Making music in the operating theatre
BMJ 2014; 349 doi: https://doi.org/10.1136/bmj.g7436 (Published 11 December 2014) Cite this as: BMJ 2014;349:g7436All rapid responses
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I would like to add that, in my recent experincee of an operating playlist involving smooth jazz versus drum and bass, the tempo of the music can significantly affect the speed fat is harvested during liposuction.
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I am not a surgeon, but was allowed to bring music to the operating theatre during the deliveries of my two children (both by C-section). The first was born to George Michael's 'Freedom' (yes, really!) and the second to Spandau Ballet's 'Only when you leave' (my husband vetoed any Duran Duran on both occasions). It was both sad and sobering when my second child was born to realise that half the theatre staff were too young to know Spandau Ballet, but some conceded that they liked 'old music'. Thanks!
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After 15 years of surgical practice, I can't imagine an operating room environment without music. And I have seen that this habit is widespread in our neighbor countries, while performing a Shoulder & Elbow Research Fellowship at the James Cook University Hospital in Middlesbrough (United Kingdom), and a Hand & Wrist Research Fellowship at the Institut de la Main in France (Paris).
Besides classical music, which we listen during the very early morning hours (including Placido Domingo, Juan Diego Florez, Javier Camarena and Luciano Pavarotti performances), I'd like to highlight the album "Getz / Gilberto" published in 1964, including "The Girl from Ipanema", composed by Antonio Carlos Jobim and Vinicius de Moraes in 1962, among others songs (Corcovado, Desafinado, So danço samba...), in which are also involved Stan Getz, Joao Gilberto and Astrud Gilberto.
Another composer that we love is Cole Porter, and I'd like to highlight the performers Ella Fitzgerald and Sarah Vaughan, especially their tributes to Cole Porter and The Beatles.
If we listen to relaxing live music I'd like to highlight the station www.fipradio.com (France) and Radio3 (www.rtve.es-Spain), especially its "When elephants dream about music" program, from my great friend Carlos Galilea.
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The only practical difference I found on being appointed a consultant surgeon ten years ago was that my musical choices in theatre had not been switched off by the time I had finished scrubbing. We listen to heavy metal in our theatre. There are initial reservations among new staff but they are quickly won over and we receive visitors from neighbouring theatres to see what we are listening to this week. The general favourites are the German industrial metal titans Rammstein, with a theatre sister and consultant anaesthetist having bought CDs and several others downloads. For songs with humorous medical implications it is hard to beat Combichrist's "What the fuck is wrong with you" although the fierce anger of this track is best for getting over the latest petty e-mail from management.
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Frank Sinatra's "I've got you under my skin" provides the opener for most general surgeons, whilst cardiac surgeons quickly get to "deep in the heart of me" !
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I'm not a doctor but can I be allowed to add 'The laughing policemen'......I need a good laugh to alleviate the gloom in the NHS.
Happy Christmas all especially r.r. editors
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I would like to give a case report of the benefits of music in preventing c-section. Four years ago (to the day) my 2nd son was pulled out by forceps in a particularly difficult delivery. It was the night of the hospital obstetrics department Christmas party. The theatre team asked me what kind of music I like (call it patient involvement in shared decision making). We had the delivery theatre pumping with classic rock music. This gave me the strength and determination to push hard enough to release my 'stuck' son, so the need for the threatened c-section was averted. It also put the team in the mood for their Christmas party, which had started 2 hours previously. Son finally came out to Bachman Turner Overdrive's 'You ain't seen nothing yet', followed by a period of recovery on the table to Lynard Skynard's 'Free Bird'. Result. I suggest an RCT of rock vs classical in childbirth.
Competing interests: No competing interests
Dear Sir/Madam,
It was with interest that I read "Making music in the operating theatre" by Bosanquet et al. After reflection, I have the following suggestions:
One should always start the day's operating with a throwback to the antisepsis lessons of Lord Lister using "Iodine" by Leonard Cohen. However, it is recognised that an updated "Chlorhexidine" version is long overdue.
As part of the WHO surgical safety checklist Bob the Builder's "Can We Fix It?" can help clarify what the surgical team hope to achieve.
Next, Sheryl Crow's "The First Cut Is The Deepest" is a good reminder to proceed with due caution and skill once inside a body cavity.
Whilst some surgeons may wish to play "My Way" by Frank Sinatra at this point, "Together We Are One" by Delta Goodrem is a far better choice to emphasise the need for teamwork in surgery.
Leona Lewis' "Bleeding Love" for its line "you cut me open and I keep bleeding" is particularly suited to the vascular surgery theatre, although may also apply to individual surgeons in other specialties. Anaesthetists will be particularly grateful for inclusion of this as a reminder to ensure appropriate packed red cells are on standby.
Evanescence kindly penned the song "Bring Me To Life" to be on standby for any intra-operative catastrophes, although Hugh Cornwell's "Nerves Of Steel" could also be an appropriate choice.
"Closure" by Owl Eyes is fundamental during the latter stages of an operation but should be followed closely by "Secure Yourself" by the Indigo Girls for obvious reasons.
Finally, the inclusion of Esmee Denters’ "Outta Here" is sure to be appreciated at the end of a busy day by all operating theatre staff (and probably also the patients).
Competing interests: No competing interests
Re: Making music in the operating theatre
Dear BMJ-
Your article describes how music in theatre is a two-edged sword - enhancing surgeon performance, but a distraction in the event of anaesthetic problems. The operating theatre can be heavily noise polluted (e.g. orthopaedic surgery), and important tones and alarms from the anaesthesia monitor can be difficult or impossible to hear, especially in the setting of loud music. However, there is technology to improve this and allow integration of the theatre music system with the anaesthesia monitor. We now have cars that do not play loud music unless seatbelts are fastened. Why should we tolerate surgical music systems ignorant of the pulse oximeter?
-Alistair MacDonald MD
alistair@canarysounddesign.com
Competing interests: co-owner of Canary Sound Design, LLC, maker of CanaryBox.