{"id":2117,"date":"2020-08-24T13:46:24","date_gmt":"2020-08-24T13:46:24","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmjebmspotlight\/?p=2117"},"modified":"2020-08-26T13:02:47","modified_gmt":"2020-08-26T13:02:47","slug":"instructions-for-the-day-of-your-surgery-please-create-a-playlist-of-your-favourite-music","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmjebmspotlight\/2020\/08\/24\/instructions-for-the-day-of-your-surgery-please-create-a-playlist-of-your-favourite-music\/","title":{"rendered":"Instructions for the day of your surgery: \u201cPlease create a playlist of your favourite music\u201d"},"content":{"rendered":"<p>Blog entry written on: <a href=\"https:\/\/ebm.bmj.com\/content\/early\/2020\/08\/19\/bmjebm-2020-111382\"><em>Heterogeneity of Outcomes for Intraoperative Music Interventions: A Scoping Review and Evidence Map <\/em><\/a>(bmjebm-2020-111382)<\/p>\n<p><em>Authors: Melanie Ambler, Stacey Springs, Dioscaris Garcia, Christopher Born<\/em><\/p>\n<hr \/>\n<p><span style=\"font-weight: 400\">We know that <\/span><a href=\"http:\/\/www.joacp.org\/article.asp?issn=0970-9185;year=2011;volume=27;issue=3;spage=354;epage=357;aulast=George\"><span style=\"font-weight: 400\">87% of operating room staff<\/span><\/a><span style=\"font-weight: 400\"> report listening to music in the OR, but an emerging body of <\/span><a href=\"https:\/\/doi.org\/10.1002\/bjs.10853\"><span style=\"font-weight: 400\">evidence<\/span><\/a><span style=\"font-weight: 400\"> suggests that listening to music during surgical procedures can also be beneficial for patients. A relaxing recording of Debussy\u2019s <\/span><i><span style=\"font-weight: 400\">Clair de Lune <\/span><\/i><span style=\"font-weight: 400\">or Bach\u2019s <\/span><i><span style=\"font-weight: 400\">Solo Cello Suites<\/span><\/i><span style=\"font-weight: 400\"> can significantly decrease a patient\u2019s <\/span><a href=\"https:\/\/journals.lww.com\/annalsofsurgery\/Abstract\/9000\/The_Effect_of_Perioperative_Music_on_Medication.94997.aspx\"><span style=\"font-weight: 400\">need for sedation and post-operative opioid medication<\/span><\/a><span style=\"font-weight: 400\">. Listening to music has been shown to diminish the activation of the <\/span><a href=\"https:\/\/doi.org\/10.1371\/journal.pone.0070156\"><span style=\"font-weight: 400\">hypothalamic pituitary axis (HPA)<\/span><\/a><span style=\"font-weight: 400\">, which is implicated in human stress responses. Surgical procedures are profound sources of stress and <\/span><a href=\"https:\/\/doi.org\/10.1016\/j.aorn.2010.04.017\"><span style=\"font-weight: 400\">anxiety for patients<\/span><\/a><span style=\"font-weight: 400\">. There is a perceived <\/span><a href=\"https:\/\/aornjournal.onlinelibrary.wiley.com\/doi\/abs\/10.1016\/j.aorn.2010.04.017\"><span style=\"font-weight: 400\">loss of control<\/span><\/a><span style=\"font-weight: 400\"> and vulnerability during surgery; this can lead to prolonged healing time, increased postoperative pain, and risk for infection. There is additional <\/span><a href=\"https:\/\/europepmc.org\/article\/med\/16723934\"><span style=\"font-weight: 400\">evidence<\/span><\/a><span style=\"font-weight: 400\"> to suggest that anxiety during surgery puts the patient at greater anaesthetic and surgical risk.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">Music elicits emotional and physical responses; medical music interventions can be tailored to the individual patient or surgical environment (e.g., <\/span><a href=\"https:\/\/doi.org\/10.1016\/j.jvn.2012.10.002\"><span style=\"font-weight: 400\">Gorecki\u2019s Symphony of Sorrows<\/span><\/a><span style=\"font-weight: 400\"> delivered via headphones to patients or <\/span><a href=\"https:\/\/www.businessinsider.com\/rock-music-surgeons-operating-room-2017-8\"><span style=\"font-weight: 400\">Metallica<\/span><\/a><span style=\"font-weight: 400\"> playing over speakers for everyone in the surgical suite