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Feb Feb 28, 2012

Can the surgeon and patient benefit from the same music?

By |February 28, 2012|Characteristics of music for surgery, Common Fears in Surgery, Dangers and Side-effects of anesthesia, How music works|1 Comment

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 I would say that this is a moderately controversial subject.  Here’s why:  if the patient and surgeon are both going to benefit from music being played in the operating room, then the music will have to be delivered ambiently to the doctor and through headphones to the patient.  Why?  Because the surgeon needs to hear more lively and energizing music, while the patient needs to hear calming and soothing music that will keep them relaxed and keep their blood pressure, heartrate and breathing slow and steady.

Luckily, this is quite possible!  Less than a year ago I was invited to do a Grand Rounds presentationat the Cleveland Clinic Florida on the use of music as an adjunct to anesthesia.  Most of the studies we looked at talked about music in the OR being played through speakers on the wall or an iPod being played through speakers.  Although this usually benefits the OR staff, it does nothing for the well-being of the patient and completely disregards the concept of rhythmic entrainment.

The more recent studies look at the benefits of patients listening to their own favorite music through headphones.  Now this has been taken a step further:  wireless, cordless headphones are now available, pre-programmed with the ideal, slow, steady, soothing music that has been proven to slow down and keep steady the heartbeat and breathing.  Rhythmic entrainment is a phenomenon that has been acknowledged for over three hundred years!  It is this phenomenon that causes us to clap our hands, snap our fingers, or get up and dance spontaneously when favorite music comes on!  The reverse is also true, therefore, when a patient arrives at the hospital to have surgery, popping on some cordless headphones, pre-programmed with calm, slow, steady and soothing music, is an ideal way to begin the sedation process.  Oftentimes, less medication will be required as a direct result of this musical intervention.

If surgery is in your future, please consider your alternatives.  Feel free to contact me directly if I can help you!

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Feb Feb 17, 2012

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

By |February 17, 2012|Music and Anesthesia, Music in the hospital, Music in the hospitals, Music with Brain Surgery|0 Comments

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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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Jan Jan 16, 2012

Which hospitals in the U.S. are using the Surgical Serenity Headphones?

By |January 16, 2012|Anesthesia, Common Fears in Surgery, Dangers and Side-effects of anesthesia, Music and Anesthesia, Music in the hospital, Music in the hospitals, which hospitals use music headphones|1 Comment

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 This is a question that I get more and more these days.  As people around the country and around the world, find out about our ready-to-go, pre-programmed surgical headphones, they want to know that the research is there and that nationally-known, reputable hospitals are already using them.

 

Well, good news!  They are already being used at the Mayo Clinic in Minnesota and the Cleveland Clinic in both Ohio and Florida.  Individuals have purchased them and used them here in Louisville, KY at Baptist Hospital East, Jewish Hospital and Norton Hospital downtown as well as Norton Suburban Hospital.  They’ve been used at hospitals in New York City, Greenville, S.C., Spartanburg, S.C., Birmingham, AL, Houston, TX, San Francisco, CA and in Canada, Hawaii and London.

Several patients were afraid that they would not be able to wear them into surgery, but only two people nationwide were told that they could not take them into surgery.  These patients both concluded simply that it had not been done before and that the surgeon or anesthesiologist did not want to try it.  No medical or safety precaution could be cited.

To date, all patients who actually used the music before, during, and after their surgery have reported that they will never have surgery again without using their headphones and music.  Patients have said that they drift off to sleep feeling as though they’re at the beach, listening to favorite music through headphones and totally forget that they’re in a hospital about to have surgery.  Needless to say, when patients are not tensed up and rigid with fear and anticipation, the procedure goes better:  less anxiety meds, less anesthesia, less pain medicaltion = faster and safer procedure and recovery!  Who could argue with that?

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Jan Jan 15, 2012

Fear of Anesthesia: How Can the Right Music Help?

By |January 15, 2012|Common Fears in Surgery, Dangers and Side-effects of anesthesia, Headphones for other medical procedures, Music and Anesthesia, Music and Propofol, Music in the hospitals, Rhythmic entrainment, Surgical Headphones reviews|1 Comment

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Waiting for a Ceasarean-section childbirth

  As a therapist and a clinical musicologist, I talk to people nearly every day that have just been told that they need to have surgery and are almost more fearful of the anesthesia than they are of having surgery!  Why?  Because general anesthesia is very powerful medication and occasionally people do not survive the anesthesia.  The vast majority of people do fine, but if the patient is elderly or in a fragile health state already, it is a delicate balance.

