Orthopedic surgeries are identified as one of the most noisy surgeries inside the OR (operation room). The highest noise sound level could reach up to around 130 dB, which is harmful to patients’ well-being and are likely to evoke negative feelings during surgery. In the previous study investigating the emotional experience of patients who receive spinal or general anesthesia in orthopedic surgeries, results showed that different kinds of sounds inside the OR could lead to fluctuating emotions for patients, such as nervousness, curiosity, and relaxation. Therefore, this project is mainly focusing on this user group and aims to improve their experience, especially regarding sounds inside the OR. The research phase of the report includes two parts. The research in LUMC mapped out the patient journey, for instance, when, and how the design should intervene. Questionnaires for surgeons provided strong support for the rationale and effectiveness of musical interventions in this design project. Later on, the second part of the research, the one on AI music alignment proved that to some extent, AI generative model could understand the textual input with emotional descriptors, and output desired emotionally effective music that could influence the listeners’ perception. With this in mind, the design could refer to the circumplex model that Hevner and Schubert developed on music emotions to position the descriptors of specific musical emotions in two dimensions and achieve control of musical emotions in spatial terms. The design concept mainly has two phases, the preference input phase, which allows patients to choose their favorite prompt list for the AI model to generate later on adding the emotional descriptors together as prompts; the music experience phase on the other hand, mainly happens during surgery when inside the OR, patients will be able to freely explore the music emotion variations during surgery with their favorite music styles (prompts). The design goal for the project would be to design a music companion product for orthopedic surgery patients who are undergoing spinal anesthesia. The product interaction aims to improve their emotional experience during the surgery period. The interaction should be distracting, desirable, and immersive for patients. Once the general direction of the design concept is determined, the iteration phase began. The prompt input part is based on the brainstorming session and the co-creation session to develop an ideal interface for the experience. While for the music experience part, one of the three interaction ways will be chosen through the concept testing and evaluation procedure. The chosen concept will be further developed into the final concept - Music · Wave. In the future, I imagine that the OR would be an immersive sensing space for the patients as well, so adding visuals into the whole design would be another vision, that maybe will be further designed in later projects. This project, however, would only give a rough glance into what the whole experience could be like in the future, and how the surgery soundscape could be reframed.