New research shows that music reduces anxiety and pain perception during heart surgery


Music and Cardiac Surgery is a match made in Heaven!  One of the primary ways that music reduces anxiety is by synchronizing and stabilizing the heartbeat with the process of rhythmic entrainment.  Heartbeat and breathing are the two main rhythmic activities going on in a healthy body.  When a person is feeling either anxiety or pain their heartrate speeds up greatly and often becomes erratic as well.

Here’s the introduction from the study that just came out in the Netherlands yesterday in the journal “Open Heart” ( Kakar E, Billar RJ, van Rosmalen J, et al. Music intervention to relieve anxiety and pain in adults undergoing cardiac surgery: a systematic review and meta-analysis. Open Heart 2021;7:e001474.doi:10.1136/openhrt-2020-001474)


Patients undergoing cardiac surgery often have perioperative anxiety and severe postoperative pain, despite the administration of benzodiazepines and opioids. Postoperative admission to the intensive care unit (ICU) exposes them to stressors known to increase anxiety and pain, such as noise, sleeplessness, mechanical ventilation and immobility. These stressors may lead to longer hospitalisation and higher use of benzodiazepines and opioids, with their inherent risk of side effects and adverse events. Research efforts have been directed towards approaches to relieve anxiety and pain. Apart from pharmacological therapies, nonpharmacological therapies have provided promising results.

A music intervention is relatively inexpensive and an easily applicable nonpharmaceutical intervention which has no known side effects. Previous studies in mixed surgical populations have found statistically significant beneficial effects of perioperative  recorded music on patients’ anxiety, pain and neurohormonal stress response, with less consumption of intraoperative sedatives and postoperative opioids.

This is particularly interesting to Surgical Serenity Solutions because our first patient was a 75-year old female undergoing bypass surgery and valve replacement.  It was a very positive experience for her compared to other surgeries this patient had undergone, such as hip replacements, back surgery, appendectomies and many others. This patient reported that as she was going under anesthesia the music felt very comforting to her and as she woke up, hours later, hearing the same music let her know that she was awakening from surgery and was OK.

The patient reported that in the recovery area that music was even more important because the post-op patients were just separated by curtains and she could faintly hear other patients moaning and calling for the nurse.  With her headphones on, she didn’t have to worry about that and she focused on the beautiful music and seeing her family again.  Later she said “I’ll never have surgery without these headphones again!!”

Surgical Serenity Solutions is the only company that that provides pre-loaded headphones exclusively for the patient.  Many hospitals play music chosen by the doctore overhead.  That music may be good for the doctor but is often very upbeat and not at all suitable for the patient.  Our music has the tempo of the healthy resting heartbeat and has been used in surgeries of all kind.  They are also very effective with dental procedures and anything procedure that causes anxiety and fears about pain.

Hospitals can purchase a starter pack of 12 headphones at

Patients can purchase their own individual pre-loaded headphones at

The music on the heaphones plays continuously for 8 hours and headphones can be reused!


Hospitals Using Pre-loaded Headphones for Patients Having Surgery

Over-ear headphones

These headphones can be paired with our streaming surgery playlists or be pre-loaded with one of our 5 playlists.

As the research keeps rolling in on the power of music for the patient having surgery, hospitals are beginning to invest in our pre-loaded headphones for their patients.  Probably 25-30 hospitals nationwide have invested and we are pretty sure that the number will double by the end of the year and then triple by end of 2022!

For the first decade of our product’s existence, we were primarily marketing to the patients.  Many patients from all over the world ordered the headphones for their upcoming surgery and I even wrote an article for them entitled “How to Talk to Your Dr. about using Music during Surgery.”

After about 2014 we realized that hospitals and Ambulatory Surgery Centers were really our target market, so we began to focus on educating them about  the benefits that research was showing. Our first big sale came in summer of 2014 when we sold 100 headphones to a Veteran’s Hospital in Kentucky.  Then, one by one, hospitals began popping up in other states that wanted to try our pre-loaded headphones with their surgery patients. The results were always outstanding and now we also have the 5 mobile app playlists that can be used with bluetooth headphones or earbuds.

