Anesthesia and the baby born on Christmas


Newborn Baby at Christmas

 All over the world today, Christmas babies were born.  Having a baby on Christmas day is indeed a special thing and these babies have got to feel special for their entire lives.  Earlier today, I was talking with my son-in-law who is an anesthesia resident at a large hospital in Boston.  I asked him how many of the Moms that gave birth today used music during their procedure and was surprised to hear that not many of them did!?

Of course, he pointed out that he was only present for C-sections and those are very different from vaginal delivery births where the mom has gone into labor on her own and hopefully,  planned her childbirth experience very intentionally.
Over the years, Moms and doctors have told me of babies born on Christmas to the strains of “For Unto Us a Child is Born,”  “O Holy Night,” and other appropriate Christmas birthing music!  The fact is, music during labor can do lots of wonderful things, from calming, comforting and distracting the Mom between contractions, to actually keep labor moving along with a consistent, persistant rhythmic beat.  I’ve always thought that Ravel’s “Bolero” during labor would be quite enjoyable and helpful!
If you or a loved one had a baby at Christmas, please share your experience with me!
By DrAlice|December 26, 2011|delivery|0 Comments

Music and Surgery: Music Medicine or Music Therapy?


Many people do not understand the difference between music medicine and music therapy.  To me, it’s not a big deal, but to some people it is a huge deal.  My mentor, Dr. Arthur Harvey, explained it to me like this:  in order to conduct a music therapy session, a music therapist must be present.  It is the therapeutic relationship between the music therapist “doing” music with the patient that creates the result.  Music therapy is what worked miracles with Gaby Giffords.  Music therapy is a wonderful, fantastic modality with many situations, especially situations needing rehabilitation.

This is not true with music medicine.  The use of music during surgery is an example of music medicine.  In this situation, the music, as chosen by a clinical musicologist for its unique properties and suitability for pre-surgery, surgery, and recovery works all by itself.  When played for the patient through wireless, lightweight headphones, well-documented benefits result!  The surgery suite needs a surgeon, an anesthesiologist and several nurses and surgery techs.  They do not need one extra person!

This may not sound earth-shaking to you, but in a litigious society, and a hospital community that is terrified of lawsuits and staph infections, the surgery headphones provide a lot of comfort and benefits for both patient and doctor.   The anesthesiologist gets the patient to sleep more easily because the patient is already relaxed by music.  The patients wake up faster and with fewer complications, because they required less anesthesia.  In recovery, they require less pain medication because the soothing music and the entrainment phenomenon have kept the patient relaxed and therefore they experience less pain.

We have two clinical trials in progress right now and are working with hospitals around the country to get our headphones into their operating rooms for all patients.  If you or a friend or a family member is having surgery, please be sure that they have the information about music and surgery!


Surgical Serenity Headphones: Wireless or Cordless?


  When people contact me about helping them use music during surgery, my first    recommendation is always the pre-programmed, cordless headphones I have created.  When I first had the idea to create cordless, pre-programmed headphones, back in 2005, the term “wireless” was not nearly as associated with “wireless network” as it is now. 

 My intention was to have headphones that were entirely “self-contained” and not dependent on being tethered to an iPod or any other transmittal device.  I just figured that it would be one less thing for surgeons and anesthesiologists to worry about getting tangled up with their equipment!

I called them “wireless” at that time, but now I think it is important to confirm that they are indeed “cordless” but are not what today we call “wireless.”  This is quite an important differentiation too, because transmitting a signal in the OR would involve FCC communication and just throw another stumbling block up to people and hospitals that are contemplating using them in the OR. 

Please let me know what your questions might be!  We certainly are hearing from hundreds of satisfied customers around the world about their effectiveness in calming the patient before surgery, and reassuring them when they wake up in surgery with beautiful music still playing!


Propofol and Music during surgery


The trial of Conrad Murray is over and he was found guilty.  Things have to get pretty bad for someone to need propofol to sleep every night!  But Dr. Murray was willing to do this for Michael for enough money!

  It seems that Propofol has been used in surgery for about 35 years now and has been used safely.  Of course, Propofol (diprivan) was never intended to put people to sleep; people who suffer from insomnia and are at home.  Propofol is en extremely effect agent for inducing anesthesia and temporary amnesia.  Because of its milky appearance and its usefulness in the operating room, it is sometimes called “Milk of Amnesia.”  Tragically, Dr. Murray was accused of involuntary manslaughter because he illegally gave Michael Jackson Propofol in his home, because Jackson had severe insomnia.  Apparently, Murray had been doing this for sometime but did not know enough about the whole process to prevent this from happening.

Can music through headphones be used to affect the amount of Propofol required by the patient?  Take a look at this  study, done back on 2005, which I now present to you:

Anaesthesia. 2005 Oct;60(10):990-4.

