Surgery with Music Blog Series, #17 “What do Hospital Administrators say about Our new book?”

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In the last 15 or 20 years, so much has been published in medical journals about the benefits for the patient of music during surgery.  When the patient is listening to music that incorporates rhythmic entrainment, through headphones, wonderful things begin to happen!  My colleagues in music therapy were very insistent that I offer some kind of choice in types of music to the patients.  Initially, the playlist was 50 minutes of classical piano music.  Of course I thought it was beautiful but not everyone likes classical music.  So, o.”ur second playlist was Smooth Jazz.  This was a playlist put together by jazz musicians friends of mine and it does incorporate rhythmic entrainment.  Then my friend Jonathan Goldman offered me a playlist of his beautiful New Age music that utilizes rhythmic entrainment.

Finally, I decided that the best way to disseminate all of the information about the power of music with surgery would be to write a book.  In December of 2019 I published “Having Surgery?  Using Music to reduce Anxiety and Pain Perception.”  I am doing the official “launch” of this book on January 27, Mozart’s birthday!  For a 3-day period you’ll be able to get my book for $1.99!!

Here is what a Vice-President of a hospital wrote:

preparing for surgery

Dr Cash’s book on surgery

It is rare to find a book that is as beneficial to clinicians as it is to patients and their caregivers.  Dr. Alice Cash’s Music for Surgery & Recovery: A Sound Approach to Reduced Anxiety and Faster Healing is such a work.  Laying out findings from her years of dedication to this field, Dr. Cash combines a wealth of useful advice, instructive and inspiring personal and patient stories, and perspectives on research.  The result?  A clear demonstration of how the experience of music correctly applied around the time of surgery and in other stressful situations can enhance resilience and improve both clinical outcomes and quality of life.

As head of clinical research, I worked with hospital administration for over two decades. The possibilities of music decreasing pain perception, especially in this time of the opioid crisis, and of increasing patient satisfaction, which is critically important to reimbursement, is especially exciting.

The organization of the book – moving from well-grounded practical advice for a wide variety of clinical scenarios to the history and science of music medicine to ways in which music can be integrated into medical environments – provides an engaging way both of going deeply into practice and theory and of finding needed concepts and specifics quickly and easily.  Kudos to Dr. Cash!

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Surgery with Music Blog Series, Post #16: What are your options for using headphones during your surgery?

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For almost 30 years now, I’ve been researching the benefits of the right music, through headphones,  during surgery.  What are the reasons for the patient having music during their surgery?  Here are a few of them:

  • Patient can have the ideal soothing, instrumental, rhythmic entrainment, music
  • Patient doesn’t hear the more upbeat music that surgeon has chosen
  • Patient enters into a sonic cocoon when putting on the headphones and begins to relax immediately
  • Patient doesn’t hear conversations in the OR that are sometimes upsetting to the patient

So where does the patient get these headphones?  There are two kinds of headphones available.  The first category is our pre-loaded headphones and inventory is extremely low because of their popularity!  These headphones can be found in two different models, one of which has a built-in MP3 player, and the other uses a built-in micro SD card.  Both of these headphones utilize the classical piano playlist, but any playlist can be loaded to it and we have 4 other playlists, perfectly suited for surgery (or dental procedures, medical test, or any anxiety-provoking procedure.)

Here is a picture of a patient wearing the pre-loaded headphones.  You can tell that he is perfectly comfortable and in the “sonic cocoon” that I mentioned earlier. As you can see also he is having a dental procedure.  Dental procedures are especially unpopular for most people because you never know when a nerve or sensitive area will be hit, accidentally of course.  Most people sit in the dental chair, gripping the chair tightly and just waiting for pain to hit!