to hear). Music applied in the healthcare context is a <\/span><a href=\"https:\/\/doi.org\/10.1093\/eurpub\/ckr084\"><span style=\"font-weight: 400\">complex intervention,<\/span><\/a><span style=\"font-weight: 400\"> in that there is not standardization across applications. Complexity derives from the ways in which music is administered to patients (i.e., <\/span><a href=\"https:\/\/www.jclinepi.com\/article\/S0895-4356(17)30630-3\/fulltext\"><span style=\"font-weight: 400\">intervention complexity<\/span><\/a><span style=\"font-weight: 400\">) such as delivering music via headphones or through speakers in the operating room. Additionally, music has unique <\/span><a href=\"https:\/\/europepmc.org\/article\/med\/17367577\"><span style=\"font-weight: 400\">neurobiological and psychological<\/span><\/a><span style=\"font-weight: 400\"> impacts and these outcomes can interact with other clinically important outcomes in surgical care (i.e., <\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/28720511\/\"><span style=\"font-weight: 400\">pathway complexity<\/span><\/a><span style=\"font-weight: 400\">).\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">To better understand the ways in which music has been studied as an intervention in the surgical setting, we undertook a <\/span><a href=\"https:\/\/www.tandfonline.com\/doi\/abs\/10.1080\/1364557032000119616\"><span style=\"font-weight: 400\">scoping review<\/span><\/a><span style=\"font-weight: 400\"> and used <\/span><a href=\"https:\/\/systematicreviewsjournal.biomedcentral.com\/articles\/10.1186\/s13643-016-0204-x\"><span style=\"font-weight: 400\">evidence mapping<\/span><\/a><span style=\"font-weight: 400\"> to document the breadth and distribution of experimental designs and outcome measures reported in studies of music interventions during surgical procedures. Our review, entitled <\/span><a href=\"https:\/\/dx.doi.org\/10.1136\/bmjebm-2020-111382\"><span style=\"font-weight: 400\">\u201cHeterogeneity of outcomes for intraoperative music interventions: a scoping review and evidence map,\u201d<\/span><\/a><span style=\"font-weight: 400\"> included 21 studies, with a total of 2283 patients. Overall, studies measured 42 different outcomes. Two-thirds used at least one outcome measure unique to that study, barring opportunities for comparison to other studies of similar design.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">Our review demonstrated the need for more complete reporting of study details and standardization of outcome measures. The heterogeneity of outcome measures limits our ability to synthesize data across studies to understand the effectiveness of intraoperative music interventions on surgical patients. In 2017, the <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC6688399\/\"><span style=\"font-weight: 400\">National Institutes of Health<\/span><\/a><span style=\"font-weight: 400\"> co-hosted a workshop on music and the brain entitled Sound Health, where the expert panel reported recommendations to support the study of music interventions. Among their recommendations was to promote more rigorous reporting of interventions, methodologies, and results and to establish standardized and\/or personalized outcome measures. In their scoping review of &gt;3000 studies of arts interventions in health, <\/span><a href=\"https:\/\/www.euro.who.int\/en\/publications\/abstracts\/what-is-the-evidence-on-the-role-of-the-arts-in-improving-health-and-well-being-a-scoping-review-2019\"><span style=\"font-weight: 400\">Fancourt et al 2019<\/span><\/a><span style=\"font-weight: 400\"> identified that increasingly, studies of arts and health interventions include rigorous study designs to improve opportunities to conduct comparative effectiveness research in the field.