Prepare the patient and pump up the AC/DC
Music played during surgery can impede the work of OR team, study finds
“Australian rock music impairs men’s performance when pretending to be a surgeon” is probably the strangest headline I’ve ever seen in the usually dead serious Medical Journal of Australia. To be fair, it was the winning entry in its “Christmas cracker” competition. Despite the frivolous title, the paper reports real research and there are some lessons for men buried in it.
The researchers note the increasing presence of music in operating rooms or, as they quaintly call them in Australia and the U.K., operating theatres.
“Music is reportedly played 62 to 72 per cent of the time in theatre,” they write, “with classical music being the most popular genre, followed by folk, rock, jazz and blues.” Indeed it can be a theatrical experience for the surgical team to enter to the accompaniment of Thus Spoke Zarathustra or the Imperial March from Star Wars. But does music affect their performance on the job?
The researchers first faced an ethical dilemma. Could they try out different music in real surgical settings? What if they piped in Bryan Adams’ Cuts Like a Knife or Emerson Lake and Palmer’s Brain Salad Surgery and things went horribly wrong on the operating table? That wouldn’t make for a very humorous article and it might even cut short some promising careers.
They decided to use aspiring surgeons and a simulated patient. Members of the general public were recruited at a public engagement event at Imperial College, London. The only qualification was to be at least 16 years old with no formal surgical training or known hearing impairment.
Their task was to extract three organs from Cavity Sam, the long-suffering patient in the board game Operation. Participants first listened to one of three soundtracks: Normal operating room sounds; Thunderstruck by hard-rockers AC/DC; or the Andante movement of Mozart’s Sonata for Two Pianos, K 448. After hearing the music, subjects were rated on how quickly and accurately they operated on Sam.
The results showed a significant gender difference. Overall, men were slightly quicker with the fake surgical tweezers, but music really impeded their performance. The worst effect came from the AC/DC track, which raised the average number of mistakes made by men to 36 compared to an average of 28 for the other groups. They were also slower after the blast of AC/DC.
Women suffered no impairment, regardless of the music played.
The researchers theorize that men are somehow more sensitive to auditory stress than women and they perceived AC/DC’s music as stress inducing. Other Australian researchers have compared Star Wars music to popular music in an endoscopy clinic, reporting better outcomes when surgeons listening to Episode III: Revenge of the Sith. Some studies have also suggested playing a patient’s favourite music might lower pre-operative anxiety and the dose of anesthesia drug required.
Is music in the operating room a serious threat to patient safety? Probably not in most cases, although further research is certainly needed. One especially worrying report comes from a Scottish survey that showed 26 per cent of anesthetists reported that music playing reduced their vigilance. In fact, 11.5 per cent felt that “music might distract their attention from alarms."
An operating room is often a noisy, busy place with people saying important things through a mask. British researchers watched videos of 20 operations. As they wrote in the Journal of Advanced Nursing, “repeated requests were five times more likely to occur in cases that played music than in those that did not.” They concluded this frequently impeded the ability of nurses to follow the surgeon’s commands promptly.