Benefits and limits of music during colonoscopy

Researchers from the University of Missouri School of Medicine, in Columbia reviewed 8 studies and came to different conclusions than researchers at The Chinese University of Hong Kong.

Let’s compare notes.

The Chinese University of Hong Kong, September 2008

• Data from 8 studies (722 patients) were included in a meta-analysis.
• Studies differed in design, but no publication bias was detected.
• Benefits
  • Colonoscopy duration was shorter (but not significantly) with music vs. no music.
  • Significant reduction in sedation with music.
• Conclusion: Listening to music is effective in reducing procedure time and amount of sedation during colonoscopy and should be promoted.

University of Missouri, January 2009

• Data from 8 studies (712 patients) were included in a meta-analysis.
• Benefit
  • Overall experience was significantly improved with music.
• No differences
  • Procedure times
  • Pain score
  • Doses of midazolam (Versed, sedation)
  • Doses of meperidine (Demerol, discomfort)
  • Willingness to repeat the same procedure in future.
• Conclusion: Music improves patients’ overall experience with colonoscopy.

The bottom line?
Based on the results of 8 studies of a little more than 700 patients, both reviewers reported benefit, although the specific value of music differed.

Regarding the potential for music to shorten procedure time, consider all the other options (confounding variables) available to minimize patient discomfort and enhance insertion of the colonoscope. These include using a pediatric colonoscope, variable stiffness colonoscope, or gastroscope. In addition, the anesthetist might opt for inhalation of nitrous oxide or insufflation of carbon dioxide. And don’t forget the use of hypnosis, audio distraction, or simply allowing patients to participate in administration of the medication.

Surrounded by a veritable cacophony of competing factors, it’s not surprising that researchers and reviewers might have difficulty teasing out the effect of a little music, which might not even be to the patient’s liking.

Even before the patient gets wheeled into the colonoscopy suite, there’s another confounding factor that significantly affects the total duration of colonoscopy — poor bowel preparation. Researchers from the University of Lausanne, in Switzerland showed that cleansing quality was poorer in the elderly and in hospitalized patients. And procedures in poorly prepared patients took longer, were more difficult, and more often incomplete.

All things considered, it’s hard to believe that the response to music during the brief time from entry to the endoscopy suite until full sedation could significantly shorten total procedure time, as suggested by the Singapore reviewers.

Note to music researchers. Be sure to control for confounding factors.

4/23/09 13:31 JR