Our goal eventually is to license this music to hospitals and surgery centers around the world and let hospitals buy the bluetooth or pre-loaded headphones of their choice.  We are working on creating more playlists in more genres but for now, we have our five basic genres:  Classical, Jazz, New Age, Lullabies, and Memory Care.  To download any of these, go to  

We also have a book about Music with Surgery for patients and physicians alike.  This book informs about how music works on the mind-body to reduce anxiety and pain perception and can be purchase at

I absolutely believe that music through headphones for the patient will one day be standard procedure in every hospital on the planet.  Why not get YOUR hospital on board now? Hospitals can go to .

As always, please don’t hesitate to contact me with any questions or comments!




Surgical Serenity Jazz Playlist is Creating “Buzz”


As soon as I wrote that title, I thought “Hmmm…maybe people could misinterpret that “buzz” word.  Of course what I’m talking about is that our Jazz playlists for surgery is getting lots of acclaim.  A lady contacted me last night saying that she had begun to run a low-grade fever and was feeling puny and depressed about the Covid-19 virus.  She decided to download one of the Serenity playlists and said that she couldn’t believe how soothing and comforting it was!  I wish I had recorded the phone call because she mentioned several things like “better than Valium” and how the saxophone just carried her to a whole different place where everything was beautiful and healthy and optimistic.  This was really exciting for me to hear because the Jazz Playlist is the only one that I specifically commissioned for Surgical Serenity since Jazz is not  style that I play.  Dozens have people have told me that they really do love it and that it is a “Go-To” when anxiety hits!  To get a download of the playlist, go to

Speaking to Drs about the power of rhythmic entrainment.

The instruments in this playlist are Piano, Saxophone, String Bass, and light drums with brushes.  The musicians are all international Jazz professionals with 30+ years experience each.  No wonder it turned out so well!  But the real key to why all of playlists work so well is that ingredient of rhythmic entrainment.  An article in “Science Direct” quotes these facts about rhythmic entrainment from:

Rhythmic entrainment as a musical affect induction mechanism

Rhythmic entrainment represents an affect induction mechanism.

Rhythmic entrainment occurs on the perceptual, autonomic, motor, and social level.

The basal ganglia play a key role in the link of rhythmic entrainment and affect.

Rhythmic entrainment supposedly induces positive valence and social dispositions.


One especially important feature of metrical music is that it contains periodicities that listeners’ bodily rhythms can adapt to. Recent psychological frameworks have introduced the notion of rhythmic entrainment, among other mechanisms, as an emotion induction principle. In this review paper, we discuss rhythmic entrainment as an affect induction mechanism by differentiating four levels of entrainment in humans—perceptual, autonomic physiological, motor, and social—all of which could contribute to a subjective feeling component. We review the theoretical and empirical literature on rhythmic entrainment to music that supports the existence of these different levels of entrainment by describing the phenomena and characterizing the associated underlying brain processes. The goal of this review is to present the theoretical implications and empirical findings about rhythmic entrainment as an important principle at the basis of affect induction via music, since it rests upon the temporal dimension of music, which is a specificity of music as an affective stimulus.

So, although I certainly didn’t invent or discover rhythmic entrainment, Surgical Serenity Solutions was the first company to apply these principles to the surgical experience!  Get these playlists NOW at

Please let me know your questions or comments!



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


Which Do You Prefer?


Are you a fan of mobile apps?  I don’t know how I could get along without them!  But for surgery?? People have been suggesting to me for 5-6 years now, that we put our Surgical Serenity playlists on an app.  I was reluctant to do this because I really believe in the simple convenience of having the best music on a device that had no cords hanging down and would allow our powerful, therapeutic music to be immediately available to the patient in a simple and easy to deliver format!

BUT, time marches on, and after the 100th (at least) person mentioned it yet again, I thought “Ok, there must be something I’m missing about this but let’s give it a try!  The way I understand it, in order to use this music, it must be downloaded on your iPhone, iPad, or iPod.  Now those particular devices on known to be pretty germ-y!  Especially the iPhone!  Do we really want to be taking something like that into surgery?  But now I’m thinking that the music can also be streamed by bluetooth so that each OR can have a couple of pair of nice blue tooth headphones and a subscription to our five playlists.

