Another first-person account of music during surgery!

Jane Zellmer was anxious about her second knee replacement surgery.



The first surgery on her left knee was done under general anesthesia. She said she doesn’t do well under general anesthesia, and she had a difficult time waking up and was nauseous the first time.



This time the 54-year-old Ettrick, Wis., woman wanted spinal anesthesia, which would allow her to be conscious while numbing her right knee.



Zellmer also chose music to help with her anxiety and make her relax. Mike Jacobson, a nurse anesthetist at Franciscan Skemp, had a library of music from which she could pick. She chose her favorite music, country, and a favorite artist, George Strait.



With her headphones on, she listened to Strait’s music during surgery.



“It was very calming listening to the music, and I was comfortable,” Zellmer said. “I was nervous about the spinal anesthesia, but the music helped me relax.



“I felt like I was lying in the sun with headphones on,” she said. “Music did its thing, and it was a place to go, something to escape into. The spinal anesthesia and music worked real well together.”



For several years, a number of hospitals, including Franciscan Skemp and Gundersen Lutheran, have offered music to patients during surgery. Zellmer heard about the use of music through a friend who listened to music during surgery at Gundersen Lutheran.



More and more hospitals are using music for patients because research is showing it helps reduce moderate pain and anxiety, and it might result in less sedation and faster recovery.



A Yale University showed patients listening to music required much less sedation during surgery. Another study showed listening to music helps minimize the rise in blood pressure associated with surgery. Researchers say the best results are likely to come from people being able to listen to the music of their own choice rather than being given music thought to be soothing.



For many years, surgery rooms have been filled with the sound of music selected by and for surgeons.



“Music often helps surgeons relax, and some like it for background music,” Jacobson said. “One surgeon likes very loud rock ’n’ roll.



“Patients have their own music option, but it’s the surgeon’s choice in the room,” he said. “I’ve never been asked what I want to hear, but I think whatever music helps the surgeon is a good choice.”



Dr. Mark Connelly, a Gundersen Lutheran facial plastic surgeon, has played music in his operating room for more than 25 years. He has a CD of Broadway show tunes, pop, country and classical music.



“The music is soothing, and it helps me relax,” Connelly said.



“Occasionally, the staff will sing along to ‘Stand By Your Man,’” he said. “Surgeons get to choose the music, but it’s nice when the operating group likes it.”



Jacobson is one of the DJs at Franciscan Skemp. He is in charge of a cart of CDs from which patients can choose, or they can bring in their own CDs.



“Some people like country, some like classical and some New Age, but more patients like soothing music,” Jacobson said. “Music does help calm the patient.”



Dr. Marisa Baorto, a Franciscan Skemp anesthesiologist, said music is used in conjunction with “conscious sedation,” such as spinal and regional anesthesia, for surgeries such as foot, carpal tunnel, knee replacement and breast biopsies.



Baorto said some pregnant women bring in their own music to listen to during labor.



“A lot of patients enjoy the music, and then they don’t have to hear what’s going on in surgery,” Baorto said. “Music helps them phase out and get less sedation.”



Jacobson said he can tell the difference in patients who enjoy the music.



“We can tell the patient is more calm,” Jacobson said. “I don’t think it is fluff. There are benefits to the patient, even some benefits during general anesthesia.”

Two Major Hospitals Now Recommend Music with Surgery

In the past two months, both the Mayo Clinic in Minnesota and the Cleveland Clinic in Ohio have come out advocating music!  The Mayo Clinic said:

"Research on the effectiveness of music therapy dates back to the 1920s, when a study reported individuals' blood pressure dropped when listening to music. Currently, our program is conducting a research study to measure the effects of music therapy on pain, anxiety and tension. As part of the Cardiovascular Surgery Healing Enhancement Program, rooms for cardiac surgery patients have music systems. A selection of CD music is available at each cardiac surgical unit. "

The Cleveland Clinic said:

"Research on music and the brain has shown that it can reduce stress, alleviate pain and promote relaxation. And new research from the Cleveland Clinic shows that music can even reach into deep brain structures unrelated to hearing and memory to literally soothe nerves.

Patients receiving deep-brain-stimulation surgery for Parkinson's disease, essential tremor and several other conditions have to be awake for much of the surgery to tell surgeons if their symptoms improve when electrodes are placed deep in their brains.

