Music in surgery: harmony or discord?

Surgeons’ music choices can shape how teams feel and work, new research from the University of Auckland shows.

The study, published in Scientific Reports, reveals that different sounds can bring teams together or create tension, boost confidence or distract, and even signal how a procedure is progressing.

Lead researcher Dr Anantha Narayanan, a trainee vascular surgeon and PhD candidate in the Faculty of Medical and Health Sciences, was inspired to explore the topic as a medical student after noticing music being used to create a calming atmosphere in theatre. A saxophonist, he combined his enthusiasm for music with his dedication to research.

“It started with a simple question,” he says, “does music actually have an effect in the operating theatre, or do people just enjoy it?”

That question grew into his PhD, culminating in the final Background Auditory Conditions in Healthcare (BACH) study, a qualitative exploration of music’s role in surgery.  

The study shows music is neither simply good nor bad. When chosen collaboratively, it can improve teamwork, lift mood and help patients feel at ease. But when imposed, it can create discomfort, heighten tension and reinforce hierarchy.

“A key finding is that how music is chosen matters as much as what music is chosen,” Narayanan says. “Operating theatre teams should make shared decisions, because not everyone experiences it in the same way.”

When staff are included, music can foster a relaxed and positive environment, but exclusion can highlight tensions. Many of the stories shared in the study underline how personal musical taste can be.

One participant recalled a moment of strong team cohesion when music lifted the mood during a break. “There was a point in the afternoon where three circulating nurses were all having a little dance in the back, everyone was on board, things were on track, and it was a nice time.”

But not every experience was as harmonious.

In one case, a surgeon’s affinity for opera clashed with colleagues’ preferences, while other accounts described music causing frustration or conflict. And country music from a surgeon was “quite painful when it was on for about 15 hours,” one participant said.

Music could also create awkward moments. One surgeon operated on a teenage boy who had requested rap music during a minor procedure. “It was quite appalling in terms of the language that was going on, and I was quite shocked while he was going off to sleep,” the surgeon says.

Sometimes, music underscored unforgettable moments. The Lion King’s iconic 'Circle of Life' played as a baby was lifted from the womb during a caesarean section, at the mother’s request.

Music can act as an environmental cue, the study finds. “Observers or participants in the theatre environment may use it as information to check if things are going well or not,” Narayanan says. A soundtrack may help teams relax and focus but is often turned off during critical moments to allow full focus.

Researchers conducted structured interviews with seven surgeons, anaesthetists and nurses about their experiences with music in theatre. The data was analysed qualitatively, he says, revealing five key themes: “reflection of team cohesion, contributing to a therapeutic space, not a panacea for all, a mirror to power or hierarchy and a useful environmental cue.”

Narayanan says the takeaway is simple.

“It’s not about choosing the perfect song,” he says. “It’s about making sure everyone feels included.”

He says music can be a powerful tool in the operating theatre when used thoughtfully, enhancing teamwork, communication, and the overall surgical experience.

The study, A qualitative exploration of the perceptions of music use by healthcare professionals in the operating theatre (the BACH study), was supervised by Associate Professor Anna Serlachius, with co-authors Sian Ellett, Associate Professor Manar Khashram and Professor James Fisher from the University’s Faculty of Medical and Health Sciences.