Two Major Hospitals Now Recommend Music with Surgery

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In the past two months, both the Mayo Clinic in Minnesota and the Cleveland Clinic in Ohio have come out advocating music!  The Mayo Clinic said:

“Research on the effectiveness of music therapy dates back to the 1920s, when a study reported individuals’ blood pressure dropped when listening to music. Currently, our program is conducting a research study to measure the effects of music therapy on pain, anxiety and tension. As part of the Cardiovascular Surgery Healing Enhancement Program, rooms for cardiac surgery patients have music systems. A selection of CD music is available at each cardiac surgical unit. “

The Cleveland Clinic said:

“Research on music and the brain has shown that it can reduce stress, alleviate pain and promote relaxation. And new research from the Cleveland Clinic shows that music can even reach into deep brain structures unrelated to hearing and memory to literally soothe nerves.

Patients receiving deep-brain-stimulation surgery for Parkinson’s disease, essential tremor and several other conditions have to be awake for much of the surgery to tell surgeons if their symptoms improve when electrodes are placed deep in their brains.

All of this is very exciting news to me as I am hoping to make my surgical headphones standard in hospitals around the world.  Right now I am selling them online at http://www.surgicalheadphones.com/, but I hope eventually to sell them to hospitals so that they can give them to all surgical patients.  Stay tuned!  The big launch will be in 2010!

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Cleveland Clinic researchers find music can have a soothing effect during brain surgery

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Cleveland Clinic researchers find music can have a soothing effect during brain surgery
By Brie Zeltner, The Plain Dealer

December 01, 2009, 12:01AM

Lynn Ischay, The Plain DealerDr. Damir Janigro, left, a neuroscientist at the Cleveland Clinic, found that melodic passages of music seemed to calm patients when played while they remainied conscious during deep brain stimulation. With Janigro, in this picture from 2007, is Italian cellist Umberto Clerici. They are holding the 1769 Guadagnini cello that belonged to Janigro’s father, the great Italian cellist Antonio Janigro, which Clerici has on loan.

If you’ve ever come home after a long day and turned on, say, Brahms to relax, or jacked up the volume on Queen’s “We Are the Champions” to get psyched for a workout, you know that music can change your mood.

Research on music and the brain has shown that it can reduce stress, alleviate pain and promote relaxation. And new research from the Cleveland Clinic shows that music can even reach into deep brain structures unrelated to hearing and memory to literally soothe nerves.

Patients receiving deep-brain-stimulation surgery for Parkinson’s disease, essential tremor and several other conditions have to be awake for much of the surgery to tell surgeons if their symptoms improve when electrodes are placed deep in their brains.

“I witnessed several hundred brain surgeries with awake patients, and I noticed that these patients were going through a very traumatic experience, much worse than a root canal, for hours, and yet they were wide awake. So they need to be conscious, but no one said that they have to be upset or bored.”

Damir Janigro, Cleveland Clinic neuroscientist

Neuroscientist Damir Janigro took advantage of this conscious period to play clips of music for the patients to see what effect it had on their brain function and on their stress levels during the surgery, which can be many hours long.

Janigro decided to play music for these patients after his own experience in a noisy operating room this year. While being prepped for spinal surgery, he thought of how dentists often give patients headphones to listen to music or a TV to watch to ease anxiety.

“The reason why they do it — I asked my dentist — is because

[the procedure is] easier, and you go home faster,” Janigro said.

Janigro presented his findings Oct. 30 at the Music and the Brain symposium in New York. Janigro is one of many specialists who work in the Clinic’s Arts and Medicine Institute, which is studying how the arts can be used to enhance healing.

Dirk Hoch, 52, of Delphi, Ind., agreed to participate in the music study without hesitation. Hoch is a former postal worker who had to retire in 2005 due to essential tremor, a neurological condition that causes involuntary shaking, particularly evident during voluntary movements like holding a fork.

During the April surgery, Hoch listened to different music clips and told Janigro how he felt.

Like all the other participants, about a dozen in this initial study, Hoch preferred the melodic music clips to the others. Janigro also offered purely rhythmic music and a clip that combined rhythmic and melodic music.

To eliminate the possibility of any emotional associations with the music related to memory, Janigro had Gregory Bonanno of the Cleveland Institute of Music compose the clips.

Hoch said the music was a welcome distraction from the pain of the halo-like metal clamp that held his head in place during the surgery.

“You were at ease and at peace with the surroundings, which, given the circumstances, is something,” he said. “I mean, after all, they’re drilling holes in your head and inserting electrodes. It just really made a huge difference.”

Janigro and his team could see that difference at work in Hoch’s brain.

When he and the other patients listened to the rhythmic music or the clip that was both rhythmic and melodic, the overactive firing in their subthalamic and thalamic neurons didn’t change. These are the areas of the brain that control the surface cortex and are particularly important in movement.