I guess that there are many ways to handle this and each hospital will have to decide what works best for them.  I would love to sell just the five playlists in a digital subscription to hospitals but I’m not sure what the best way to do that might be.  And so, I am soliciting your feedback!  We are going through a beta-testing process right now and are looking for more beta-testers!  If you have a smartphone and are willing to listen to our music and give us some valuable feedback, please answer in the comments here with your email, name, and whether you have an iPhone or Android.  We’d also appreciate knowing a little bit about you, but you certainly don’t have to be a musician, a music therapy, or an anesthesiologist!

Thanks for your help and, as always, enjoy your favorite music every day!!


Another VA Hospital Adopts a Surgery with Music Program


When the VA Hospital in Louisville, KY decided to purchase 100 of our headphones and conduct a clinical study on the benefits of music with surgery, we, Surgical Serenity Solutions, were thrilled!!   At the time, we were not aware of any other Veteran’s hospitals that had a music with surgery program, but that has now changed!!

The VA Hospital in Durham, NC has started a program for music with surgery and it’s very similar to ours, but also different.  They are using iPods that are loaded with a variety of surgery playlists, connected to disposable headphones.   Their music was selected based on veterans’ preferences whereas mine is chosen specifically for it’s ability to induce rhythmic entrainment.  Both methods are good, I think, but I do like the aspect of cordless headphones that already contain the music that will be used for surgery, loaded onto headphones!

I’ll probably be talking to them about trying our our headphones later this week!  Will keep you posted!!  Meanwhile, which would YOU prefer?


The #1 Service Everyone Needs to Know about for Music in the Perioperative Period


Are you having surgery or an anxiety-provoking medical procedure, you need to know about Surgical Serenity Solutions!  Our pre-loaded, cordless headphones have been on the market since 2009 and have been successfully used from coast to coast with hundreds of different medical procedures.

The music on our pre-loaded headphones is slow, soothing, steady music that was specially chosen by a clinical musicologist…me!!  Patients have raved about what a difference this music made to them and how they didn’t need ANY valium or other anxiety medication before their procedure.

Many patients have reported that even after having general anesthesia, they were NO nausea and vomiting afterwards and that they were able to go home in the shortest possible amount of time; often just hours.

There is so much clinical research documenting the many benefits of using music during the perioperative period including:

  • Less anxiety medication
  • Less pain medication
  • Less anesthesia
  • Blocking of disturbing conversation between medical staff
  • Blocking of sounds of surgery which can include drilling, hammering and sawing!
  • Faster recovery from the procedure, the anesthesia given and the incisions

The patient can now order their own headphones directly from  Don’t wait!  Get your headphones today, even before you need them.  They are also great for dental visits and procedures.  The whole family can use them!  Just go to!


Learn about the benefits of music with surgery!

C-section Serenity Headphones

Benefits of music with surgery

The benefits of music with surgery are very great, but the majority of patients are not aware of them!  Nobody wants to have surgery and that’s a fact!!  I’ve had just a few procedures under the knife and with general anesthesia and it is not a pleasant experience. But now we know that using the right kind of music for the patient, before, during, and after the procedure can make a huge difference in how the patients feels, and even in how the procedure goes!

In the early 1990’s I was given the amazing opportunity to work at the University of Louisville’s School of Medicine, conducting clinical research on the healing powers of music.  It was such a dream job for me because I knew that music was powerful medicine in all kinds of situations, but my boss, Dr. Joel Elkes, said that the medical world now demanded empirical evidence that this was the case, and that I would be the one to gather this empirical evidence!  Jump to 1994 and I was told that I need back surgery for a bulging/ruptured disc.  By then, I know that I was going to have specially chosen music (by me!) to listen to before, during and after the procedure.  I asked my surgeon, Dr. Wayne Villanueva if I could bring in my Walkman with three difference cassette tapes to listen to, and he that if I could also bring a friend to change the tapes at each juncture, that would be fine.

In July, 1994, I arrived at an excellent hospital here in Louisville, KY for my surgery.  I had put together a tape of my my favorite slow, steady, soothing and comforting music for the entire procedure, ending when I was released from the recovery room.  A friend changed the tapes for me as I left pre-surgery, and again when I arrived back into the recovery room.  The doctors were amazed!  They said that my procedure was faster than expected and that I required not only less pain medication and anxiety medication, but I actually used less anesthesia!  I felt nothing of course, but I did really enjoy the music as I was wheeled into the operating room and the anesthesia began to take effect.  In no time, I was waking up in recovery with the awareness of where I was and what had happened, but without the usual nausea and dizziness/confusion/brain fog.