 

 

Cataract Surgery with Bluetooth headphones and Surgical Serenity Lullaby playlist

Dr Cash’s cataract surgery using Bluetooth headphones and Surgical Serenity playlist

The other choice for music through headphones during surgery, would be Bluetooth headphones (or Bluetooth ear-buds) using our 5 Mobile apps in the App Store and Google Play Store.  The apps have been out for about six months and are being downloaded all over the world!  The downside as I see it, is that the Bluetooth headphones are just a tad clunky.  I decided to try them last week during my cataract surgery.  They were effective in transporting me to that “sonic cocoon,” and blocking out the conversations around me.  They also were quite comfortable, but when I look at the picture, they do look clunky.  I suppose that something that can be lived with.  Right now, some hospitals are providing Bluetooth headphones with our playlists, especially during joint replacement surgeries.  Orthopedic surgery is especially important for headphones because during the removal of the old knee, or hip, or shoulder, there is hammering, sawing, and drilling!!

Right now I am talking with several international Bluetooth headphone manufacturers about partnering with Surgical Serenity Solutions to provided a considerable discount on their Bluetooth headphones.  Stay tuned for more new on this story as I will choose the best headphone with the very best discount for our customers.

Thanks for sticking with us during the 30-day blog post series!  Please leave your comments and forward this to your friends and family!  See you tomorrow!

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Surgery with Music Blog Series, Post #15: What do doctors and other medical professionals say about this concept?

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The truth is, some doctors have been using music in the operating room for many decades.  In ancient Greece and Rome, music was a staple of the physician’s healing tools and physicians knew the healing powers of specific instruments, specific rhythms, harmonies, and modes.  But then people became “civilized” and much of the routine use of music as a healing modality slipped away.

Dr Leatherman was one of the first physicians in Louisville to use music in the operating room.

In Louisville, KY, I am aware that one Dr Kenton Leatherman used music at Norton Hospital before World War II.  Dr. Leatherman was a specialist in spine surgeries, which in the early 40’s were particularly long and laborious.  He was the first surgeon in Kentucky to treat scoliosis with metal rods.  Dr. Leatherman was in the audience in the early 1990’s when I spoke to a group of retired physicians in the Cato Society.  He told the assembled group during the Q and A period, about how he had used music at Norton Hospital to help scoliosis surgery patients, as well as himself.  Dr. Leatherman paid a lady to sit in a corner of the operating room with a record player and a stack of 78 RPM records, which she had to change every 2-3 minutes!  He told us, with a smile, about the day that the patient began waking up unexpectedly, and the music that was playing was “When the Saints Go Marching In!”  He said that they quickly clapped the ether mask over her face because she was clearly confused about whether she was still on the Earth or in Heaven!!  🙂

Of course now, things are much more sophisticated and doctors are very accustomed to having their own preferred music playing in the operating room.  Sometimes, they think that the patient will enjoy what they enjoy, but other times, they just think that the patient won’t really hear it and that it doesn’t matter anyway.  Because of that, I feel that educating medical professional about the benefits of music, through cordless headphones, during surgery is my #1 mission!  One of the first anesthesiologists to actually write an essay about this, was Dr. Thomas Mayo, an anesthesiologist in Boston.  Here is what Dr. Mayo said:

“As an anesthesiologist with an extensive background in classical music, I am a strong proponent of Dr. Cash’s headphones.                                   Rarely, if ever, in medicine is there an intervention that has repeatedly demonstrated efficacy in multiple studies                                that also carries with it virtually no risk to the patient. As a physician, I am always weighing the risks and benefits of each treatment to determine if it’s worth utilizing. Surgial Serenity Headphones are unique in that they carry immense benefits without any downside. I am always pleased to accommodate a patient’s wishes to bring music into the operating room. I would be particularly enthusiastic if they had these pre-programmed cordless headphones that would maximize the physiologic benefits through rhythmic entrainment. I recommend talking to your surgeon as soon as possible in the process, and certainly mention your desire to bring headphones in on the day of surgery to the anesthesia team. This would best be accomplished if you have a pre-op appointment with someone from anesthesia, but not everyone will have this chance. This could also happen during a pre-op phone call. Whenever it happens, try to be prepared to assuage any concerns or skepticism with the fact that these headphones, and music in general, have been and are currently being used in operating rooms across the planet, including many world-renowned medical centers.”

