Original Articles
Relaxation music decreases the dose of patient-controlled sedation during colonoscopy: A prospective randomized controlled trial

https://doi.org/10.1067/mge.2002.120387Get rights and content

Abstract

Background: A prospective randomized controlled trial was performed to test the hypotheses that music decreases the dose of sedative medication required for colonoscopy and that the combination of music and patient-controlled sedation improves patient acceptance of colonoscopy. Methods: One hundred sixty-five patients scheduled to undergo elective colonoscopy were randomized to receive 1 of 3 different modes of sedation: Group 1, a combination of music and patient-controlled sedation with a mixture of propofol and alfentanil; Group 2, patient-controlled sedation alone; Group 3, music alone with diazemuls and meperidine administered intravenously if requested by the patient. Each bolus of patient-controlled sedation delivered 4.8 mg propofol and 12 μg alfentenil. Music was provided by means of a portable compact disc machine with headphones. Outcome measures assessed immediately after colonoscopy and 24 hours later included dose of patient-controlled sedation used, complications, recovery time, pain score, satisfaction score, and willingness to repeat the procedure with the same mode of sedation. Results: The mean (SD) dose of propofol used in Group 1 was significantly less than Group 2 (0.84 mg/kg [0.69 mg/kg] vs. 1.15 mg/kg [0.83 mg/kg]; p = 0.02, t test). The mean (SD) satisfaction score was higher in Group 1 (7.8 [2.1]) compared with Group 2 (6.8 [2.3]) and Group 3 (7.4 [2.3]) (p = 0.05, 1-way analysis of variance). The majority of patients in Group 1 were willing to repeat the same mode of sedation when queried immediately after colonoscopy (87%) and 24 hours later (75%), which was significantly different from the corresponding results in the other 2 groups; p = 0.04 and p < 0.01 respectively, chi-square test. Conclusions: Music can decrease the dose of sedative medication required for colonoscopy. The combination of music and patient-controlled sedation was the best-accepted mode of sedation among 3 groups. (Gastrointest Endosc 2002;55:33-6.)

Section snippets

Patients and methods

Between May and September 2000, 165 patients between the ages of 16 and 75 years scheduled for elective outpatient colonoscopy agreed to participate in the trial. Patients were randomly assigned by using computer-generated numbers to 1 of 3 groups: Group 1, PCS with music; Group 2, PCS alone; and Group 3, music alone. Patients in Group 3 could request intravenous administration of diazemuls (0.1 mg/kg) and meperidine (0.5 mg/kg) if they could not tolerate the procedure. PCS was delivered by

Results

The 3 groups were comparable with regard to age, gender, indications for colonoscopy, American Society of Anesthesiology grading, previous colonoscopy, number of complete colonoscopies, episodes of hypotension, and recovery time (Table 1).

. Summary of results

Empty CellGroup 1 (n = 55) PCS + musicGroup 2 (n = 55) PCS aloneGroup 3 (n = 55) Music alonep value
Median age (interquartile range)54 (46-68)47 (39-67)51 (40-65)0.21*
Gender (male:female)33:2229:2627:280.51†
Indications
 Rectal bleeding1722220.74†
 Change in

Discussion

The beneficial effects of music therapy have been recognized for many years. The results of clinical studies suggest that music has positive psychological and physiologic effects, and thus music has been used as an anxiolytic for relieving stress or for stress-related intervention.5, 6, 7, 8 However, differences with respect to sample sizes, control groups, or outcome measures make it difficult to interpret the results of these studies. The use of music as an adjuvant to sedation for GI

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Reprint requests: Angus C.W. Chan, MD, Department of Surgery, North District Hospital, Sheung shui, N.T., Hong Kong SAR, China.

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