Jump to 2005 and a fabulous conference in Cancun, Mexico that I went to, sponsored by the National Speaker’s Association.  This was a conference on Product Innovation and this is when I came up with the idea for Surgical Serenity Solutions!  To have pre-programmed headphones for the surgical patient, ready to go and deliver beautiful music, specially chosen for surgery, is a gift that is truly priceless!  We now have models for the patient to buy as well as for the hospital to have on hand for the patients.  I hope you’ll get yours today!  Don’t wait til you need surgery?  People are now using them for dental visits, insomnia, long plane rides and many more options!!


Music After Surgery: PACU benefits


Music in the PACU

Have you used music after surgery in the PACU?  The surgery is over but the patient is still under anesthesia and just beginning to emerge.  The headphones are still on the patient’s head but is the music actually help the patient?  YES it is!  Based on the hundreds of people who have used the headphones, we have learned that the music can:

  • reduce nausea and vomiting
  • provide orientation to time and place, after being disoriented under anesthesia
  • allow for a faster release from the Post Anesthesia Care Unit
  • decrease perception of pain and pain med requirements
  • Help patient get back to the life before surgery was needed

Are these significant benefits?  You bet they are!  The thing about having the Surgical Serenity music playing from the moment you arrive at the hospital on the morning of surgery, is that it begins slowing down your rapid breathing (anxiety) and your rapid heartbeat (anxiety).  When you are anxious, your breathing becomes very shallow and rapid.  You feel like you might go into a “fight or flight” response.  How does the music slow down these involuntary responses?  It does it through a process called “Rhythmic Entrainment.”  This is the same phenomenon (from physics) that makes you clap your hands when you hear rhythmic music.  The process also works with slow, rhythmic music to calm you down by synchronizing your heartbeat and breathing to the pulse of the slow, rhythmic music.

healthy resting heartbeat entrains to music through headphones

Patient enjoying serene music that entrains with healthy resting heartbeat

When you go into surgery, the music helps KEEP the heart and breathing slow and steady, so you need less anesthesia during the surgery.  When this music is coming through our cordless headphones, patient doesn’t hear the surgeon’s conversation or music, which is often faster than healthy resting heartbeat.

By the time the patient gets to the recovery room, or PACU, the heartbeat and breathing remain slow and steady, but as the patient wakes up, the music helps to orient them to where they are and reminds them, in a positive way, of what just happened!  This is just a birdseye view of what happens when the patient uses our Surgical Serenity Solutions headphones during their surgery or other medical/dental procedure. To purchase these for your PACU or ASC, go to


Pre-programmed headphones will make appearance around the country


With the addition of our new “patient” model headphones, we are beginning to get calls from around the country from hospitals, pain clinics, surgery centers, and dental centers.  We’ve finally found a great headphone that is able to hold our patented and proven playlist and is quite affordable for these centers to GIVE to each patient.  That way there is absolutely no concern about spreading bacteria between patients, and patients can continue to heal after their surgery to the same music that soothed them before and during their procedure.

After spending many hours in hospital waiting rooms I’ve experienced that high level anxiety that permeates the atmosphere of most of the patients.  Just one week ago I was at a large hospitals waiting room downtown here in Louisville, KY and it was very obvious that they were understaffed and not well-prepared for the number of sick patients that crowded into every available chair.  After being called back into an examining room, the anxiety was still quite palpable and even behind the closed door, I could hear loud conversations from both nurses and patients.  There were even patieCystoscopySSSnts lying in the hallways and every interaction was quite public.

Imagine if this was you, and someone brought you a set of lightweight headphones with beautiful, calming soothing music to put on while you wait?  My family member, of course, had some because I always keep some with me for demonstrations.  It was really a huge relief for her because the noise level was so high and also  the anxiety hung heavy in the air.  Between conversation and examinations, she was actually able to sleep and tune out the noisy hallways and even the noisy nurses station.

If you are interested in getting our headphones into your local hospital or dental center, surgery center, pain center, or any medical facility, just get in touch with me through and we’ll be happy to prepare an estimate for you.  The research is there.  Calm, soothing music makes a huge difference in reducing pain and anxiety in the surgical/dental setting.


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