More and more physicians are recognizing the benefits of music in the perioperative period and I will be citing some other physicians from the USA as well as internationally as I present Week 3 of this Series on “Surgery with Music.”

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Surgery with Music Blog Series, Post #14: Why Research into Music Intervention is so important!

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In the post two weeks we’ve talked about all of the research that has been done over the past 25 years into music as a powerful intervention in surgery, as well as other areas of medicine such as chemotherapy, childbirth, behavioral health, and painful testing procedures such as MRI, CT-scan, colonscopies and biopsies.  Of course some are more painful than others and it varies from person to person, but the bottom line is that music can powerfully reduce the amount of anxiety and pain perception that the patient experiences.

Why then can’t we just tell this to patients and to physicians and have them believe it, especially since they know intuitively that this is true?  I think you probably know the answer.  Everyone wants to see the NUMBERS, which to them means, the TRUTH!  If someone did a study that carefully and scientifically measured the reactions of the patient’s body to the music that was administered, then it’s REAL.  Despite all the many possible variables, if the primary components of the studies theory are addressed, and the type of music and delivery method of the music are addressed, then the study is probably valid.

As I mentioned on the first day of this series, people in fields other than Music Therapy, tend to call their music intervention “music therapy.”  They simply don’t realize that all people who are studying the benefits of music in medicine or behavioral health are not music therapists.  Technically, music therapy can only be done with an board-certified music therapist present.  Many hospitals only employ 2 or 3 music therapists, so obviously one can’t be present at with every patient undergoing surgery, childbirth, or a colonoscopy.  In the hospitals that do employ music therapists, many patients don’t know to ask for one, or the physician doesn’t realize he has to write an order for music therapy.  So, it seems to be that there is a lot of communication and education that still has to happen!

preparing for surgery

Dr Cash’s book on surgery

Obviously, lots of research has to be done on an ongoing basis and not just in Music Therapy, but also in Surgery, Nursing, Music Medicine, and Oncology.  And it’s happening, but not in a way that informs everyone of each other’s studies!  That’s why I decided to write a book that is for the patient and the doctor, and cites lots of te best and most recent studies!  The book is called “Having Surgery?  Using Music to reduce anxiety and Pain Perception” and you can get it on Amazon right now!!  For only $9.99, you can learn all about how music affects the mind-body connection, why it’s so important to use during surgery, dental procedures, childbirth, and major medical tests and even minor procedures, such as a blood draw.

Especially as the Baby Boomers age, we are needing all kinds of hip replacements, knee replacements, bypass surgeries, not to mention dental work!  We’ve got to educate each other about aging gracefully and not sticking our heads in the sand!  That’s one of the main reasons I decided to do this blog post series, right after I’d just finished my first book!  I do hope you’ll check it out, share it with your friends, and let me know your questions and comments!  Have a great week-end!

 

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Surgery with Music Blog Series, Post #13, another cataract surgery with a different kind of music

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So, yesterday was my second cataract surgery, this time on the left eye.  Overall, it’s been a relatively minor and pain=free experience, but because I had the multi=focal lens implanted afterwards I think it was a little more complicated than if they were JUST removing the cataract.  The good news is that I have no pain at all in the left eye, but the bad news is, I still need to use my reading glasses for sure.  Without them, things seem fuzzy and a little bit faint.  But, it’s only been one day and they are telling me that all vision, far, near and arm’s length will continue to improve for awhile.

I’m really not a fan of surgery, but if you really need it for whatever reason, I think you should probably have it.  But I am not one that will be getting cosmetic surgery just to look younger or have some far removed!  I know that surgery carries quite a few risks with it and that’s why I had the idea to add music to the procedure in a meaningful way that would truly make a different.

When I started reading about the phenomenon of rhythmic entrainment back in 1991 or so, I thought that this was an amazingly powerful process that was already going on in the universe and even in the human body, so why could we not harness this power to make surgery a safer and more tolerable procedure.  The first thing I did was to bounce this idea off of my music therapy colleagues as well as doctors and nurses that I knew were interested and knowledgeable.  They all said something like” I don’t know why that woudn’t work?  And I don’t know why someone didn’t think of this long ago!”

