Music, aromatherapy put patients at ease during medical procedures

Before a magnetic resonance imaging exam, MRI technologist David Gonzalez of Irvine, Calif., brings out his secret weapons.

He displays a black case with an eclectic collection of CDs: Beethoven, James Taylor, Yanni, Frank Sinatra, Eurythmics, Alanis Morissette.

As you lie on the scanning table, he pops your choices into a CD player. Soon, the music wafts through your headphones. Then, he covers your eyelids with an aromatherapy eye pillow scented with a few drops of cucumber or lavender essential oils.

Aaah, let the MRI begin.

The music may not completely drown out the machine's loud bangs, but it and the scent may help you tune out the stress and anxiety during what some consider an unsettling and claustrophobic experience.

An increasing number of health-care providers say they're using these and other methods to help patients banish anxiety during diagnostic tests and before surgery. Gonzalez uses aromatherapy and music at Irvine Regional Hospital and Medical Center.

Some methods are borrowed from spas, others, such as guided imagery, from psychotherapeutic practice.

Visualization techniques — using words to paint soothing mental pictures — are among the most popular methods. Health-care providers lead patients through the visualizations just before surgery, or patients can be guided by audiotape or CD in the days before the procedure.

Methods being studied and used in other parts of the nation include acupuncture at Yale-New Haven Hospital in Connecticut and hypnosis.

Sometimes, it's a matter of an anesthesiologist taking the time to listen with compassion to a patient's worries or gently holding the patient's hand just before the sedative takes over, said Dr. Debra Morrison, director of preoperative services at University of California Irvine Medical Center in Orange, Calif. "It's an emotional relationship," Morrison said. "We're the last faces they see before the anesthesia kicks in."

The hospital identifies which surgical patients may have anxieties or worries that need to be addressed. Morrison and her staff contact them. In other cases, patients ask for discussions with the pre-op staff in the weeks or days before the surgery.

Those conversations sometimes can take a few hours, she said. "We tend to be emotionally available to them. Patients usually don't think of doctors in that way — emotionally available."

The stress-relief techniques continue in the moments before surgery in the pre-op.

"As people go to sleep, I might tell them, 'Pick a place you want to go and who do you want to go with.' If they choose a beach, I tell them to smell the salt air, listen to the waves. If they're in a field, I tell them to smell the flowers.

"When children go to sleep, I tell them about Mary Poppins and how she and the children laugh and float off the ceiling hand in hand. Or I might talk about being in space, going to the moon or Mars. We use nitrous oxide as an anesthetic, so I tell them that Martian air smells different. 'If you smell something, just blow it away.' "

Soft and soothing instrumental music such as "Ocean Surf: Escape to Serenity" floats in the background in the pre-op room. Sometimes patients will bring their own portable music players and headphones and use them just before their surgery, Morrison said.

But does it work?

A study published recently in the medical journal Anesthesia and Analgesia showed that patients who listened to 30 minutes of music of their choice during the preoperative period experienced less anxiety than patients who did not.

The radiology staff at Irvine Regional Hospital has found that to be true, said Dr. Mark Stein, medical director of radiology. The number of patients who cannot tolerate an MRI has decreased since the music option was offered several years ago. That number has dropped further since the department began providing aromatherapy, though by how much is not known.

Younger patients bring the music they play in their cars or CDs they pick after their MRI is scheduled, said Donna Bode, director of diagnostic imaging.

Blue Shield of California recently released its study on the effectiveness of guided-therapy tapes or CDs in reducing pain and anxiety from surgery.

The study found that 57 percent of patients who listened to the audio recordings said they experienced less pain than expected from their surgery; 45 percent had high anxiety before listening to the tapes, but less than 5 percent experienced similar anxiety after listening to tapes before surgery. The more anxious patients felt, the more frequently they listened to the recordings and the greater improvement they documented.