Listening to Music During Surgery Reduces Pain and Stress at Erasmus MC

Music as medicine successfully halves postoperative delirium rates in hospital patients, according to clinical findings published by researchers at Erasmus MC in Rotterdam. Led by anesthesiologist Markus Klimek, the ‘Music as Medicine’ research program demonstrates that allowing patients to select their own preferred musical genres—ranging from jazz and classical to techno and hardrock—significantly reduces postoperative complications, pain, and anxiety.

Postoperative Delirium Halved Through Patient-Selected Music

Recent results published in The American Journal of Geriatric Psychiatry by Klimek and his colleagues show a dramatic drop in severe post-surgery confusion. In a controlled trial of more than 500 patients, the control group experienced a 16 percent rate of postoperative delirium. By comparison, the patient group that listened to preferred music experienced an 8 percent rate—effectively cutting the occurrence in half, according to the published data.

Following these findings, the research team is calling on hospital departments to integrate music as a standard, cost-effective form of clinical care. Klimek notes that health insurance providers have already expressed interest in the study’s outcomes. Calculating the exact financial savings remains complex due to the difficult-to-quantify cognitive and social impacts of delirium, but researchers anticipate substantial healthcare savings from this low-cost intervention.

Overcoming Skepticism and Finding the Right Musical Genre

The institutional research program began in 2012 under the direction of Hans Jeekel, emeritus professor of surgery and a dedicated pianist who launched the initiative upon his retirement. Initial reactions from hospital colleagues were deeply skeptical. According to Klimek, music was historically dismissed as a soft intervention, prompting the team to enforce rigorous scientific methodologies that evaluate music with the same scrutiny applied to pharmaceutical drugs.

To determine which genres offer the best analgesic effects, researchers tested healthy volunteers at the Lowlands music festival and in laboratory settings by exposing participants to ice water and mild electrical shocks. While classical music is widely associated with the “Mozart effect,” Erasmus MC’s research demonstrated over the past five years that a patient’s personally preferred music yields the strongest reduction in pain. However, researchers apply a caveat for a small percentage of emotional listeners who might associate specific tracks—such as Whitney Houston’s “I Will Always Love You”—with pain, rendering those choices counterproductive.

Measuring Physiological Impact and Future Anesthesia Reduction

Patient-reported stress and anxiety levels drop by 30 to 50 percent when listening to preferred playlists, a metric supported by biological measurements of the stress hormone cortisol, as detailed by Erasmus MC researchers. The hospital protocol instructs patients to bring their own personal music devices and playlists prior to admission, though participation remains entirely voluntary, allowing patients to opt out for religious or personal reasons.

While the exact neurological mechanism remains under investigation, a publication from February outlines five potential pathways. Music increases overall brain activity, connects distinct musical elements like pitch and rhythm to specific brain regions, and boosts concentrations of neurochemicals such as oxytocin, serotonin, dopamine, and endorphins. Researchers are also exploring potential placebo effects, though finding a suitable control alternative remains a methodological challenge.

Frequently Asked Questions

What types of music can patients choose?

Patients can choose any genre of music they prefer, including jazz, pop, classical, techno, hardrock, or gangstarap, according to Erasmus MC researchers.

Does music reduce pain across all surgical procedures?

Yes, clinical testing shows similar reductions in pain, stress, and anxiety across various operations, including gastrointestinal surgery, pediatric plastic surgery, neurosurgery, and intensive care treatments.

Are patients forced to listen to music in the hospital?

No, the music intervention is entirely voluntary. Patients are informed beforehand and can choose to decline based on personal or religious preferences.

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