Music is Beneficial for Awake Craniotomy Patients: A Qualitative Study

Abstract

Objectives: Patients undergoing awake craniotomy may experience high levels of stress. Minimizing anxiety benefits patients and surgeons. Music has many therapeutic effects in altering human mood and emotion. Tonality of music as conveyed by composition in major or minor keys can have an impact on patients' emotions and thoughts. Assessing the effects of listening to major and minor key musical pieces on patients undergoing awake craniotiomy could help in the design of interventions to alleviate anxiety, stress and tension. Methods: Twenty-nine patients who were undergoing awake craniotomy were recruited and randomly assigned into two groups: Group 1 subjects listened to major key music and Group 2 listened to minor key compositions. Subjects completed a demographics questionnaire, a pre-and post-operative Beck Anxiety Inventory (BAI) and a semi-structured open-ended interview. Results were analyzed using modified thematic analysis through open and axial coding. Results: Overall, patients enjoyed the music regardless of the key distinctions and stated they benefitted from listening to the music. No adverse reactions to the music were found. Subjects remarked that the music made them feel more at ease and less anxious before, during and after their procedure. Patients preferred either major key or minor key music but not a combination of both. Those who preferred major key pieces said it was on the basis of tonality while the individuals who selected minor key pieces stated that tempo of the music was the primary factor. Conclusion: Overall, listening to music selections was beneficial for the patients. Future work should further investigate the effects of audio interventions in awake surgery through narrative means.RÉSUMÉ: La musique est bénéfique chez les patients qui subissent une craniotomie en état vigile : une étude qualitative. Objectifs: Une craniotomie peut provoquer un stress important chez les patients et tant les patients que les chirurgiens bénéficient d'une réduction de l'anxiété. La musique a plusieurs effets thérapeutiques sur l'humeur et les émotions chez les humains. La tonalité de la musique d'oeuvres en mode majeur et d'oeuvres en mode mineur peut avoir un impact sur les émotions et les pensées des patients. Le but de l'étude était d'évaluer les effets sur les patients d'oeuvres musicales en mode majeur et d'oeuvres en mode mineur pendant la craniotomie en état vigile afin d'aider à élaborer des interventions destinées à soulager l'anxiété, le stress et la tension. Méthode: Nous avons recruté 29 patients qui subissaient une craniotomie en état vigile. Ils ont été randomisés en deux groupes : les patients du groupe 1 écoutaient de la musique en mode majeur et ceux du groupe 2 écoutaient de la musique en mode mineur. Les sujets ont complété un questionnaire démographique, l'inventaire d'anxiété de Beck avant et après la chirurgie et une entrevue semi-structurée à questions ouvertes. Les résultats ont été analysés au moyen d'une analyse thématique modifiée, par codage ouvert et codage a...

Anaesthesia Management for Awake Craniotomy: Systematic Review and Meta-Analysis

“…Data of the study characteristics are shown in Table 1 . A total of fourteen case series [ 10 , 17 , 19 , 20 , 23 , 28 , 39 , 41 , 44 , 47 , 51 , 53 , 54 , 60 ] thirteen prospective studies [ 18 , 21 , 22 , 25 – 27 , 30 , 33 , 35 , 38 , 52 , 55 , 61 ], seventeen retrospective studies [ 24 , 29 , 31 , 34 , 37 , 40 , 42 , 43 , 45 , 46 , 48 – 50 , 57 – 59 , 62 ], two RCTs [ 32 , 56 ], and one pseudo-RCT [ 36 ] comprising 5945 AC procedures in 5931 patients were analysed ( Table 1 ). Of note, during the data extraction process it appeared that nine studies [ 20 , 22 , 27 , 31 , 42 – 46 ] partially repor...…”

First Report of Awake Craniotomy of a Famous Musician: Suprasellar Tumor Surgery of Pianist Clara Haskil in 1942

“…Classical harmonic instrumental music in major or minor keys and in a moderate and calm mood are more suitable than expressive and fast music or pop and rock music. 11,63 Patients who preferred major keys liked the emotional feeling of the music. Patients who preferred minor keys chose it to alleviate their anxiety.…”

“…Patients who preferred minor keys chose it to alleviate their anxiety. 11 Because of extensive preoperative management, moderate sedation, and adequate local anesthesia, most patients who underwent awake craniotomy found it to be a positive experience. 64 Patients who underwent awake craniotomy had a positive short-term response and showed no signs of posttraumatic stress disorder.…”

“…[6][7][8][9][10] Awake cranial surgery is stressful and anxiety producing for patients. 11 However, no study has reported the effect of playing Mozart piano music on an awake craniotomy patient. In this case report, we describe the intriguing case of famous pianist Clara Haskil, who underwent an awake procedure for a suprasellar tumor, during which she mentally played a Mozart piano concerto.…”

Is outpatient brain tumor surgery feasible in India?

“…[14] Since 1991, the senior author has routinely performed awake craniotomy for intra-axial brain tumors with low complication rates and minimum resource utilization. [9,10,12,31] In 1996, a pilot study was initiated at the senior author's hospital in Toronto to assess the feasibility of performing craniotomy for tumor resection as an outpatient procedure. [13] The results of this study were reported in 2001.…”