San Pedro, Maria Adora A.

BSN IV-Sec.6 Grp. D

JOURNAL: Music in the Operating Room

During the nineties I investigated the effect of therapeutic music on patients under
adequate anesthesia. And this was what we found.

"We trust that the magic of sound, scientifically applied, will contribute in ever
greater measure to the relief of human suffering, to a higher development and a
richer integration of the human personality, to the harmonious synthesis of all
human "notes" of all "group chords and melodies" - until there will be the greater
symphony of the One Humanity."Roberto Assagioli M.D.

Music can be employed as an aid in obtaining physical, emotional and spiritual

health. During the first half of the nineties, I investigated the therapeutic
consequences of distinct types of music on patients under adequate anesthesia.
This investigation was done in Johannesburg at the Garden City Clinic, over a period
of four years (1991-1995), with statistics done at the Witwatersrand University, by
Dr. Jackie Galpin.

Data available on investigations done to test the therapeutic benefits of music,

would fill a library of its own. That was not what was done. The effect of music with
a known therapeutic value, was investigated on patients under adequate anesthesia
- testing for reduction in pain levels and a shorter recovery period. It is an accepted
dictum in psychology that people in a deep sleep, coma or under anesthesia can
hear (not remember). That the auditory pathways up to the auditory cortex actually
remain open and untouched by anesthesia. That you can talk to people in a coma or
undergoing surgery, and that the body would respond to whatever was said. In
many hospitals, positive suggestions are given to patients in a coma and on the
operating table. The capital aim of the project was to test music to serve as a
credible alternative for the positive verbal suggestions.

Science, Medicine and Anthropology have completed many years of investigation on

the effect of music on the physical body. As early as 1830, articles were published
by J. Dogiel, which outlined experiments done to affirm music's dynamic effect on
the body. Absolute physiological reactions were established, and amongst other
things, it was proved that music act on the circulation of blood, and can cause blood
pressure to rise and fall. According to this, these alternations of pressure rely
mainly on the influence which auditory stimulation has on the medulla oblongata
and the auditory nerve.

Reaction :

Listening to melodic music decreased the activity of individual neurons in the deep
brain, says Janigro, adding that the physical responses to the calming music ranged
from patients' closing their eyes to falling asleep.Patients can be more relaxed in
the operating room. And that relaxation may mean not only that procedures involve
less medication to control blood pressure, which increases with stress.

Patient Safety In The Operating Room

Main Category: Urology / Nephrology

Also Included In: Clinical Trials / Drug Trials

Introduction: Good clinical outcomes have assumed safety in pediatric surgery. We

analyzed the operative environment to help identify patterns of variability and
processes that may affect patient safety and outcomes. There is limited formal
analysis of system constraints (staffing, resource availability, planning behaviors,
communication, scheduling cycles, through put pressures) on safety. Our
prospective study uses a formal systems engineering and human factors approach.

Methods: Minute to minute direct observations were conducted on 10 complex

urological cases. Fifteen major variables including communication, planning, task
execution, behavior, resource procurement, staffing and physical environment
features were measured. Correlations were made between the variables and their
influence of case progression, safety compromising event or near misses.

Results: One hundred and eight hours of observations resulted in > 9000 annotated
events. Clinical outcomes were consistent with expectations. However, significant
variations were noted in process outcomes: prolonged operative times -mean =
00:33:21 min; replication of procedural steps or tasks - mean = 6 per case;
unexpected modification in planned procedure due to resource unavailability - n =
2; delayed emergence from anesthesia due to uncertainty about end of case - n =
2. Detailed analysis revealed that inadequacy in communication relating to surgical
plan, including accuracy of initial booking and delayed communication of changes in
core surgical plan to other team members. Safetycompromising events included
moderate hypothermia with mild cardiac rhythm disturbances (n = 6), respiratory
depression requiring assisted ventilation post-extubation (n=2). Each safety-
compromising event had identifiable and preventable precursors.

Reaction:

This prospective analysis exposed significant preventable process variations and

events affecting patient safety. This study enabled us to objectively establish
relationships between system conditions and human factors that compromised
patient safety. The system-based vulnerabilities identified offer targets for
intervention to reduce the burden on providers and increase margins of safety.