Effects of music on target-controlled infusion of propofol requirements during combined spinal-epidural anaesthesia.


Department of Anaesthesiology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. [email protected]


The sedative effects of music were evaluated using the bispectral index (BIS) during target-controlled infusion (TCI) propofol. A total of 110 women undergoing hysterectomy were randomly allocated to receive either music or no music. Propofol was administered using target-controlled infusion and the concentration adjusted gradually to achieve an observer’s assessment of alertness/sedation (OAA/S) score of 3 intra-operatively. The haemodynamic and bispectral index values during the sedation phase were recorded. Interleukin-6 was evaluated before, immediately after and 1 h following intervention. The music group had a significant reduction in mean (SD) induction time of sedation: 12 (12) min vs. 18 (12) min, p < 0.01; propofol target concentration: 1.6 (0.3) vs. 2.4 (0.4), p < 0.0001; intra-operative amount of propofol: 171 (98) mg vs. 251 (92) mg, p < 0.0001; and significantly higher levels of satisfaction with their peri-operative care: 9.6 (0.6) compared to the control group: 8.1 (1.0), p < 0.0001. No other differences were found. The results show the influence of music on the induction time of sedation, concentration and level of propofol during surgery, and suggest sedative benefits of music.



Preparing for anesthesia during surgery


Recently, the Chicago Tribune posted an interesting article about people who are quite fearful of anesthesia during surgery.  They don’t mention the use of music, but of course that is one of the most helpful ways to calm yourself and require less anestheisa.

“For many patients, anesthesia is the scariest part of surgery. But you can ease your fears — and help prevent the rare negative outcome — with awareness and good communication with doctors, says Dr. Paul Rein of Virginia Anesthesia VAPCS in southeastern Virginia.

•Don’t panic. The chances of dying in a car crash are about 40 times greater than from an anesthetic, Rein says. “The reality is anesthesia has become very safe because of better techniques, better monitoring and better practitioners,” he says.

•Don’t cheat on “no food or drink” orders. As a rule, patients should have nothing for eight hours before surgery — even gum. If you vomit while under anesthesia, the contents can get into your lungs, which can be dangerous.

•Know your medical history. Tell your doctor the specific names and doses of all drugs you take, as well as past surgeries. If you’ve had problems with anesthesia before — including nausea — speak up. Also pass along any known family history of complications.

•Stop taking herbal medications. Doctors generally advise avoiding these products for two weeks before an operation, as they can cause increased bleeding.

•Ask questions. Meet with your anesthesiologist and get all the answers you need before heading into the operating room. Learn about the type of drugs you will get; you may have a choice between general or regional anesthesia.

•Arrange for a caregiver. A responsible adult should drive you home and stay with you the day of an outpatient surgery, even after minor operations. Don’t take a taxi or get dropped off at home alone; on top of recovering from surgery, you’ll likely feel the effects of anesthetic drugs for several hours


Surgery with Music Series Post #30: A Recap of why music is so important for your surgery


If you’ve been reading this 30-day series of posts of music with surgery, and you’re still not convinced of music’s power during surgery, I just don’t know what to tell you.  People all over the world, both patients and medical staff including surgeons, anesthesiologists, nurse anesthetists and techs of all kinds are recommending the use of music before, during and after surgery.  There are absolutely no drawbacks or side-effects and so many benefits that the choice is clear.

If you have the ability to make your own playlist, that’s great!  If you have enough lead time to do it, I think it’s a great idea.  I did it for myself back in 1994 when I had a lumbar laminectomy.  The doctors were astounded at how well everything went and how quickly I recovered.  I did it for my mother’s heart bypass in the early 90’s and after quite a bit of skepticism initially, she had such a positive experience that she said she would never again have surgery without music and headphones.

I have been helping patients to use music during their surgery since late 1990 when I began reading about the work of well-known music therapist, Helen Bonny.  I would usually mention her work when I went out speaking at hospitals and universities and associations.  Invariably, someone would say “Dr. Cash, I don’t believe that many people at all know about this music and surgery idea.  I think you should really try to get the word out!

After that, the rest is history.  I have worked with thousands of patients around the world and in 2008 I got a patent on my Surgical Serenity Headphones.  Although you can purchase them online at, my main goal is to get them into hospitals around the world so that they are ready to go when a patient arrives for surgery.  They would be told about the process of wearing the headphones upon arrival at the hospital and would be issued a set of headphones that would then be theirs to keep, eliminating the risk of infection from previous users.

If you are associated with a full-service hospital, please check out the headphones and the documented benefits.  Using the headphones can greatly reduce the amount of drugs and anesthesia required and create a calmer more peaceful atmosphere for the patient.   As a result of less anesthesia, the patient will recover faster and get back to work sooner and with less trauma.  Every doctor or nurse that I have ever talked to about these has said it is a great idea and that they will be standard equipment in all operating rooms one day!  Please join me in making this dream come true.


