Personalized Perioperative Music Listening: A Human-Centered Approach to Precision Anesthesia

Modern anesthesia has achieved remarkable advances in safety, monitoring, and pharmacologic precision, yet perioperative anxiety continues to be a common and under-addressed aspect of surgical care, affecting a substantial proportion of patients undergoing surgery. Patients increasingly request personalized music during transport to the operating room and prior to anesthetic induction. Although often viewed as a comfort measure, this practice may represent an important component of a wider movement toward human-centered perioperative care. This narrative review summarizes contemporary evidence on perioperative music listening interventions and proposes a framework for integrating individualized sensory preferences into anesthesia practice. Sixteen empirical studies, including major systematic reviews, meta-analyses, and randomized controlled trials, are synthesized across general surgery, cardiac surgery, obstetric anesthesia, intensive care, awake craniotomy, orthopedic and breast cancer surgery, and pediatric anesthesia. The evidence generally demonstrates reductions in preoperative anxiety, postoperative pain, analgesic consumption, sedative requirements, and selected physiologic stress responses, with one randomized trial reporting greater anxiety reduction with music than with oral midazolam premedication. A neurochemical mechanism involving dopaminergic reward circuitry, hypothalamic-pituitary-adrenal axis modulation, immune mediators, and oxytocinergic social-affiliation pathways is also reviewed. A practical perioperative workflow, comparison with prior reviews, and a research agenda focused on personalization and digital perioperative profiling are presented. Personalized perioperative music listening is a low-cost, scalable, evidence-supported intervention that may help anesthesia evolve toward a more humane, patient-centered surgical experience.