The fact is that people have been using music in the operating room (and the dental operatory) for decades, but that music was usually played so that doctor and patient could both hear it.  My idea was that doctor and patient each needed different music because patient needed to be calmed down and doctor needed to be focused and energized!  It took me until 2005 to come up with the idea of pre-programmed, cordless headphones with the ideal music on them but once I did, it really took off!

Anyway, what music did I use yesterday?  Well, now that I have my 5 mobile apps for surgery, people have the option to bring their own Bluetooth headphones and choose once of our apps.  I’ve used the pre-loaded headphones quite a few times for various procedures, so I decided to bring my Bluetooth headphones and use my Lullaby app.  I found it to be wonderful!  Of course I was listening to myself playing a beautiful Steinway grand in a recording studio here, but it brought back wonderful memories and I was pretty “blissed out” by the time I was wheeled into surgery.  As you can see, the headphones are considerably large than our programmed headphones, but it didn’t seem to matter.  As they had promised, the surgery was over in about 20 minutes and then before I knew it I was back home, resting comfortably  and so happy to have this cataract journey behind me!

If you want to hear a sample of the Lullaby playlist, simply go to Our Mobile Apps for Surgery, and you can hear a sample of each of the 5 playlists!  See you tomorrow!

 

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Surgery with Music Series, Post #12: Research in the field of Music and Dentistry

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Music and Dentistry, what a great idea!  The first time I ever stood before a crowd of investors and entrepreneurs and described what I had just gotten a patent on, then-president of the Venture Club of Louisville, Robert Brown, Esq, immediately went to the microphone and said “you should introduce this idea to dentists!  No one likes going to the dentist.”  Of course I had thought of that, but this has been proven out time and again here in Louisville, as well as around the world.  Here’s the problem with people going to the dentist:  When you visit a dentist you are put on your back in a very vulnerable position.  A man or woman that you don’t know is within inches of your face and sometimes leaning again your arm or other body part.  This alone can be traumatizing for some.  When a woman, especially, has suffered abuse of a physical or sexual nature, the thought of being in this vulnerable position, and then suffering dental pain on top of that, is unbearable.  For this reason, many women and men avoid going to the dentist and, as a result, their teeth get into a terrible condition and their suffering is simply postponed.

Education around this topic is critically important, but another way that dental professionals can help is to offer soothing music through cordless headphones to their patients.  We now have three options:  two different pre-loaded headphone models, OR Bluetooth headphones, belonging to patient or dentist, and one of our well-researched playlists in 5 different genres!  To see these choices, go to Bluetooth Headphones with Digital Playlists

One of the big issues, whether in dental or medical fields, is the opioid crisis.  See the article below to read an excellent article about the power of music and of Surgical Serenity Solutions in dentistry.  One of the interesting points that this article mentions is the fact that Dentistry was an early adapter of what they called “Audio Analgesia” in the 1950’s.

 

              “Audio-analgesia”

Professional interest in the use of audio-analgesia first appeared in the Journal of the American Dental Association in October 1961. In August 2015, the Lancet published a systematic review of more than 4,200 articles, including 73 controlled trials, that concluded: “Music could be offered to help patients reduce pain and anxiety during the postoperative period. Music is a noninvasive, safe, and inexpensive intervention that can be delivered easily and successfully in a hospital setting. We believe that sufficient research has been done to show that music should be available to all patients undergoing operative procedures.”1

Dental Economics Magazine 

Surgical Serenity Solutions has also created a Kit for Research Studies or for clinical practice that includes 12 Pre-loaded headphones, a bag of 50-pair of disposable headphones covers, includes shipping and handling for $1750.00.  If you’re interested in getting a price for your dental school or dental practice, email me at DrCash@SurgicalSerenitySolutions.com.

To download our surgical playlists to your smartphone, prior to surgery, simply go to www.SurgicalSerenitySolutions.com/calm.

