The Soothing Power of Sound in the Operating Theatre
Hospitals across India are increasingly exploring gentle, non-invasive methods to support patients undergoing surgical procedures. These approaches aim to work alongside standard anaesthesia without introducing additional risks. One particularly promising technique involves the strategic use of calming music in operating rooms, with researchers investigating how specific sounds can influence the body's stress response even when patients are fully unconscious.
While modern anaesthetic drugs remain highly effective, they often impact recovery time, blood pressure stability, and overall patient comfort. The growing interest in whether music can alleviate these challenges reflects medicine's ongoing search for simple, practical tools that create smoother surgical experiences for both patients and medical teams.
How Music Influences the Unconscious Brain During Surgery
A groundbreaking study published in Music and Medicine provides compelling evidence about music's physiological effects during laparoscopic cholecystectomy procedures performed under total intravenous anaesthesia. The research demonstrated that non-lyrical, slow instrumental music—particularly flute and piano pieces with gentle tempos—correlated with lower propofol consumption and more stable vital signs.
This finding suggests the brain continues to process and respond to auditory stimuli despite the patient's unconscious state. The gentle rhythms and predictable melodies appear to signal safety to the nervous system, thereby reducing the stress response typically triggered by surgery. Consequently, the body requires less chemical support to maintain stability, positioning music as a subtle yet meaningful complement to contemporary anaesthetic care.
Patient-Chosen Music Enhances Surgical Outcomes
A distinctive aspect of the research involved allowing patients to select between two calming instrumental tracks. Many participants chose a flute composition blending Raga Yaman and Raga Kirwani, both renowned for their smooth, comforting qualities. These selections weren't arbitrary—music with steady beats and warm tones naturally encourages the nervous system to slow down.
This effect proves particularly valuable during surgery, as the body typically reacts to environmental changes through increased blood pressure or elevated heart rate. When music provides a gentle auditory anchor, the autonomic nervous system becomes less reactive and more balanced.
The benefits of familiar or preferred music include:
- Enhanced emotional comfort through preferred tonal patterns
- Reduced autonomic reactivity leading to steadier blood pressure
- Decreased release of stress hormones like cortisol
- A calmer internal environment requiring fewer anaesthetic adjustments
Even under anaesthesia, deeper brain regions continue processing rhythm and melody. These areas help regulate emotional and physical responses, so when they detect soothing patterns, the body releases fewer stress chemicals and exhibits fewer abrupt fluctuations. This creates a more tranquil internal state, reducing the need for frequent anaesthetic modifications and providing dual-layer support through both intravenous drugs and reassuring sound.
Reduced Drug Requirements and Improved Vital Sign Stability
One of the study's most significant findings concerned propofol consumption differences. Patients listening to music required significantly less medication to maintain the same anaesthesia depth as the control group. Propofol dosage typically increases when the body displays physiological stress indicators like blood pressure spikes or unexpected movements. When music softens these reactions, anaesthetists can maintain appropriate sedation with fewer adjustments.
Music serves as a supportive substitute for sedative effects by:
- Stabilising cardiovascular responses and reducing sudden spikes
- Diminishing the body's stress-driven need for higher propofol doses
- Encouraging natural release of calming neurochemicals
- Reducing requirements for additional intraoperative fentanyl
The music group also demonstrated more stable blood pressure readings, particularly during the thirty to forty-five minute surgical period when physiological reactions to surgical stimulation typically peak. Patients exposed to calming music maintained greater stability, indicating their internal stress pathways were less reactive. This stability extended to analgesic needs as well.
Since certain harmonic structures promote the release of natural pain-relieving brain chemicals, the reduced fentanyl requirement aligns with the overall pattern. These combined effects highlight that music doesn't function as a sedative itself but rather helps the body maintain equilibrium, making anaesthetic drugs more efficient and enhancing intraoperative balance.
Gentler Recovery and Reduced Stress Markers
Cortisol, a primary stress hormone, provided another crucial measurement of the body's surgical response. While levels increased in both study groups, the rise was noticeably smaller among patients who listened to music. This lower cortisol increase suggests the overall stress burden of surgery diminished, despite all patients undergoing identical procedures and anaesthetic techniques.
This softer hormonal response helps explain why the music group displayed a calmer early recovery profile. Awakening from anaesthesia often mirrors the body's internal condition, with lower-stress patients typically regaining awareness more smoothly without significant agitation or confusion. The study found music-exposed patients scored more favorably on awakening scales, indicating a more settled return to consciousness.
The sound heard before and during procedures may have provided continuity, making the transition between sedation and wakefulness less abrupt.
Overall benefits of surgical music implementation include:
- Reduced cortisol elevation post-surgery
- Smoother awakening with fewer agitation signs
- Lower anaesthetic and analgesic consumption
- Improved haemodynamic behaviour throughout procedures
- A calmer perioperative experience without added clinical risk
Although patient satisfaction scores were similar between groups, the physiological changes speak compellingly. Reduced cortisol, decreased drug consumption, and improved haemodynamic behaviour collectively indicate that calming music creates a more supportive internal environment. The effect remains subtle yet consistent, demonstrating how simple sensory input can positively influence the body's surgical journey.