All of this is very exciting news to me as I am hoping to make my surgical headphones standard in hospitals around the world.  Right now I am selling them online at http://www.surgicalheadphones.com/, but I hope eventually to sell them to hospitals so that they can give them to all surgical patients.  Stay tuned!  The big launch will be in 2010!

Cleveland Clinic researchers find music can have a soothing effect during brain surgery

Cleveland Clinic researchers find music can have a soothing effect during brain surgery
By Brie Zeltner, The Plain Dealer

December 01, 2009, 12:01AM



Lynn Ischay, The Plain DealerDr. Damir Janigro, left, a neuroscientist at the Cleveland Clinic, found that melodic passages of music seemed to calm patients when played while they remainied conscious during deep brain stimulation. With Janigro, in this picture from 2007, is Italian cellist Umberto Clerici. They are holding the 1769 Guadagnini cello that belonged to Janigro’s father, the great Italian cellist Antonio Janigro, which Clerici has on loan.

If you've ever come home after a long day and turned on, say, Brahms to relax, or jacked up the volume on Queen's "We Are the Champions" to get psyched for a workout, you know that music can change your mood.



Research on music and the brain has shown that it can reduce stress, alleviate pain and promote relaxation. And new research from the Cleveland Clinic shows that music can even reach into deep brain structures unrelated to hearing and memory to literally soothe nerves.



Patients receiving deep-brain-stimulation surgery for Parkinson's disease, essential tremor and several other conditions have to be awake for much of the surgery to tell surgeons if their symptoms improve when electrodes are placed deep in their brains.



"I witnessed several hundred brain surgeries with awake patients, and I noticed that these patients were going through a very traumatic experience, much worse than a root canal, for hours, and yet they were wide awake. So they need to be conscious, but no one said that they have to be upset or bored."

Damir Janigro, Cleveland Clinic neuroscientist

Neuroscientist Damir Janigro took advantage of this conscious period to play clips of music for the patients to see what effect it had on their brain function and on their stress levels during the surgery, which can be many hours long.



Janigro decided to play music for these patients after his own experience in a noisy operating room this year. While being prepped for spinal surgery, he thought of how dentists often give patients headphones to listen to music or a TV to watch to ease anxiety.



"The reason why they do it -- I asked my dentist -- is because [the procedure is] easier, and you go home faster," Janigro said.



Janigro presented his findings Oct. 30 at the Music and the Brain symposium in New York. Janigro is one of many specialists who work in the Clinic's Arts and Medicine Institute, which is studying how the arts can be used to enhance healing.



Dirk Hoch, 52, of Delphi, Ind., agreed to participate in the music study without hesitation. Hoch is a former postal worker who had to retire in 2005 due to essential tremor, a neurological condition that causes involuntary shaking, particularly evident during voluntary movements like holding a fork.



During the April surgery, Hoch listened to different music clips and told Janigro how he felt.



Like all the other participants, about a dozen in this initial study, Hoch preferred the melodic music clips to the others. Janigro also offered purely rhythmic music and a clip that combined rhythmic and melodic music.



To eliminate the possibility of any emotional associations with the music related to memory, Janigro had Gregory Bonanno of the Cleveland Institute of Music compose the clips.



Hoch said the music was a welcome distraction from the pain of the halo-like metal clamp that held his head in place during the surgery.



"You were at ease and at peace with the surroundings, which, given the circumstances, is something," he said. "I mean, after all, they're drilling holes in your head and inserting electrodes. It just really made a huge difference."



Janigro and his team could see that difference at work in Hoch's brain.



When he and the other patients listened to the rhythmic music or the clip that was both rhythmic and melodic, the overactive firing in their subthalamic and thalamic neurons didn't change. These are the areas of the brain that control the surface cortex and are particularly important in movement.



During the melodic music clips, the firing in these areas slowed down, and Hoch and the other patients felt calmer.



It wasn't exactly what Janigro expected.



"It's strange because these are motor sensors, so you would expect that boom, boom, boom would have more of an effect -- the rhythmic music."



The next step for Janigro and his colleagues will be to find out if melodic music in the operating room has any effect on stress measures, like the amount of the stress hormone cortisol circulating in the blood or the amount of blood-pressure medication needed during the procedure.



Ultimately, Janigro hopes the musical intervention will mean patients heal faster.



"I bet you that they will go home sooner," he said. "That's the goal, really. Happy people don't stay in the hospital."