Louisville, KY at Baptist Hospital East, Jewish Hospital and Norton Hospital downtown as well as Norton Suburban Hospital.  They’ve been used at hospitals in New York City, Greenville, S.C., Spartanburg, S.C., Birmingham, AL, Houston, TX, San Francisco, CA and in Canada, Hawaii and London.

Several patients were afraid that they would not be able to wear them into surgery, but only two people nationwide were told that they could not take them into surgery.  These patients both concluded simply that it had not been done before and that the surgeon or anesthesiologist did not want to try it.  No medical or safety precaution could be cited.

To date, all patients who actually used the music before, during, and after their surgery have reported that they will never have surgery again without using their headphones and music.  Patients have said that they drift off to sleep feeling as though they’re at the beach, listening to favorite music through headphones and totally forget that they’re in a hospital about to have surgery.  Needless to say, when patients are not tensed up and rigid with fear and anticipation, the procedure goes better:  less anxiety meds, less anesthesia, less pain medicaltion = faster and safer procedure and recovery!  Who could argue with that?

Many people do not understand the difference between music medicine and music therapy.  To me, it’s not a big deal, but to some people it is a huge deal.  My mentor, Dr. Arthur Harvey, explained it to me like this:  in order to conduct a music therapy session, a music therapist must be present.  It is the therapeutic relationship between the music therapist “doing” music with the patient that creates the result.  Music therapy is what worked miracles with Gaby Giffords.  Music therapy is a wonderful, fantastic modality with many situations, especially situations needing rehabilitation.

This is not true with music medicine.  The use of music during surgery is an example of music medicine.  In this situation, the music, as chosen by a clinical musicologist for its unique properties and suitability for pre-surgery, surgery, and recovery works all by itself.  When played for the patient through wireless, lightweight headphones, well-documented benefits result!  The surgery suite needs a surgeon, an anesthesiologist and several nurses and surgery techs.  They do not need one extra person!

This may not sound earth-shaking to you, but in a litigious society, and a hospital community that is terrified of lawsuits and staph infections, the surgery headphones provide a lot of comfort and benefits for both patient and doctor.   The anesthesiologist gets the patient to sleep more easily because the patient is already relaxed by music.  The patients wake up faster and with fewer complications, because they required less anesthesia.  In recovery, they require less pain medication because the soothing music and the entrainment phenomenon have kept the patient relaxed and therefore they experience less pain.

We have two clinical trials in progress right now and are working with hospitals around the country to get our headphones into their operating rooms for all patients.  If you or a friend or a family member is having surgery, please be sure that they have the information about music and surgery!

  When people contact me about helping them use music during surgery, my first    recommendation is always the pre-programmed, cordless headphones I have created.  When I first had the idea to create cordless, pre-programmed headphones, back in 2005, the term “wireless” was not nearly as associated with “wireless network” as it is now. 

 My intention was to have headphones that were entirely “self-contained” and not dependent on being tethered to an iPod or any other transmittal device.  I just figured that it would be one less thing for surgeons and anesthesiologists to worry about getting tangled up with their equipment!

I called them “wireless” at that time, but now I think it is important to confirm that they are indeed “cordless” but are not what today we call “wireless.”  This is quite an important differentiation too, because transmitting a signal in the OR would involve FCC communication and just throw another stumbling block up to people and hospitals that are contemplating using them in the OR. 

Please let me know what your questions might be!  We certainly are hearing from hundreds of satisfied customers around the world about their effectiveness in calming the patient before surgery, and reassuring them when they wake up in surgery with beautiful music still playing!

Right now the trial of Dr. Conrad Murray is in progress in Los Angeles.  It seems that Propofol has been used in surgery for about 35 years now and has been used safely.  Of course, Propofol (diprivan) was never intended to put people to sleep; people who suffer from insomnia and are at home.  Propofol is en extremely effect agent for inducing anesthesia and temporary amnesia.  Because of its milky appearance and its usefulness in the operating room, it is sometimes called “Milk of Amnesia.”  Tragically, Dr. Murray is now being accused of involuntary manslaughter because he illegally gave Michael Jackson Propofol in his home, because Jackson had severe insomnia.  Apparently, Murray had been doing this for sometime but did not know enough about the whole process to prevent this from happening.

Can music through headphones be used to affect the amount of Propofol required by the patient?  A study was done back on 2005, which I now present to you:

Effects of music on target-controlled infusion of propofol requirements during combined spinal-epidural anaesthesia.