Music in Surgery: A Study from Delhi

In an operating room in Delhi, a woman lies still as surgeons prepare to remove her gallbladder. She’s under general anaesthesia—fully unconscious and immobilized by medication designed to ensure deep sleep and pain relief.

Amid the sounds of medical equipment and the surgical team’s movements, soft flute music plays through her headphones. It’s intriguing, isn’t it? Even though her brain is largely muted by the anaesthetic, the pathway for sound remains partially active. When she eventually wakes up, she is expected to regain consciousness faster and more clearly, thanks to lower doses of anaesthetic compared to those who didn’t listen to music.

This finding comes from a new study by researchers at Maulana Azad Medical College. Published in the journal Music and Medicine, it suggests that playing music during anaesthesia can effectively lower drug requirements and improve recovery outcomes.

The research focused on patients undergoing laparoscopic cholecystectomy, which is a relatively quick procedure—a lot of pressure for a speedy recovery, really. To grasp the researchers’ reasoning behind using music, one must first look at how modern anaesthesia operates.

“Our goal is to have patients discharged quickly after surgery,” remarks Dr. Farah Husain, a senior anaesthesia specialist and music therapist involved in the study. “They need to wake up alert and ideally without pain. Better pain management can help ease the stress response.”

To achieve this, anaesthesiologists usually combine five or six drugs to keep patients unconscious while managing pain and muscle relaxation.

During procedures like gallbladder removal, it’s common now for anaesthesiologists to complement this mix with regional anaesthetic techniques, known as blocks. “General anaesthesia plus blocks is standard practice,” explains Dr. Tanvi Goel, the study’s lead investigator. “We’ve been doing it for decades.”

Yet, even when patients are under anaesthesia, their bodies react. Heart rates can spike, hormones can surge, and blood pressure might increase. Managing this physical stress is crucial, as it can slow down recovery and escalate inflammation.

Interestingly, the stress response can begin even before surgery starts, during the intubation process, where a breathing tube is placed in the patient’s windpipe. This step, although routine, is often the most stressful part of anaesthesia for patients’ bodies, despite them being unconscious.

As Dr. Sonia Wadhawan, director of anaesthesia at the college, puts it, “Even when unaware, patients’ heart rates and hormone levels change due to stress.” Of course, medication has come a long way; older ether masks have given way to intravenous treatments like propofol, which is favored for its quick action. “Propofol works in about 12 seconds,” notes Dr. Goel. “It’s especially great for shorter surgeries because it avoids the ‘hangover’ effect of gas-based anaesthetics.”

The research aimed to see if music could allow for a reduction in propofol and fentanyl dosage. Less medication means quicker awakenings and fewer side effects. A pilot involving eight patients led to a larger 11-month trial with 56 adults, divided into two groups. Both groups received the same drugs, but only one listened to music through noise-cancelling headphones.

Patients selected from calming instrumental tracks—soft flute or piano. Dr. Husain remarks, “The unconscious mind has areas that stay active. Even if the music isn’t remembered, it can still positively influence the brain.”

The findings were quite revealing. Those who listened to music required lower doses of anaesthetic, recovered more smoothly, and had better-managed stress levels during surgery. “Since hearing remains intact under anaesthesia,” the researchers note, “music can influence the brain’s internal state.”

It appears that music helps quiet the mind during such an intense experience. “The auditory pathways are still engaged even when you’re unconscious,” explains Dr. Wadhawan. “You might not remember it, but your brain registers it.”

The concept that a patient may still perceive their environment—even in a state of deep sedation—has fascinated researchers. Some rare cases of “intraoperative awareness” show that patients can recall snippets of conversations from the operating room.

So, if the brain can remember stressful moments, then could it also register more soothing experiences like music? Dr. Husain suggests that we are just scratching the surface of understanding how the unconscious mind reacts to non-drug interventions like music, indicating a trend toward more human-centered approaches in surgery.

Music therapy isn’t entirely new to healthcare; it has found its place in various fields like psychiatry and rehabilitation. However, its application in the highly technical domain of anaesthesia signals a noteworthy shift.

If such a straightforward intervention can lessen drug intake and promote quicker recoveries—even just a bit—it could transform surgical practices in hospitals. As the team gears up for further studies on music-aided sedation, one insight is clear: Even when a patient’s body is still, and their mind is resting, the right notes can set the stage for healing.