During the melodic music clips, the firing in these areas slowed down, and Hoch and the other patients felt calmer.

It wasn’t exactly what Janigro expected.

“It’s strange because these are motor sensors, so you would expect that boom, boom, boom would have more of an effect — the rhythmic music.”

The next step for Janigro and his colleagues will be to find out if melodic music in the operating room has any effect on stress measures, like the amount of the stress hormone cortisol circulating in the blood or the amount of blood-pressure medication needed during the procedure.

Ultimately, Janigro hopes the musical intervention will mean patients heal faster.

“I bet you that they will go home sooner,” he said. “That’s the goal, really. Happy people don’t stay in the hospital.”

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Music during Surgery: What the experts say

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“We trust that the magic of sound, scientifically applied, will contribute in ever greater measure to the relief of human suffering, to a higher development and a richer integration of the human personality, to the harmonious synthesis of all human “notes” of all “group chords and melodies” – until there will be the greater symphony of the One Humanity.”

Roberto Assagioli M.D.
 
 

Music can be employed as assistance in obtaining physical, emotional and spiritual health. During the first half of the nineties, I investigated the therapeutic consequences of distinct types of music on patients under adequate anaesthesia. This investigation was done in Johannesburg at the Garden City Clinic, over a period of four years (1991-1995), with statistics done at the Witwatersrand university, by dr. Jackie Galpin.

Data available on investigations done to test the therapeutic benefits of music, would fill a library of its own. That was not what was done. The effect of music with a known therapeutic value, was investigated on patients under adequate anaesthesia – testing for reduction in pain levels and a shorter recovery period. It is an accepted dictum in psychology that people in a deep sleep, coma or under anaesthesia can hear (not remember). That the auditory pathways up to the auditory cortex actually remain open and untouched by anaesthesia. That you can talk to people in a coma or undergoing surgery, and that the body would respond to whatever was said. In many hospitals, positive suggestions are given to patients in a coma and on the operating table. The capital aim of the project was to test music to serve as a credible alternative for the positive verbal suggestions.

Music has powerful effects on people, whether they are educated in music or not. Wertheim (1961) states that “muscle perception and performance is an inborn capacity of the human brain. This ability is common among human beings and is independent of education or culture…..” This makes the application of music as a therapy, or music as an aid to any other therapy, very simple.

Science, Medicine and Anthropology have completed many years of investigation on the effect of music on the physical body. As early as 1830, articles were published by J. Dogiel, which outlined experiments done to affirm music’s dynamic effect on the body. Absolute physiological reactions were established, and amongst other things, it was proved that music act on the circulation of blood, and can cause blood pressure to rise and fall. According to this, these alternations of pressure rely mainly on the influence which auditory stimulation has on the medulla oblongata and the auditory nerve.

During the first half of the previous century, many investigators throughout Europe agreed that music increases metabolism in a very adequate way, and that it changes muscular energy and enhances respiration.

The positive effects of music on physical and psychological health are truly widespread. In an article on music as cause of disease and healing agent, Assagioli (1965) states that “through its influence upon the subconscious, music can have a still more definite and specific healing effect of a psychoanalytic character. If of an appropriate kind, it can help in eliminating repression and resistance and bring into the field of waking consciousness many drives, emotions and complexes which were creating difficulties in the subconscious”.

It is known that certain kinds of music have the ability to reduce pain, whether it is physical or emotional. Scarantino (1987) states that “Pythagoras of Samos taught his students that certain musical sequences, chords and melodies produced definite responses in the human organism, and could change behaviour patterns that accelerated healing processes”

In a further discussion Scarantino states “In the 1970’s, Bulgarian researchers, under the direction of Dr. Georgi Lazanov, discovered a holistic approach to learning, that allows the body and mind to work in harmony through the linking of music and verbal suggestions…. While listening to largo movements from works of Baroque era composers, with tempos slower than the average heartbeat (sixty beats per minute or slower), the vital signs of test subjects slows down in rhythm with the music, relaxing them physically but leaving their minds alert for the assimilation of information. When the various educational data was presented to the students while the music played in the background, the students experienced significant increases in awareness and retention of information and a whole repertoire of health benefits, including relief from pain and headaches…..”

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Pediatric Anesthesia: New Research Results

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Very interesting study done using music with pediatric surgery patients.

