Wednesday, August 19, 2015

Cue Handel's Messiah, Please

When I left my appointment with the orthopedic surgeon who will be doing my knee replacement surgery, I was clutching a thick spiral notebook crammed with all sorts of stuff. So I've been going over everything, and saw the information about my surgery preferably being done under spinal since it appears that spinal anesthesia contributes to a decreased incidence of post operative infection and better pain control post operatively when compared to a general anesthesia.

Interesting, I thought. I did not realize this; thinking that surely a general anesthesia would be preferable mostly because I would think patients would not want to be aware of the sounds that take place during the surgery. But dang - better pain control and fewer infections? It's hard to argue with that kind of logic and I've pretty much reconciled myself to the strong likelihood that I'll be receiving a spinal. And a bonus: I've read that patients are also frequently given IV sedation and that are offered the opportunity to listen to music during the procedure. Which both sound like excellent ideas, to me. Count me in for sedation and my favorite music blasting through a set of headphones.

But guess what? The patient surgical experience only gets more interesting, people: yesterday an article entitled, "Music Improves Some Postoperative Outcomes," published online here on Medscape Nurses. (This site requires you to register for free before reading.)

Check out these intriguing excerpts here but head over to read it all here. Bolding mine:

Surgical patients who listened to music were significantly less anxious and more satisfied postoperatively compared with those who did not, according to a systematic review and meta-analysis of data from 72 trials. They also needed less pain medication and reported significantly less pain, Jenny Hole, MBBS, from Queen Mary University of London, United Kingdom, and colleagues report in an article published online August 12 in the Lancet. 
The analysis included randomized controlled trials that compared any type of music initiated before, during, or after surgery with standard care of other nondrug interventions in adult patients undergoing any form of surgery, excluding central nervous system or head and neck procedures. The outcomes of interest were postoperative pain, analgesia needs, anxiety, infection rates, wound healing, costs, length of stay, and patient satisfaction. 
Music played preoperatively was associated with the greatest reduction in pain, analgesia, and anxiety, followed by intraoperative and postoperative music, according to the analysis. 
"Music reduced pain, even when given under general anaesthetic, but the intervention had an increased effect on pain when patients were conscious," the authors report. 
"Cognitive activities such as listening to music can affect perceived intensity and unpleasantness of pain, enabling patients' sensation of pain to be reduced," the authors write, suggesting a possible mechanism to explain the effects of music on outcomes. 
"Another potential mechanism could be reduced autonomic nervous system activity, such as reduced pulse and respiration rate and decreased blood pressure." 
On the basis of their findings, the authors believe that "sufficient research has been done to show that music should be available to all patients undergoing operative procedures." Patients should be able to choose the type of music they listen to, but the music must not interfere with the medical team's communications with each other or the patient, they stress. ........continue reading here
I'm thinking that the Hallelujah Chorus from Handel's Messiah would drown out almost any kind of racket drummed up by a surgical team, wouldn't you agree?

Do y'all have any other musical suggestions?

What would YOU listen to during a surgery?


Melodie said...

More important than the music is a nice pair of noise canceling earbuds. As for the music, I am a big fan of loud disco music under stressful conditions. Best of luck!

Shara from Seattle said...

Oooh, Disco. Forgot how much fun that is but I'm a mover and shaker so nothing that makes me want to dance or tap my toes. I'm perfectly happy with elevator music if that's the only thing playing in the background. I remember the words to Would you like to fly in my beautiful balloon. Which brings up another problem when I'm listening to music- singing.

Wanna hear about a fun new symptom that I'm having you guys? The glands in my boobs are going through painful fits! Who else is or has experienced something like this???

Best of luck Julia, I know you will be fine. You are resilient. You have the best support group on the planet. Knee replacements are always turning out to be a happy thing once its done.

Anonymous said...


Unknown said...

Before my cervical fusion I listened to Belleruth Naparstek's pre-surgery guided imagery and affirmations. There is also a 60 minute music track. Not everyone's cupof tea. I loaded it all plus some other soothing music on a small iPod. They were great about letting me have it in the OR, was still playing when I woke up in recovery. Do you have a date?

Laura said...

Bells! Cast In Bronze, or tubular bells, or....

Jewel - Absence of Fear

Lots of Loreena McKennitt

Jimmy Buffet - One Particular Harbour, Fruitcakes, Nautical Wheelers

Great Big Sea - almost anything.

...I'm weird, yes.