How can music help?  Music therapy and Operating Room nursing journals have shown repeatedly shown that listening to your favorite calming, comforting, soothing music can make a very positive difference in your overall surgical experience.  There are also dozens, if not hundreds, of clinical studies showing that music in the recovery area can help the patient stay calm and comfortable as they regain consciousness and begin to feel the pain of the surgery.
Now, studies are being conducted to confirm that music DURING surgery can also make a positive difference and possibly decrease the amount of anesthesia needed to achieve the same degree of sedation, but without as much risk.  This is achieved by tapping into the power of rhythmic entrainment, by which the slow, steady tempo of the music brings the heartrate and the breathing into synchronization with the music and thereby keeps the body relaxed.
To learn more about the incredible power and benefits of music during anesthesia and surgery, please check out:  www.SurgicalHeadphones.com.
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Dec Dec 26, 2011

Anesthesia and the baby born on Christmas

By |December 26, 2011|delivery|0 Comments

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Newborn Baby at Christmas

 All over the world today, Christmas babies were born.  Having a baby on Christmas day is indeed a special thing and these babies have got to feel special for their entire lives.  Earlier today, I was talking with my son-in-law who is an anesthesia resident at a large hospital in Boston.  I asked him how many of the Moms that gave birth today used music during their procedure and was surprised to hear that not many of them did!?

Of course, he pointed out that he was only present for C-sections and those are very different from vaginal delivery births where the mom has gone into labor on her own and hopefully,  planned her childbirth experience very intentionally.
Over the years, Moms and doctors have told me of babies born on Christmas to the strains of “For Unto Us a Child is Born,”  “O Holy Night,” and other appropriate Christmas birthing music!  The fact is, music during labor can do lots of wonderful things, from calming, comforting and distracting the Mom between contractions, to actually keep labor moving along with a consistent, persistant rhythmic beat.  I’ve always thought that Ravel’s “Bolero” during labor would be quite enjoyable and helpful!
If you or a loved one had a baby at Christmas, please share your experience with me!
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Dec Dec 1, 2011

Music and Surgery: Music Medicine or Music Therapy?

By |December 1, 2011|Anesthesia, Characteristics of music for surgery, Common Fears in Surgery, Music in the hospital, Rhythmic entrainment, Surgery Music|1 Comment

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Music Medicine or Music Therapy

Many people use the terms “music medicine” and “music therapy” interchangeably.  To me, it’s not a big deal, but to some people, it is a huge deal.  My mentor, Dr. Arthur Harvey, explained it to me like this:  in order to conduct a music therapy session, a music therapist must be present.  It is the therapeutic relationship between the music therapist “doing” music with the patient that creates the result.  Music therapy is what worked miracles with Gaby Giffords.  Music therapy is a wonderful, fantastic modality for many situations, especially situations needing rehabilitation.

This is not true with music medicine.  The use of music during surgery is an example of music medicine.  In this situation, the music, as chosen by a clinical musicologist for its unique properties and suitability for pre-surgery, surgery, and recovery works all by itself.

How does Music Medicine help during surgery?

Patient awakening from surgery using the surgical serenity headphones

When played for the patient through wireless, lightweight headphones, well-documented benefits result!  The surgery suite needs a surgeon, an anesthesiologist and several nurses and surgery techs.  They do not need one extra person!

Not only is it about having one more person in the operating room, but most hospitals only have 3-4 music therapists on staff during any given shift and those wonderful music therapists are working with cancer patients, children with cerebral palsy and other disease, or possibly in the hospice setting. Sending a music therapist to the surgery suite almost never happens.

Surgical Serenity Solutions is hoping to change that!

This may not sound earth-shaking to you, but in a litigious society, and a hospital community that is terrified of lawsuits and staph infections, the surgery headphones provide a lot of comfort and benefits for both patient and doctor.   The anesthesiologist gets the patient to sleep more easily because the patient is already relaxed by music.  The patients wake up faster and with fewer complications, because they required less anesthesia.  In recovery, they require less pain medication because the soothing music and the entrainment phenomenon have kept the patient relaxed and therefore they experience less pain.

