BACH Study: Music’s Role in Operating Theatre Soundscapes

Music is commonly played in the operating theatre, and healthcare professionals believe it reduces stress. A new qualitative study reveals their experiences are far more complex, exposing music’s role as a tool for both team cohesion and interpersonal conflict.

Exploring the Soundscape of Surgery

The Background Auditory Conditions in Healthcare (BACH) study, led by Anantha Narayanan and colleagues at the University of Auckland, set out to document this everyday experience. Published in Scientific Reports, the research aimed to understand health care professionals’ (HCPs) experiences, beliefs, and perspectives on background music in the operating theatre (OT).

Between February and November 2024, the team conducted semi-structured interviews with seven HCPs: three surgeons, two anaesthetists, and two theatre nurses from general, vascular, and ENT specialties. Participants were recruited using purposive and snowball sampling. The researchers analyzed the interview data using qualitative content analysis, developing themes through an iterative process of open coding and collaborative review.

Music’s Dual Role: Building Cohesion and Creating Conflict

The analysis identified five major themes, painting a picture of music as a powerful but double-edged environmental factor.

Team cohesion reflected in music was a dominant theme. Participants described how shared musical taste or a collectively enjoyed playlist could improve communication, synchronize team movement, and elevate the shared mood, making a long or complex procedure feel more manageable.

Conversely, the theme Power and protection play out through music revealed the flip side. Music choice often defaulted to the senior surgeon’s preference, reinforcing existing hierarchies. Disagreements over volume or genre could create tangible tension. Some staff reported feeling unable to request a change or to turn music off, even when it hindered their concentration or caused distress.

This directly connects to conditions like misophonia, where specific sounds trigger strong negative emotional reactions. An operating theatre is a high-stakes environment where an individual’s auditory sensitivities could be significantly impacted by uncontrolled background noise.

Therapeutic Value, Environmental Cues, and Clear Limits

HCPs strongly perceived that music contributed to a therapeutic space, benefiting both staff and patients. They believed it could lower anxiety for conscious patients and reduce stress and fatigue for the surgical team. However, the authors note a critical gap: these perceived benefits lack robust objective evidence from psychological or physiological measures.

The study also found music functions as an environmental cue. The presence, type, or volume of music helped staff interpret the situation—for instance, a quiet or absent soundtrack might signal a serious complication or a critical moment in the surgery.

Importantly, the theme Music is not a panac (NAC supplement)ea established clear boundaries. All participants agreed music should never compromise patient safety or verbal communication. Its use was seen as inappropriate during certain high-risk phases of an operation or for specific patient groups.

Implications for Hearing Health and Clinical Environments

The BACH study has practical implications beyond the operating theatre. It highlights how ambient sound is a meaningful component of any clinical environment, affecting well-being and performance.

For individuals with tinnitus, hyperacusis, or misophonia, uncontrolled auditory environments can be debilitating. The finding that music can “disproportionately impact some individuals negatively” underscores the need for awareness and accommodation. Creating therapeutic soundscapes, a concept explored in tinnitus therapies from neurodegenerative research, requires considering all listeners.

The study calls for the development of structured, agreed-upon policies for music use in operating theatres. Such policies should consider volume limits, who controls selection, and protocols for turning music off. This mirrors a patient-centered approach, acknowledging that the auditory environment is part of care. The complex interplay between sound, emotion, and brain function suggested here relates to broader research on thalamocortical dysrhythmia in chronic pain and tinnitus, where maladaptive brain rhythms are influenced by sensory input.

Ultimately, the research by Narayanan et al. (PMID: 42252292) moves the conversation beyond anecdote. It provides a framework for understanding how a common practice shapes a high-pressure workplace, offering evidence that can guide more thoughtful and inclusive auditory environments in healthcare settings.