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">Based on an accumulating body of <\/span><a href=\"https:\/\/doi.org\/10.1002\/bjs.10853\"><span style=\"font-weight: 400\">evidence<\/span><\/a><span style=\"font-weight: 400\">, music appears to be a promising complement to medical care and should be explored with necessary rigor and enthusiasm in future studies. To move the field forward, the adoption of thorough study designs that account for the complexity of music interventions and the standardization of outcome measures, such as the development of core outcome sets for music interventions, may improve our understanding of music as an intervention. The development and uptake of reporting guidelines to ensure full reporting of key study features\u2014specifically the component parts of music interventions that are non-standardized across applications\u2014may support improved understanding of the role of music in clinical care.\u00a0<\/span><\/p>\n<hr \/>\n<p><strong>AUTHORS:<\/strong><\/p>\n<p><a href=\"https:\/\/www.linkedin.com\/in\/melanieambler\/\">Melanie Ambler<\/a>, MS<\/p>\n<p>Brown University, Providence, RI, USA<\/p>\n<p><a href=\"https:\/\/fulbrightfranceclassof2020.wordpress.com\/2020\/05\/26\/melanie-a\/\">Fulbright Scholar<\/a>, Caen, France<\/p>\n<p>No conflict of interest to declare<\/p>\n<p><a href=\"https:\/\/blogs.bmj.com\/bmjebmspotlight\/files\/2020\/08\/Melanie-Ambler.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-2119\" src=\"https:\/\/blogs.bmj.com\/bmjebmspotlight\/files\/2020\/08\/Melanie-Ambler.jpg\" alt=\"\" width=\"213\" height=\"213\" srcset=\"https:\/\/blogs.bmj.com\/bmjebmspotlight\/files\/2020\/08\/Melanie-Ambler.jpg 280w, https:\/\/blogs.bmj.com\/bmjebmspotlight\/files\/2020\/08\/Melanie-Ambler-150x150.jpg 150w\" sizes=\"auto, (max-width: 213px) 100vw, 213px\" \/><\/a><\/p>\n<p><a href=\"https:\/\/vivo.brown.edu\/display\/sl19\">Stacey Springs<\/a>, PhD<\/p>\n<p>Research Associate at Brown University School of Public Health, Providence, RI, USA<\/p>\n<p>Twitter: <a href=\"https:\/\/twitter.com\/springsstacey?lang=en\">@SpringsStacey<\/a><\/p>\n<p>No conflict of interest to declare<\/p>\n<p><a href=\"https:\/\/blogs.bmj.com\/bmjebmspotlight\/files\/2020\/08\/Stacey-Springs.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-2120\" src=\"https:\/\/blogs.bmj.com\/bmjebmspotlight\/files\/2020\/08\/Stacey-Springs-300x274.jpg\" alt=\"\" width=\"212\" height=\"193\" srcset=\"https:\/\/blogs.bmj.com\/bmjebmspotlight\/files\/2020\/08\/Stacey-Springs-300x274.jpg 300w, https:\/\/blogs.bmj.com\/bmjebmspotlight\/files\/2020\/08\/Stacey-Springs.jpg 437w\" sizes=\"auto, (max-width: 212px) 100vw, 212px\" \/><\/a><\/p>\n<hr \/>\n<p><b>DISCLAIMER<\/b><\/p>\n<p>The views and opinions expressed on this site are solely those of the original authors. They do not necessarily represent the views of the BMJ and should not be used to replace medical advice. All information on this blog is for general information, is not peer-reviewed, requires checking with original sources and should not be used to make any decisions about healthcare. No responsibility for its accuracy and correctness is assumed by us, and we disclaim all liability and responsibility arising from any reliance placed on such commentary or content by any user or visitor to the Website, or by anyone who may be informed of any of its content. Any reliance you place on the material posted on this site is therefore strictly at your own risk.<!--TrendMD v2.4.8--><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Blog entry written on: Heterogeneity of Outcomes for Intraoperative Music Interventions: A Scoping Review and Evidence Map (bmjebm-2020-111382) Authors: Melanie Ambler, Stacey Springs, Dioscaris Garcia, Christopher Born We know that 87% of operating room staff report listening to music in the OR, but an emerging body of evidence suggests that listening to music during surgical [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmjebmspotlight\/2020\/08\/24\/instructions-for-the-day-of-your-surgery-please-create-a-playlist-of-your-favourite-music\/\">Read 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