How can I get these headphones for myself or my hospital?

Nurses and Music

Nurses are using music in the ICU more than ever before.

We have our pre-loaded headphones in hospitals around the world right now and are working with new hospitals to get our headphones into their operating rooms for all patients.  If you or a friend or a family member is having surgery, please be sure that they have the information about music and surgery!

To purchase our pre-loaded headphones, go to https://www.surgicalserenitysolutions.com/patient-headphones

To purchase our pre-loaded headphones for your hospital or surgery center, go to www.surgicalserenitysolutsion.com/hospitalheadphones

To hear samples of our five therapeutic playlists, in five different genres, go to www.surgicalserenitysolutions.com/calm

Here’s to your successful surgery, whether as patient or physician!

 

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Oct Oct 9, 2011

Surgical Serenity Headphones: Wireless or Cordless?

By |October 9, 2011|Anesthesia, Common Fears in Surgery, Dangers and Side-effects of anesthesia, Headphones for other medical procedures|1 Comment

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  When people contact me about helping them use music during surgery, my first    recommendation is always the pre-programmed, cordless headphones I have created.  When I first had the idea to create cordless, pre-programmed headphones, back in 2005, the term “wireless” was not nearly as associated with “wireless network” as it is now. 

 My intention was to have headphones that were entirely “self-contained” and not dependent on being tethered to an iPod or any other transmittal device.  I just figured that it would be one less thing for surgeons and anesthesiologists to worry about getting tangled up with their equipment!

I called them “wireless” at that time, but now I think it is important to confirm that they are indeed “cordless” but are not what today we call “wireless.”  This is quite an important differentiation too, because transmitting a signal in the OR would involve FCC communication and just throw another stumbling block up to people and hospitals that are contemplating using them in the OR. 

Please let me know what your questions might be!  We certainly are hearing from hundreds of satisfied customers around the world about their effectiveness in calming the patient before surgery, and reassuring them when they wake up in surgery with beautiful music still playing!

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Sep Sep 30, 2011

Propofol and Music during surgery

By |September 30, 2011|Music and Anesthesia, Music and Propofol|0 Comments

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The trial of Conrad Murray is over and he was found guilty.  Things have to get pretty bad for someone to need propofol to sleep every night!  But Dr. Murray was willing to do this for Michael for enough money!

  It seems that Propofol has been used in surgery for about 35 years now and has been used safely.  Of course, Propofol (diprivan) was never intended to put people to sleep; people who suffer from insomnia and are at home.  Propofol is en extremely effect agent for inducing anesthesia and temporary amnesia.  Because of its milky appearance and its usefulness in the operating room, it is sometimes called “Milk of Amnesia.”  Tragically, Dr. Murray was accused of involuntary manslaughter because he illegally gave Michael Jackson Propofol in his home, because Jackson had severe insomnia.  Apparently, Murray had been doing this for sometime but did not know enough about the whole process to prevent this from happening.

Can music through headphones be used to affect the amount of Propofol required by the patient?  Take a look at this  study, done back on 2005, which I now present to you:

Anaesthesia. 2005 Oct;60(10):990-4.

Effects of music on target-controlled infusion of propofol requirements during combined spinal-epidural anaesthesia.

Source

Department of Anaesthesiology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. zlxu@mails.tjmu.edu.cn

Abstract

The sedative effects of music were evaluated using the bispectral index (BIS) during target-controlled infusion (TCI) propofol. A total of 110 women undergoing hysterectomy were randomly allocated to receive either music or no music. Propofol was administered using target-controlled infusion and the concentration adjusted gradually to achieve an observer’s assessment of alertness/sedation (OAA/S) score of 3 intra-operatively. The haemodynamic and bispectral index values during the sedation phase were recorded. Interleukin-6 was evaluated before, immediately after and 1 h following intervention. The music group had a significant reduction in mean (SD) induction time of sedation: 12 (12) min vs. 18 (12) min, p < 0.01; propofol target concentration: 1.6 (0.3) microg.ml(-1) vs. 2.4 (0.4) microg.ml(-1), p < 0.0001; intra-operative amount of propofol: 171 (98) mg vs. 251 (92) mg, p < 0.0001; and significantly higher levels of satisfaction with their peri-operative care: 9.6 (0.6) compared to the control group: 8.1 (1.0), p < 0.0001. No other differences were found. The results show the influence of music on the induction time of sedation, concentration and level of propofol during surgery, and suggest sedative benefits of music.