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Surgery with Music Series: Post #11 Spotlight on Music Therapy Researcher, Deforia Lane

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One of the first music therapists that I ever met was a lady named Deforia Lane. Deforia had just taken her PhD dissertation defense and she was feeling very relieved.  This was mid-1990 and I had just met my soon-to-be mentor, Arthur Harvey, DMA.  Arthur was presenting a workshop in Cleveland and invited me to go with him to see how he presents.  Deforia joined us at the very end of the workshop and I could tell that she was extremely passionate about music therapy and about music therapy research.  Her PhD dissertation had to do with testing salivary iGA (immuno-globulin, in patients that had just had a music therapy session.  I believe that her research showed that the music therapy session did increase the amount of salivary iGA, which means it does boost the immune system.

This was almost 30 years ago and since then, Dr Deforia Lane has conducted many ground-breaking studies on different aspects of music therapy.  One of her most recent stories has to do with music therapy before surgery with women diagnosed with breast cancer.  Listen to her talk about how this study played out: (video starts with one of Dr Lane’s colleagues singing the patients favorite song, before she is taken into surgery.)

I have met with Deforia Lane many times as of 2020, and have found her to be a dynamic speaker, an approachable researcher, and a compassionate clinician.  One of my favorite videos of her working with children  here

In addition to her research and clinical work, Dr Lane is a much-in-demand speaker who has done numerous Ted Talks around the country.   I’ll leave you with one final video of one of my heroes, Deforia Lane:

I hope you’ve enjoyed this blog post and will leave me some comments and questions!

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Surgery and Music Blog Series, Post #10: A look at the Meta-analysis of 100’s of Studies

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You may have heard of a meta-analysis.  It’s when scientists and researchers looks at hundreds of studies that have been done on a specific issues, or even just an aspect of that issue.  For example, researchers have looked at hundreds of studies that were done on Surgery with Music, one looking at anxiety reduction, and another looking at a reduction in pain perception.  Then they distill the most important imformation from the study and publish it.

In 2015, the prestigious British Medical Journal, “The Lancet” published an important meta-analysis:

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)60169-6/fulltext

This publication garnered so much attention world-side, that I got at least a dozen notifications that this study had come out around the world.  The final summary states,

Summary

Background

Music is a non-invasive, safe, and inexpensive intervention that can be delivered easily and successfully. We did a systematic review and meta-analysis to assess whether music improves recovery after surgical procedures.

Methods

We included randomised controlled trials (RCTs) of adult patients undergoing surgical procedures, excluding those involving the central nervous system or head and neck, published in any language. We included RCTs in which any form of music initiated before, during, or after surgery was compared with standard care or other non-drug interventions. We searched MEDLINE, Embase, CINAHL, and Cochrane Central. We did meta-analysis with RevMan (version 5.2), with standardised mean differences (SMD) and random-effects models, and used Stata (version 12) for meta-regression. This study is registered with PROSPERO, number CRD42013005220.

Findings

We identified 4261 titles and abstracts, and included 73 RCTs in the systematic review, with size varying between 20 and 458 participants. Choice of music, timing, and duration varied. Comparators included routine care, headphones with no music, white noise, and undisturbed bed rest. Music reduced postoperative pain (SMD −0·77 [95% CI −0·99 to −0·56]), anxiety (−0·68 [–0·95 to −0·41]), and analgesia use (−0·37 [–0·54 to −0·20]), and increased patient satisfaction (1·09 [0·51 to 1·68]), but length of stay did not differ (SMD −0·11 [–0·35 to 0·12]). Subgroup analyses showed that choice of music and timing of delivery made little difference to outcomes. Meta-regression identified no causes of heterogeneity in eight variables assessed. Music was effective even when patients were under general anaesthetic.

