Surgical playlists – harmony or tension in the operating theatre?


If you’re an operating theatre nurse, does your working day have a soundtrack chosen by someone else? Or do you get to control the ipod during surgery? We consider the possibly vexed question of music during surgery.

Operating theatres are noisy places. About 40 percent of the time, the noise level in theatre is over 100 decibels. In fact, noise levels in operating theatres are so high that surgical staff run an increased risk of hearing loss.

On top of all the noise generated by the surgery itself and staff conversation, music is nearly ubiquitous in theatres around the world. Some newer theatres even have built-in docking stations for ipods and phones. Music, which is generally chosen by the lead surgeon, is played roughly 62-72 percent of the time in the operating room, according to a report in The BMJ. The genre most often chosen is classical music.

There’s evidence that music can help surgeons focus and work faster. Early in 2015, one study found that plastic surgery residents closed up incisions more efficiently when they got to listen to music they liked. The findings were published in the Aesthetic Surgery Journal.

Yet even if music helps surgeons work with greater speed and accuracy, it seems to be a distraction for other members of the surgical staff.

When Sharon-Marie Weldon (senior research officer and nurse in the Department of Cancer and Surgery at Imperial College, London) and her colleagues reviewed videos of 20 surgeries at a London teaching hospital, they found that surgeons had to repeat requests to nurses five times more often when music was playing. “The impact of loud music on communications seems to be clear,” wrote the authors. “It hinders the nurses’ ability to hear the surgeon’s speech. When music masks the audibility of speech, it often results in the surgeons having to repeat themselves and consequently it takes longer for nurses to respond with assistance.”

How much longer? Delays ranged from a few seconds to just over a minute — and if there’s an emergency in the middle of an operation, seconds count.

Weldon says, “We’d like to see a more considered approach, with much more discussion or negotiation over whether music is played, the type of music and volume within the operating teams.”

surgical symphonyHowever, nurses responding to a staff survey at another UK hospital reported much more democratic control of ipods in the operating room. About a third said that surgical staff chose the music, but another third said the whole staff had a say and the remaining third thought it was up to the nurses. Fifteen percent of the surgeons surveyed agreed that the nurses had control over the music.

And that survey, in the Journal of Perioperative Practice, is also one of the few papers that describes a positive opinion about music in the operating room from nursing staff.

Roughly 80 percent of operating room staff say that music benefits communication and cooperation between team members, reduces anxiety levels and improves efficiency.

What do British surgeons choose to listen to? Here are a few offerings.

Does the playlist differ here in Australia? If you’re an OT nurse, what do you like to listen to while you’re working? Have there been conflicts or tensions about music where you work? Or are you in sweet harmony?


  1. I have a real problem with music playing because I can’t hear what is being said to me properly. I also don’t think it is a good look for the patients getting wheeled in and put on the operating table. Add people talking through surgical masks, accented English and beeping machines and it is very stressful actually. So those who think it reduces stress need to change areas if a normal OT freaks you out and you need music at work to focus.


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