School-aged children’s experiences of postoperative music medicine on pain, distress, and anxiety
STEFAN NILSSON RN, MSC*†, EVA KOKINSKY MD, PhD*, ULRICA NILSSON RNA, PhD‡, BIRGITTA SIDENVALL RN, PhD† AND KARIN ENSKÄR RN, PhD†

*Department of Paediatric Anaesthesia and Intensive Care Unit, The Queen Silvia Children’s Hospital, Sahlgrenska University Hospital, Göteborg , †Department of Nursing Science, School of Health Sciences, Jönköping University, Jönköping and ‡Department of Anaesthesiology and Intensive Care and Centre for Health Care Sciences, Örebro University Hospital, Örebro, Sweden

Correspondence to Stefan Nilsson, Department of Paediatric Anaesthesia and Intensive Care Unit, The Queen Silvia Children’s Hospital, Sahlgrenska University Hospital, 416 85 Göteborg, Sweden (email: stefan.r.nilsson@vgregion.se).

ABSTRACT
Aim: To test whether postoperative music listening reduces morphine consumption and influence pain, distress, and anxiety after day surgery and to describe the experience of postoperative music listening in school-aged children who had undergone day surgery.

Background: Music medicine has been proposed to reduce distress, anxiety, and pain. There has been no other study that evaluates effects of music medicine (MusiCure®) in children after minor surgery.

Methods: Numbers of participants who required analgesics, individual doses, objective pain scores (Face, Legs, Activity, Cry, Consolability

[FLACC]), vital signs, and administration of anti-emetics were documented during postoperative recovery stay. Self-reported pain (Coloured Analogue Scale [CAS]), distress (Facial Affective Scale [FAS]), and anxiety (short State-Trait Anxiety Inventory [STAI]) were recorded before and after surgery. In conjunction with the completed intervention semi-structured qualitative interviews were conducted.

Results: Data were recorded from 80 children aged 7–16. Forty participants were randomized to music medicine and another 40 participants to a control group. We found evidence that children in the music group received less morphine in the postoperative care unit, 1/40 compared to 9/40 in the control group. Children’s individual FAS scores were reduced but no other significant differences between the two groups concerning FAS, CAS, FLACC, short STAI, and vital signs were shown. Children experienced the music as ‘calming and relaxing.’

Conclusions: Music medicine reduced the requirement of morphine and decreased the distress after minor surgery but did not else influence the postoperative care.

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Music Before Surgery Proven Effective

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Yet another medical research study has come out documenting that listening to calm, relaxing music before surgery can calm the patient better than powerful midazolam. Time to order those pre-surgery headphones: www.surgicalheadphones.com.

Introduction: Patients who await surgery often suffer from fear and anxiety, which can be prevented by anxiolytic drugs. Relaxing music may be an alternative treatment with fewer adverse effects. This randomised clinical trial compared pre-operative midazolam with relaxing music.

Method: Three hundred and seventy-two patients scheduled for elective surgery were randomised to receive pre-operative prevention of anxiety by 0.05–0.1 mg/kg of midazolam orally or by relaxing music. The main outcome measure was the State Trait Anxiety Inventory (STAI X-1), which was completed by the patients just before and after the intervention.

Results: Of the 177 patients who completed the music protocol, the mean and (standard deviation) STAI-state anxiety scores were 34 (8) before and 30 (7) after the intervention. The corresponding scores for the 150 patients in the midazolam group were 36 (8) before and 34 (7) after the intervention. The decline in the STAI-state anxiety score was significantly greater in the music group compared with the midazolam group (P<0.001, 95% confidence interval range ?3.8 to ?1.8). Conclusion: Relaxing music decreases the level of anxiety in a pre-operative setting to a greater extent than orally administrated midazolam. Higher effectiveness and absence of apparent adverse effects makes pre-operative relaxing music a useful alternative to midazolam for pre-medication. Relaxing music as pre-medication before surgery: a randomised controlled trial H. BRINGMAN 1 , K. GIESECKE 2,3 , A. THÖRNE 1,3 and S. BRINGMAN 1,3 1 Department of Surgery, 2 Department of Anaesthesia, Södertälje Hospital, SE-152 86 Södertälje, Sweden and 3 Department of Clinical Science, Intervention and Technology Karolinska Institutet, Karolinska University Hospital, Huddinge, SE-141 86 Stockholm, Sweden Correspondence to Address: Sven Bringman Department of Surgery Södertälje Hospital SE-152 86 Södertälje Sweden e-mail: sven.bringman@ki.se This paper was presented as an oral presentation at the Swedish Surgical Week, Umeå, August 2008.

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Can the surgical patient hear under anesthesia?

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One of the most frequent questions I get is “can a surgical patient really hear when they are under general anesthesia?” The answer is an unequivocal “yes.” Patients awaken from surgery every day reporting that they remember conversations that they heard under anesthesia and they frequently report that they heard O.R. sounds related to drilling, hammering and sawing. The actions take place during joint replacements and other such surgeries.

One of the benefits of having soothing music through headphones during surgery is that they block these kinds of noises out, in addition to entraining the heartbeat and breathing with surgery, thus necessitating less anesthesia.

If you or someone you now is having surgery, you must go to www.surgicalserenity.com and order the surgical serenity headphones. Call or email me with any questions!

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