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Music in the Section Room? The Obstetricians' Perspective
Abstract Number: F-44
Abstract Type: Original Research
Introduction: Music in the operating room is a two-edged sword with studies showing conflicting risks and benefits. The OR is a noisy place and music compounds the problem. Intraoperative noise may impair concentration, communication(1) and increase stress among providers. In contrast, music can decrease team anxiety, increase cooperation(2) and even improve speed and efficiency of surgical closure(3). The obstetric OR often adds an additional consideration - the effect of music on the non-sedated patient under regional anesthesia. Music has been shown to reduce pre(4) and post-op anxiety and decrease pain and analgesic use after surgery(5). A Cochrane review of music during c-section showed improvements in maternal birth satisfaction and pulse rate. Unquestionably though, the primary focus must be on the effect of music on the obstetrician who has the single most important task in the section room. We conducted a survey to elucidate obstetricians’ perspectives on music played in the OR.
Methods: We conducted a survey of academic obstetricians in the United States on their practice and opinions regarding music played during elective cesarean section under regional anesthesia.
Results: We received 116 responses. 47% of respondents reported music was played frequently (18%) or occasionally (24%) while 53% reported rarely or never. 50% felt music “created a more positive, relaxed environment“ and “enjoyed operating with music”. 42% were indifferent while 14% felt “it is a distraction and prefer the OR with less noise”. Of those who prefer or didn’t mind music, 82% felt it should be the patients’ choice; 18% the obstetrician's. There were multiple comments on limiting the volume and on musical genre (heavy metal and rap most singled out unfavorably).
Discussion: The option of playing music during cesarean sections must be judiciously considered as a team decision. During cesarean births multiple personnel populate the operating room including the obstetric team,anesthesia, nursing, pediatrics, a support person, and ultimately, a (hopefully) screaming baby. This can lead to high levels of noise and its negative consequences. While music can increase noise levels it can potentially allay patient and provider anxiety as well. Our survey shows that half of obstetricians regard music positively while the vast majority (86%) would allow it. Most obstetricians accept the patient's choice of music. A study of cardiac surgeons showed reduced autonomic reactivity and improved task performance most significantly when they choose their own music(6). Provided the obstetric team is accepting, music may then be offered to patients. The anesthesiologist must be mindful of periods of high stress (e.g. delivery) and noise (post-delivery), control the volume and minimize distractions in the OR environment accordingly.
1.J Amer Coll Surg 2013:216
3.Aesth Surg J 2015;35
4.Anest Analg 2002:94