Surgery with Music Series Post #29: Having a C-section


 Having a Cesarean section childbirth is one of those situations that has very few absolutes.  Sometimes it is scheduled in advance and sometimes it is a relatively last-minute decision, based on a long and unproductive labor.

 The woman to your left had a scheduled C-section after going almost two weeks past her due date.   With my assistance she arrived at the hospital on the scheduled date but found that there were many women schduled before her.  She had not decided when we arrived whether or not she wanted to use the headphones.  After waiting for 30-45 minutes, she was told that she would be prepped for the C-section and then would wait in a room with other women also scheduled for C-sections.

Unlike the women who went into labor on their own, she was not given a private labor room so that she and her husband might be alone before the new baby arrived.  Upon entering the c-section waiting area she discovered that there was no privacy at all.  Somen were talking loudly on cell phones, some were talking loudly to their husbands, and one woman was berating her husband in a way that was very upsetting to the others!

It was at this point that my patient decided to put on the headphones, close her eyes and drift off to her own private sonic cocoon.   She claims that they saved her sanity without a doubt!

Needless to say, these pre-programmed headphones, with calming, soothing classical music that entrains your heart-rate, your breathing and your overall mood, can be helpful in many, many different hospitals areas.  Imagine being in the ER, the ICU or the CCU.  Imagine being in a ambulance with siren blaring or a stat flight helicopter.  Don’t wait for an emergency.  Have your headphones to be enjoying and relaxing with right now and you’ll be prepared!


Surgery with Music Series Post #28: Procedures other than surgery


We all know that there are many serious medical procedures both elective and non-elective.  People ask me all the time if the headphones can be used for situations other than surgery.  The answer is a resounding “Yes!”

There are so many medical procedure performed every day, procedure that are serious but don’t involve cutting into the body with knives or lasers.  Some of these procedures are things like kidney dialysis, chemotherapy and radiation, colonoscopy and diagnostic procedures such as MRI’s and CT scans.  Then there are the elective procedures that often are found in the cosmetic surgery realm:  liposuction, botox injections, and lifts of all kinds to various parts of the body.

Whether your surgery is mandatory or elective, music can help to relax you and calm you and enable you to use less pain medication and less anesthesia.  All of this translates to a safer procedure and a faster recover and return to life.  Of course dental procedures such as root canals, crowns, and implants would definitely benefits from using your headphones to help muffle the sound of the dreaded drill.

No matter what the procedure, using music through headphones will make it easier and less painful.


Surgery with Music Series Post #27: Can you make your own surgery playlist?


Of course you can!  If you have enough lead time for your surgery or other medical procedure, and if you understand what the best kind of music is, you absolutely can make your own playlist.

I believe that the cordless headphones are best though, because they can’t become entangled with any other hospital equipment and are not emitting a signal that could interfere with other medical equipment in the OR, ICU, Emergency Room or other area of the hospital.

So what are the advantages of ordering the Surgical Serenity Headphones?  The two biggest are conveniences are…they are ready to go and can be shipped to you overnight if necessary; they have already been programmed for you by a clinical musicologist who has been working in this area for over 20 years!

The music that I have chosen is based on my work with hundreds of surgery patients and surgical procedure of all kinds.  I am also a psychotherapist, so I understand the extreme anxiety and emotional angst that people go through when they are told that they need surgery.  This music is the absolutely most soothing and calming music that I’ve come across and it doesn’t matter so much what your usual taste in music might be.  This music seems to calm everyone that has heard it and it will work for you too.

If you want to make your own playlist, have the time to do it, and can find cordless headphones, that’s also great!  Please let me know what your questions might be!  Best wishes and good health to you always!


Surgery with Music Series Post #26: What the news media says


Our series of 30 posts on Music with Surgery is rapidly drawing to an end. I thought that perhaps my readers would like to know what some of the major news media have to say about the whole idea. They tend to be critical of such new ideas, but take a look at today’s source:

“A new study by the Yale School of Medicine confirms previous work showing that surgery patients listening to music require much less sedation.

Previous studies left open the question of whether it was music that did the trick, or just the act of blocking out the sound of dropped surgical instruments and other operating room noise.

In the new study, researchers tested 90 surgery patients at two facilities. Some wore headphones and listened to the music of their choice. Others heard white noise, that hiss and hum common to office buildings that’s designed to drown out harsh noises. Others had no headphones.

Blocking sounds with white noise did not decrease sedative requirements, the study found, music did.”

Doctors and patients should both note that music can be used to supplement sedation in the operating room,” said study team member Zeev Kain, a Yale professor in the Department of Anesthesiology.

The results are detailed in the May issue of the journal Anesthesia & Analgesia.