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


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


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


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

May 27, 2016
ESA (European Society of Anaesthesiology)
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.”


Surgical Serenity Blog Series, Post #7: Looking back on how music helped me navigate my cataract surgery


I’m hoping that you’ll excuse me for not doing a video every day with my blog post as I said that I would.  After having cataract surgery on Wednesday morning, I’m just not looking as bright and perky as I’d like to and so I’ll just use some still photos that others are taking to help me follow this process.  Yesterday was the first day post-op and I felt pretty good although a little tired from all of the Versed that they gave me.  Thinking about the music through the two different headphones that I used, I know that I would have been waayyy more anxious without it.  I could feel my breathing particularly, relax and slow down when I would put the headphones on.  I actually used both types of pre-loaded headphones at different points during the surgery, but decided on the “patient model” to wear into the cataract procedure.  The reason was just the simplicity of turning it off and on and they volume was already adjusted perfectly for me.

About 4 years ago, I had taken a friend for cataract surgery at this very same SurgeCenter and had to do much more explanation of what the headphones were about and that they had been specifically created for surgery to lower anxiety and pain perception.  This time, I didn’t have to explain anything to anyone.  On the contrary, they were asking me questions about how I like them, where I got them, and if other hospitals and doctors in Louisville were also using them!!  When I explained that Drs around the world are using not only the headphones but also the surgery playlists with Bluetooth headphones.  So yesterday for the first cataract surgery was a big success and a way for me to benefits for the healing power of music, get my vision sharpened up again, and tell people around the world about not only the two models of headphones, but also our five mobile apps,, and our new ebook on surgery:

preparing for surgery

Dr Cash’s book on surgery is available in the Kindle bookstore on Amazon for $9.99.  It will soon be available in hard copy on Amazon, as well!


Surgery Music Series: Day #6 Cataract Surgery with Music


I couldn’t post this yesterday because I was having eye surgery but I did document the procedure throughout the day and here are the pics!  This was the first time I’ve had surgery in about 26 years and my first time to use the Surgical Serenity Solutions headphones during surgery.  The procedure was cataract surgery on the right eye with replacement with a multi-focal lens.  It was supposed to be a very simple procedure, but as I said in the Day 5 blog post and video, just the thought of not being able to respond while someone works on my eye with a scalpel, was a little bit terrifying, so I knew that I needed the soothing serenity music in addition to their Versed.

When I first got there yesterday morning, it was still dark and cold outside, so here I am in the lobby of the Surge Center:  Shortly  after  this  photo,  they  summoned  me  to go  back  and  be  prepped  for  surgery.  The  very  kind  and  patient  pre-surgery  nurse  helped  me  out  of  my  clothes  and  into  my gown,  asked  me  lots  of  questions  and  then  I put  on  my  headphones  and  started  relaxing  to  the  beautiful  music.

After waiting for what seemed like an eternity and still being wide-awake, I thought I would make a little video for you:  Here is the brief video that I made, and almost immediately after this I was wheeled into surgery;


The cataract surgery didn’t take more than 20 minutes, if that.  From the moment it was over, I didn’t remember a thing about it even though I was not given a general anesthesia.  I was given the drug Versed which makes you very relaxed and makes you not remember anything.  I know that the music was playing the entire time and the team was able to do their work quickly and accurately.



I spent most of the rest of yesterday sleeping comfortably.  Here’s is the documentation of that.  The  staff  at  the  surgery  center  were  all  fascinated  by  the  headphones  and  wanted  to  know  all  about  their  history  and  where  they  could  purchase  them.  I’ll  continue  more  about  this  tomorrow.



Surgical Serenity Day 2 of our Blog Series: Why Use Music during Surgery?


The use of music during surgery is becoming more and more popular around the world. And that’s for one, important reason: it works!  Physicians and healers have known for literally thousands of years that the soothing sounds and rhythms of music can calm the human body and mind.  They have known that different instruments and voices can all produce their own kinds of healing and soothing music. The possibilities are literally endless.

So what does music do specifically during surgery?  You probably know that there are many rhythms going on in our body at any one time and when our body is calm, relaxed and healthy, those rhythms are very steady and regular.  When

you’re anxious, as most people are before surgery, rhythms such as heart rate and breathing, tend to be more rapid.  When your breathing is rapid, it’s usually also shallow and that means that your blood is not getting as much oxygen and your muscles are probably more tense.  The same is true with a rapidly beating heart.

When you listen to music, through headphones, that is calming and soothing for YOU, your heart rate and breathing tend to synchronize with the music, through a process called rhythmic entrainment.  When you are calm and relaxed going into surgery, your anxiety level goes down, your muscles release excess tension and it generally takes much less medication and anesthesia to get you ready for your procedure.

It doesn’t even matter if you’re have general anesthesia, regional, or local anesthesia, have your preferred type of music, through headphones, will make the procedure go more smoothly!  We offer 5 different playlists for surgery that can be downloaded from the App Store at, as well as a new book about Surgery with Music that is available in the Kindle Store! The title is “Having Surgery?  Using Music to decrease Anxiety and Pain Perception” and is $9.99.

See you tomorrow!


Welcome to Surgical Serenity Solutions 2020 Blog Series!


Are you hungry for information about Music and Surgery?  Have you heard tidbits here and there about music’s power to greatly improve surgical outcomes, but just not sure how to implement the idea?  Have you had some negative surgical experiences in the past and are very anxious about going through it again for fear of a repeat?

If any of these are true, then this is going to be a great month for you to cozy up by the fireplace with your laptop, iPad or iPhone, and learn a little more each day about the many, many benefits of adding music to your surgical procedure, how to acquire the very best playlists, what constitutes the very best playlists, what the scientific research says about the importance of music with surgery, what Drs and other health professionals say about music and surgery, what patients have to say about how music improved their surgical experience, and how to get the right headphones for yourself!

Because I believe so strongly in this idea, I agreed to take a challenge that one of my fellow bloggers issued to do a blog post a day for the entire month of January on a topic near and dear to our hearts!  And I’m going to sweeten the deal by adding a video version of the blog post to each day’s offering.  I hope that you will find this helpful and that you will forward this valuable information to family and friends around the globe!

I’ve now spoken to audiences on this topic all over the continental United States as well as audiences in Hawaii, Canada, England, France, Germany, Italy, South Korea, Mexico, and coming soon…Norway!!!  Here is my tentative schedule:

January 1-7:   Overview of importance and benefits of music during surgery

January 8-15:  Characteristics of the ideal music for surgery, finding this music online, choosing the best headphones for YOU!

January 16-23:  What the medical and music therapy research says about this concept

January 24-31:  What physicians, nurses, and patients report about their experiences using music with surgery!

Anytime this month that you have a question, please post it here on this blog and I will address it immediately!  You can also post it on the Surgical Serenity Solutions Facebook page!



Alice Cash, PhD, LCSW

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