Commentary: Sound of music for surgical stressors!

This article looks at the stress levels of an ophthalmic surgeon during complicated cataract surgeries compared with uncomplicated ones.[1] The authors found a significant increase in stress-related parameters of operating surgeons while doing complicated cataract surgeries. The findings are worrisome as cataract surgeries tend to be shorter in duration and have excellent postoperative outcomes when compared to corneal and vitreoretinal surgeries. The implications of high and chronic levels of stress on a surgeons’ health is therefore significant given that most of us operate for three to four decades of our life. Many of us spend sleepless nights worrying about the outcome of surgeries on one-eyed, pediatric, and trauma patients with intraoperative complications adding another layer of anxiety. This makes us wonder if we can do something to reduce our stress levels before, during, and after performing a surgery.

Looking at the patients’ perspective, attempts have been made to reduce their anxiety during surgery, for both adults and children. While providing a patient information video before cataract surgery has been successful in reducing preoperative anxiety, playing music brought down anxiety levels before, during, and after surgery.[234] These seem to be inexpensive methods to reduce stress for surgical patients.[5] The contrary was true for children, with music interventions not benefitting all young ones undergoing surgery.[6] One study found that music intervention may actually decrease cortisol levels, although the level of evidence was low.[7]

Given the convincing evidence of the positive influence of music therapy for patients requiring surgical procedures, the same can apply to operating staff. Several studies have found it to be a simple, economic, and noninterventional method with minimal investment to prevent stress or reduce anxiety for surgeons.[89] Although some claim that music has an added benefit of improving surgical finesse, the same has not been firmly established when evaluated using a simulated setting.[10] A systematic review of the subject reports that some staff find music distracting and a disturbing stressor if loud or high-beat, with a negative impact on performance. But most feel a sense of calmness when music is played during surgery, not only at an individual level but also for a better team performance.[1112] Music therapy therefore seems to be a simple and effective option to reduce operating theater stress for patients and staff.