Interpretation

Music could be offered as a way to help patients reduce pain and anxiety during the postoperative period. Timing and delivery can be adapted to individual clinical settings and medical teams.
Excited journalists from the around the world contacted me to make sure that I knew about this.  This was a huge moment for Surgical Serenity Solutions because of major validation from this meta-analysis.
Shortly after this publication, NPR did a piece on this study and how important it was in the time of the opioid crisis.  Listen to it here:
If you’re interested in knowing more about some of the many meta-analyses that have been done on Surgery with Music, simple Google the topic and read the many clinical topics.  The NPR page goes on to say:

DAVID GREENE, HOST:

There is a free and powerful treatment hospitals could probably be using more often to treat patients who have surgery. It’s music. Scores of studies have looked at the power of music to ease this kind of pain. NPR’s Richard Harris reports on new research that pulls many of these findings together.

RICHARD HARRIS, BYLINE: When researchers in London started combing through the medical literature for studies about music’s healing powers, they found hundreds of small studies suggesting some benefit. The idea goes back to the days of Florence Nightingale. And music was used to sooth surgical pain as early as 1914. Dr. Catherine Meads at Brunel University focused her attention on 73 rigorous, randomized clinical trials about the role of music among surgery patients.

CATHERINE MEADS: As the studies themselves were small, they didn’t really find all that much. But once we put them all together, we had much more power to find whether music worked or not.

HARRIS: She and her colleagues now report in The Lancet that, yes indeed, surgery patients who listen to music, either before, during or after surgery, were better off.

MEADS: Reduced pain and less anxiety and better patient satisfaction.

HARRIS: Remarkably, patients listening to music used significantly less pain medication. Meads says music on average helped them to drop two notches on the 0-to-10 pain scale. That’s often what you’d get with a dose of medicine. Music in place of heavy-duty pharmaceuticals is a good trade-off. And we’re not just talking Mozart or Yanni. Music in many of these studies was whatever patients chose for themselves.

(SOUNDBITE OF MUSIC)

MEADS: I didn’t think it mattered at all which sort of music it was. It could be anything from Spanish guitar to Chinese classical music.

HARRIS: Was there any downside?

MEADS: Doesn’t seem to have any sort of side effects or anything like that.

HARRIS: Well, maybe one. A few other studies have noted that operating rooms are very noisy places, and added music can make it harder for the surgical staff to hear what’s going on. Doctors sometimes have to repeat their commands, creating opportunities for misunderstanding.

MEADS: If surgeons are listening to music, it can be a bit of a distraction. So it may be it’s not such a wise idea to have it during the operation itself.

HARRIS: That was not, however, something Meads analyzed in her study of music and medicine. Richard Harris, NPR News.

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Surgery with Music Series, Post #9: Clinical Research on the Surgical Serenity Headphones and Therapeutic Music

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Scientists and music therapists have been conducting research on Music with Surgery for a long time.  Most of these studies are looking for specific information like whether or not there is a reduction in anxiety or pain perception.  These two things in particular have been studies with all kinds of surgeries.  Most recently there have been many studies on joint replacements, breast cancer surgeries, and diagnostic tests such as colonoscopies and endoscopies.

One of the questions that I am asked a lot is whether or not there has been a clinical study on the Surgical Serenity Solutions headphones and music.  I am very happy to report that there has been a study, conducted here at the V.A. Hospital.  The study looked at men between the ages of 18-72 who were having major abdominal surgery.  The study was conducted by Dr. MarinaVarbanova, an anesthesiologist there at the VA hospital.

In conversation with Dr Varbanova, I asked her about whether the subjects were all OK with classical piano miniatures since we know that not everyone likes classical music.  She explained that she told the subjects that this music was the best music to engage rhythmic entrainment, which would affect their anxiety and pain perception.  Only one subject decided to withdraw from the study because he only wanted country music.  At the conclusion of the study, results indicated a 20% reduction in anxiety and pain perception.  We were really thrilled with this result.  In a period of history where opioid addiction is killing thousands of people, the reality that music through headphones can be used to soothe and calm patients is truly exciting!

I am attaching to this blog post both the published study and the Powerpoint presentation that was given to staff at the VA Hospital.

Our SSS study

V.A. Hospital in Louisville, KY

 

Surg Serenity VA Hospital Pt. Evaluation

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Surgery with Music Series, Post #8: Research in Surgery with Music: where does it come from?

