Creating a harmonious operating room: The role of music and other sounds

•Hospital noise levels have risen around the world, with the operating room no exception.•Music is optional noise in the operating room.•Potential for benefit must be weighed against potential for disturbance.•Playing music should be a shared decision amongst operating room personnel. Music has traditionally been part of the culture of many operating room theatres around the world with a purported myriad of benefits to the patient, surgeon, and other staff. However, hospital noise levels have risen all around the world, and the operating room is no exception. While certain noises are unavoidable in the operating room, playing music is optional. Thus, as we continue efforts to improve surgical care, the decision to play music must be weighed against its potential as a further source of disturbance. The purpose of this article is to review sources of distractions in the OR, discuss the potential pros and cons of music, for both health care personnel as well as patients, and to delve into studies analyzing the effect of music on surgical trainees, as learners may be particularly vulnerable to noise. This review provides guidance as to how to optimize the OR environment so as to enhance teamwork and communication. We feel that the decision of whether to play music in the operating should be a shared decision between all operating room personnel, with more research needed to form a basis on how to improve operating room communication regarding noise pollution and music.