Does music improve microsurgical anastomosis performance? A randomized crossover trial in trainees

Music is frequently played in operating rooms, often credited with enhancing comfort and alleviating stress; however, its influence on microsurgical performance during training remains unclear. This study aimed to evaluate the effect of background music on clamp time during microsurgical arterial anastomosis by trainees. Secondary objectives included assessments of dexterity, vessel patency, concentration, and anxiety levels. We conducted a prospective, single-center randomized crossover study involving 20 trainees enrolled in a Level 1 microsurgery course. Each participant performed an end-to-end carotid anastomosis on a rat model under two conditions: with music and without music. The primary endpoint measured was clamp time (in minutes), while secondary outcome measures included technical self-assessment, vessel patency, perceived concentration, and anxiety levels. The mean clamp time was 48.2 ± 25.7 min with music compared to 55.0 ± 38.8 min without music (p = 0.34). No significant differences were detected in technical performance, vessel patency, concentration, or anxiety. Participants' appreciation of music correlated with their typical operating room practices but did not lead to measurable performance differences. In this crossover study, we found no statistically significant impact of background music on microsurgical performance in trainees. However, the study was underpowered to detect modest effects, indicating the need for larger-scale research to more accurately assess the role of music during microsurgical training.