Music in Surgery: Staff Perspectives

Background music is a common feature in operating theatres, widely perceived by surgeons, anesthetists, and nurses to reduce stress and fatigue. However, objective scientific evidence for these benefits is limited, creating a gap between perception and measured reality. A new qualitative study, known as the BACH study, directly explores this gap by interviewing healthcare professionals about their experiences with music in the OR. The findings reveal a complex picture where music can build team spirit but also create tension and expose workplace hierarchies, with significant implications for auditory health and comfort in high-stakes environments.

How the BACH Study Captured Staff Perspectives

Led by Anantha Narayanan and colleagues from the University of Auckland, the BACH (Background Auditory Conditions in Healthcare) study used in-depth interviews to understand the role of music from the user’s perspective. The researchers recruited seven healthcare professionals—three surgeons, two anaesthetists, and two theatre nurses—from general, vascular, and ENT (ear, nose, and throat) specialties between February and November 2024. Using a method called qualitative content analysis, the team identified patterns and themes in the interview transcripts, working collaboratively to refine their conclusions. This approach, grounded in a critical realist epistemology, aims to understand the subjective experiences and beliefs that drive behavior in the operating theatre.

Five Themes: The Dual Nature of OR Music

The analysis identified five major themes that describe the multifaceted and often contradictory role of music.

Team Cohesion and Shared Mood

Participants reported that shared musical taste or a collectively agreeable playlist could foster a positive, collaborative atmosphere. Music was seen as a social lubricant that elevated the shared mood of the team, potentially smoothing communication during long or complex procedures.

Music as a Therapeutic Space

Many healthcare professionals believed music created a calmer environment, benefiting both staff and patients. The notion that a relaxed surgical team performs better was a common perception, even in the absence of concrete physiological evidence.

Music is Not a Panac (NAC supplement)ea

Critically, the study highlighted that music is not a universal solution. The researchers identified sub-themes showing music could “create or exacerbate interpersonal tension” and “reinforce hierarchy.” Choices about volume, genre, or who controls the playlist could become sources of conflict, disproportionately affecting individuals who disliked the music or found it distracting.

Power and Protection Dynamics

This theme explicitly addresses control. Often, the most senior surgeon dictates the auditory environment, a practice that can silence the preferences or discomforts of others, including nurses, anaesthetists, and trainees. This power dynamic can leave staff feeling they have no recourse if the music causes them stress or auditory discomfort.

Music as an Environmental Cue

Staff reported using music as a situational signal. For instance, a change in music genre or volume might indicate a shift in surgical phase, from a tense moment requiring concentration to a more routine closure phase. The absence of music could also signal an emergency or a serious complication.

Implications for Auditory Health and Workplace Policy

The BACH study’s findings extend beyond the operating theatre into broader discussions about auditory health. The fact that music can “disproportionately impact some individuals negatively” directly intersects with conditions like hyperacusis (reduced tolerance to sound) and misophonia (a strong negative emotional reaction to specific sounds). A staff member with undiagnosed hyperacusis or misophonia could experience genuine distress in a music-filled OR, yet feel powerless to object due to the hierarchical themes identified.

This connects to research on misophonia stress in audiology students, which highlights how sound sensitivities can affect well-being and performance in healthcare training environments. Furthermore, the study’s call for more structured policies mirrors discussions in managing misophonia in adolescents and young adults, where controlled auditory environments are often a key accommodation.

Practically, the study suggests hospitals should consider formal guidelines for OR music. These could include designated “quiet periods,” shared playlist creation, and clear protocols that allow any team member to request a volume or music change without reprisal. Acknowledging that the auditory environment is a collective workspace issue, not just personal preference, is a vital step.

Bridging the Perception-Evidence Gap

The BACH study by Narayanan et al. provides a necessary qualitative foundation for a phenomenon long accepted but poorly examined. It confirms that while healthcare professionals believe in the benefits of music, these benefits are not guaranteed and come with significant social and psychological costs for some. Future research should measure physiological stress markers in staff under different auditory conditions to test these pervasive perceptions. For now, the study serves as a reminder that in environments dedicated to patient care, the auditory well-being of the care team itself warrants careful attention.

Source: Narayanan A, Ellett S, Fisher JP, et al. A qualitative exploration of the perceptions of music use by healthcare professionals in the operating theatre (the BACH study). Sci Rep. 2026; doi: 10.1038/s41598-026-46401-4. PMID: 42252292.