Listening to Music During Anesthesia Does Not Reduce the Sevoflurane Concentration Needed to Maintain a Constant Bispectral Index

Peter Szmuk, MD*, Nimrod Aroyo, Tiberiu Ezri, MD, Gleb Muzikant, MD||, Marian Weisenberg, MD||¶, and Daniel I. Sessler, MD
From the *Department of Anesthesia, University of Texas Southwestern Medical School and Children’s Medical Center at Dallas, Texas; Outcomes Research Consortium, The Cleveland Clinic, Cleveland, Ohio; Department of Anesthesia, Tel Aviv University, Israel; The Edith Wolfson Medical Center, Holon, Israel; ||Department of Anesthesia, The Edith Wolfson Medical Center, Holon, Israel; and ¶Sackler School of Medicine, Tel Aviv University, Israel.

BACKGROUND: Music reduces stress responses in awake subjects. However, there remains controversy about the role of music or therapeutic suggestions during general anesthesia and postoperative recovery. We thus tested the hypothesis that intraoperative exposure to soothing music reduces the end-tidal concentration of sevoflurane (ETSevo) necessary to maintain bispectral index (BIS) near 50 during laparoscopic surgery.

METHODS: Forty patients, aged 40–60 yrs, ASA I and II, undergoing laparoscopic hernias or cholecystectomy under general anesthesia were studied. All patients were connected to a BIS monitor. Anesthesia was induced with fentanyl 2 µg/kg, sevoflurane in oxygen, rocuronium (0.6 mg/kg), and maintained with sevoflurane in oxygen and 50% nitrous oxide, with an infusion of fentanyl (1 µg · kg–1 · h–1). Sevoflurane was titrated to maintain BIS near 50 throughout the procedure. Patients were randomly assigned to either listen to music or not.

RESULTS: The ETSevo necessary to maintain a BIS near 50 was virtually identical in patients who listened to music (1.29 ± 0.33%) and those who did not (1.27 ± 0.33%, P = 0.84). Patients who listened to music reported slightly less pain, but the difference was not statistically significant. Mean arterial blood pressure was slightly higher in patients who listened to music (101 ± 11 mm Hg) than in those who did not (94 ± 10 mm Hg, P = 0.040).

CONCLUSIONS: The end-tidal concentration of sevoflurane required to maintain BIS near 50 during laparoscopic cholecystectomy was virtually identical in patients exposed to music or not. Although previous work suggests that music reduces preoperative stress and may be useful during sedation, our results do not support the use of music during surgery.