Yet another research study has strongly pointed to the positive role of music in pain and stress management in patients after surgery. The study, published in the British journal ‘Lancet’, found that although music does not hasten recovery or shorten the length of hospital stay, it works so well as a pain reliever that patients need fewer prescription painkillers to manage their post-operative pain. Music is useful as a non-invasive, safe and inexpensive intervention to help patients reduce pain and anxiety. A few months ago, a study by US paediatricians found that songs by Rihanna, Taylor Swift and other pop singers significantly reduced the pain to kids after major surgeries. The study found music and audio books as a strategy to control post-surgical pain because medication like analgesics that are given to kids after surgery causes breathing problems in them. Music did not have side effects!
How does music work? Researchers have found that music disrupts the brain’s ‘pain-stress-pain’ feedback loop and generates chemicals in the brain that help reduce pain. The reason behind is that unlike verbal commands, the sound of music is processed in non-verbal areas of the brain and so does not call for patients to respond as verbal information would. Music works in combination with biofeedback techniques to lower tension as it triggers the relaxation response more effectively than verbal stimuli. In simple terms, music has a highly relaxing effect on both the mind and body, and works by slowing the pulse and heart rate, lowering blood pressure and the levels of stress hormones.
However, who chooses what music to play? Studies differ on the subject. Some studies found that it was the hospitals that made the choice of music, timing and duration. The doctors probably arrogated the powers to themselves on the simple logic that the patient was under their treatment and they knew what best to give them. However, the choice of music might not remain the same over the week or during the course of the day. The surgeon who operated the patient might recommend one type of music that he or she might like, but the other doctors might recommend other types of music depending on their choice.
Many hospitals allow surgeons to play music in the operation theatre (OT) while they are operating. Even in India a number of surgeons play music in OT. The thinking behind is that music improves the surgeon’s performance and lowers patient anxiety, more so in awake procedures when patients are aware of their surroundings. A study done in the UK found that music was played during 7 out of 10 surgeries in OTs, and 8 out of 10 surgical staff said music improved communication between the team members, lowered anxiety and improved efficiency by increasing focus on the task. The choice of music to be played during surgery in OT is decided by the leading surgeon. In India, leading surgeons choose evergreen Bollywood songs, classical instrumental music, ghazals or jazz. There is a minority view that music can potentially distract surgeons by taking up cognitive bandwidth and lowering alertness, but this has not been proven to be true.
As far as operative procedures are concerned, it is the leading surgeon who has to concentrate on his work and so he or she is well within his rights to choose what music to play in OT. However, when it comes to awake procedures or post-operative care, the choice of music should be made by the patient and not the hospital and the leading surgeon. Whats ort of music actually works in reducing post-operative pain and anxiety, it is the patient alone who knows best. People are fond of certain type of music. Some forms of music might be found too noisy and loud and uninteresting by the patient. If the patient gets to hear the music he or she likes it can work better. The US study that found music reduces pain among children after surgery also concluded that “music chosen by kids on their own works better than any other medicine as it distracts the brain to refocus on something else, and it also avoids risky side effects of analgesic drugs.”
India has great musical traditions. Ravi Shankar’s sitar music was tested on some patients in Europe and found to be more effective in reducing pain and stress than jazz. But of course, everyone is selective about music. We expect all hospitals and doctors in India to start using music for lifting up the spirits of their patients. Some hospitals play low music in outpatient lounges. That is good, but it would be better if they use it also during the surgery and post-operative care. There is a strong discipline of music therapy emerging in India too, as it is in other countries. Some music therapists go to the extent of claiming that Indian classical music can be useful in not only reducing pain and stress but also in curing depression, diabetes, headache and migraine.