Education

Pain, Anxiety and Music During Awake Surgery

Being awake does not mean being in pain. Anxiety and sound shape how a procedure feels, and music is one of the simplest tools we have.

What you may feel

Local anesthesia blocks pain signals but not necessarily pressure, pulling or vibration. Many patients describe these sensations as noticeable but not painful. Anxiety can amplify discomfort, which is one reason comfort measures matter. You can always tell the team if something hurts, and we can add more anesthetic or sedation.

What research shows about music

  • A Lancet meta-analysis of randomized trials found music was effective for postoperative pain, anxiety and analgesic use, and was effective even when patients were under general anesthesia.
  • A 2018 meta-analysis in the British Journal of Surgery examined music interventions for anxiety and pain in surgery.
  • An umbrella review of 2025 found that most included reviews reported a statistically significant effect of music listening on anxiety and pain.
  • In a randomized trial of 107 orthopedic patients under spinal anesthesia, the music group had a significant reduction in anxiety after surgery (p = 0.023) and needed less additional sedation (p = 0.004).
  • A randomized trial during carotid endarterectomy under regional anesthesia examined music for awake patients.

Caveats

The size of the effect varies between studies, and reviews note that it depends on factors such as type of music and timing. Music helps with comfort, but is not a substitute for anesthesia.

What you can do

Bring a playlist or tell us what you like. You can choose music, ask for quiet, or have a conversation. It is your surgery.

Explore your options at a consultation

References

  1. Hole J, Hirsch M, Ball E, Meads C. Music as an aid for postoperative recovery in adults: a systematic review and meta-analysis. Lancet. 2015;386(10004):1659-1671. PMID 26277246
  2. Kühlmann AYR, de Rooij A, Kroese LF, et al. Meta-analysis evaluating music interventions for anxiety and pain in surgery. Br J Surg. 2018;105(7):773-783. PMID 29665028
  3. Parr H, Hu J. Music interventions to reduce anxiety and pain in surgical patients: an umbrella review. J Perianesth Nurs. 2025;40(5):1316-1324. PMID 40448991
  4. Lee HY, Nam ES, Chai GJ, Kim DM. Benefits of music intervention on anxiety, pain, and physiologic response in adults undergoing surgery: a systematic review and meta-analysis. Asian Nurs Res. 2023;17(3):138-149. PMID 37276961
  5. Azi LMTA, Azi ML, Viana MM, et al. Benefits of intraoperative music on orthopedic surgeries under spinal anesthesia: a randomized clinical trial. Complement Ther Med. 2021;63:102777. PMID 34571144
  6. Kavakli AS, Kavrut Ozturk N, Yavuzel Adas H, et al. The effects of music on anxiety and pain in patients during carotid endarterectomy under regional anesthesia: a randomized controlled trial. Complement Ther Med. 2019;44:94-101. PMID 31126582