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There are literally hundreds of studies on the use of music with surgery.  These studies date back more than 50 years, but I’d say that the bulk of them have been done in the past 25 years.  The come from the fields of medicine, surgery, neurosurgery, nursing, psychiatry, music therapy, music medicine, and holistic medicine.  There have been many meta-analyses done (after the fact, of course) on numerous different aspects of music and surgery studies.

Many of these studies refer to “music therapy and surgery” when really it is music medicine and surgery.  Many people think that music therapy and music medicine are synonymous but they really are quite different.  In order for music therapy to be done, a Board-certified music therapist must be present.  The music therapist must be present with the patient when the intervention is done and form a therapeutic relationship with the patient, learning a little bit about what kind of music the patient likes and understanding a little about their emotional state.

In the field of music medicine, the music is the intervention and can be implemented without a music therapist being present.  In the case of the Surgical Serenity Solutions, the music has been chosen and sequenced over a period of many years before I had the idea to put this music on cordless, programmable headphones.  Instead of a music therapist, I am a musicologist, a clinical social worker, and a concert pianist.  I’ve had a very unusual career path, but it put me in the perfect condition to do the very work that I am doing today.

Since I’ve mostly been talking about cataract surgery this past week, I thought I would focus on a research study about Music with Cataract Surgery.

Music for the eyes: Music helps before surgery

Date:
May 27, 2016
Source:
ESA (European Society of Anaesthesiology)
Summary:
Having relaxing music played just before eye surgery leads to patients feeling less anxiety and requiring less sedation, concludes a new study.

Having relaxing music played just before eye surgery leads to patients feeling less anxiety and requiring less sedation, concludes a study presented at Euroanaesthesia 2016 (London, 27-30 May). The study is by Dr Gilles Guerrier, Cochin University Hospital, Paris, France, and colleagues.

Awake eye surgery is particularly stressful for patients. Music has long been known to reduce anxiety, minimise the need for sedatives, and make patients feel more at ease. The purpose of this pilot study was to evaluate the effect of music on anxiety in outpatients undergoing elective eye surgery under topical (local) anaesthesia.

A total of 62 patients were prospectively and randomly assigned to hear relaxing music or no music through headphones for around 15 minutes just before cataracts surgery, which also lasted an average 15 minutes (all patients had the same type of surgery to make the results comparable).

The music played was specifically composed to ease anxiety following strict criteria, including instrumental pieces only using a decreasing tempo and a progressive decrease in the number of instruments playing. Each patient was able to choose from a panel of 16 recorded music styles according to their own preferences, and listened through high quality headphones. There were various styles available, including jazz, flamenco, Cuban, classical and piano. The music was provided by MUSIC CARE, a Paris-based company that produces music aimed at preventing and managing pain, anxiety and depression.

Due to the massive use of disinfectant and other liquids during surgery, headphones would have been rapidly damaged if used during the actual procedure. However, there is evidence that music-induced relaxation lasts around 60 minutes after the music has stopped.

A surgical fear questionnaire (SFQ) was used to assess anxiety before and after a music session. Overall postoperative patient satisfaction was assessed using a standardised questionnaire. The proportion of patients receiving the sedative midazolam during surgery was also recorded.

The researchers found that significant differences were noted between groups in anxiety VAS after music session, with anxiety significantly reduced among the music group (score 23 out of 100) compared to the non-music group (score 65 out of 100). The music group also received significantly less sedatives during surgery compared with the non-music group (16% vs 32%). Postoperative satisfaction was significantly higher in the music group (mean score 71 out of 100 versus 55 for the non-music group).

Dr Guerrier says: “Music listening may be considered as an inexpensive, non-invasive, non-pharmacological method to reduce anxiety for patients undergoing elective eye surgery under local anaesthesia.”

He adds: “The objective is to provide music to all patients before eye surgery. We intend to assess the procedure in other type of surgeries, including orthopaedics where regional anaesthesia is common. Moreover, post-operative pain may be reduced by decreasing pre-operative anxiety, which is another study we intend to perform.”

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