 

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Aug Aug 18, 2011

Preparing for anesthesia during surgery

By |August 18, 2011|Common Fears in Surgery, Dangers and Side-effects of anesthesia|1 Comment

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Recently, the Chicago Tribune posted an interesting article about people who are quite fearful of anesthesia during surgery.  They don’t mention the use of music, but of course that is one of the most helpful ways to calm yourself and require less anestheisa.

“For many patients, anesthesia is the scariest part of surgery. But you can ease your fears — and help prevent the rare negative outcome — with awareness and good communication with doctors, says Dr. Paul Rein of Virginia Anesthesia VAPCS in southeastern Virginia.

•Don’t panic. The chances of dying in a car crash are about 40 times greater than from an anesthetic, Rein says. “The reality is anesthesia has become very safe because of better techniques, better monitoring and better practitioners,” he says.

•Don’t cheat on “no food or drink” orders. As a rule, patients should have nothing for eight hours before surgery — even gum. If you vomit while under anesthesia, the contents can get into your lungs, which can be dangerous.

•Know your medical history. Tell your doctor the specific names and doses of all drugs you take, as well as past surgeries. If you’ve had problems with anesthesia before — including nausea — speak up. Also pass along any known family history of complications.

•Stop taking herbal medications. Doctors generally advise avoiding these products for two weeks before an operation, as they can cause increased bleeding.

•Ask questions. Meet with your anesthesiologist and get all the answers you need before heading into the operating room. Learn about the type of drugs you will get; you may have a choice between general or regional anesthesia.

•Arrange for a caregiver. A responsible adult should drive you home and stay with you the day of an outpatient surgery, even after minor operations. Don’t take a taxi or get dropped off at home alone; on top of recovering from surgery, you’ll likely feel the effects of anesthetic drugs for several hours

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Jul Jul 1, 2011

Surgery with Music Series Post #30: A Recap of why music is so important for your surgery

By |July 1, 2011|Anesthesia, Dangers and Side-effects of anesthesia, Headphones for other medical procedures, Music and Anesthesia, Music in the hospitals, Surgical Headphones reviews|1 Comment

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If you’ve been reading this 30-day series of posts of music with surgery, and you’re still not convinced of music’s power during surgery, I just don’t know what to tell you.  People all over the world, both patients and medical staff including surgeons, anesthesiologists, nurse anesthetists and techs of all kinds are recommending the use of music before, during and after surgery.  There are absolutely no drawbacks or side-effects and so many benefits that the choice is clear.

If you have the ability to make your own playlist, that’s great!  If you have enough lead time to do it, I think it’s a great idea.  I did it for myself back in 1994 when I had a lumbar laminectomy.  The doctors were astounded at how well everything went and how quickly I recovered.  I did it for my mother’s heart bypass in the early 90’s and after quite a bit of skepticism initially, she had such a positive experience that she said she would never again have surgery without music and headphones.

I have been helping patients to use music during their surgery since late 1990 when I began reading about the work of well-known music therapist, Helen Bonny.  I would usually mention her work when I went out speaking at hospitals and universities and associations.  Invariably, someone would say “Dr. Cash, I don’t believe that many people at all know about this music and surgery idea.  I think you should really try to get the word out!

After that, the rest is history.  I have worked with thousands of patients around the world and in 2008 I got a patent on my Surgical Serenity Headphones.  Although you can purchase them online at www.surgicalheadphones.com, my main goal is to get them into hospitals around the world so that they are ready to go when a patient arrives for surgery.  They would be told about the process of wearing the headphones upon arrival at the hospital and would be issued a set of headphones that would then be theirs to keep, eliminating the risk of infection from previous users.

If you are associated with a full-service hospital, please check out the headphones and the documented benefits.  Using the headphones can greatly reduce the amount of drugs and anesthesia required and create a calmer more peaceful atmosphere for the patient.   As a result of less anesthesia, the patient will recover faster and get back to work sooner and with less trauma.  Every doctor or nurse that I have ever talked to about these has said it is a great idea and that they will be standard equipment in all operating rooms one day!  Please join me in making this dream come true.

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