Music Eases the Stress of Surgery—it’s a no-brainer!

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

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

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

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

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

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

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

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

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

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

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

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

And you can’t beat the cost.

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

from “Time” Magazine, 10/23/2009

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The beginnings of a 30-day series on Music with Surgery

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Dr. Cash was brought in to the Cleveland Clinic Florida to teach surgeons and anesthesiologists about music and surgery

More and more people around the world are becoming aware of the many benefits of music during surgery.   It’s  a strange paradox because you know that music affects you powerfully and that you can easily reach for the music you love best, whether to relax you or energize you.  However, you have been told by “the professionals” that when you’re under general anesthesia that your hearing chut downs and you can’t hear anything.  And so, for decades no one thought that music during surgery made any sense.

The problem is, there are hundreds and hundreds of personal stories from patients who have been under general anesthesia waking up and realizing that they did hear conversations going on.  Patients say that they heard things that they wish they had not heard.  There is no question that when people have certain surgeries such as joint replacement surgery–hip replacements, knee replacements, shoulder replacements–there is actually hammering, drilling and sawing going on.  Who wants to hear that?

Why is music during general anesthesia a good idea?  All because of the phenomenon of rhythmic entrainment!  Scientists have known of this powerful phenomenon for hundreds of years, but apparently, no one considered that if the patient listened through headphones to music that has a slow, steady pulse and a relaxing mood, that their heartrate and breathing would entrain or synchronize with that music and keep the patient more relaxed.  When the patient is more relaxed, less anesthesia and analgesia is needed and the patient can have a safer procedure and return to work or home faster. 

There are so many other benefits as well and also there are copious benefits for regional anesthesia, local anesthesia and for many other medical procedures.  Stay tuned for this unique and ground-breaking series on the use and benefits of music during surgery!  Also, feel free to post any questions or comments you might have!

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Man plays banjo during his own brain surgery!

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Several people have sent me links to this unusual video and I wanted to share it with all of my readers and clients! This well-known country music star, Eddie Adcock, was asked to bring his banjo into surgery in order to discern how part of his brain were functioning during hs brain surgery! This is truly a rare an amazing clip! Enjoy!

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