Relaxation music decreases the dose of patient-controlled sedation during colonoscopy: a prospective randomized controlled trial.
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 microg 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.
Lee
Danny W H
DW
Department of Surgery, North District Hospital, Sheung Shui, N.T. Hong Kong SAR, China.
Chan
Kin-Wing
KW
Poon
Chi-Ming
CM
Ko
Chi-Wah
CW
Chan
Kam-Hon
KH
Sin
Kwok-Sang
KS
Sze
Tak-Suen
TS
Chan
Angus C W
AC
D000293:Adolescent; D000328:Adult; D000368:Aged; D015760:Alfentanil / Q000008:administration & dosage; D000553:Ambulatory Care; D016058:Analgesia, Patient-Controlled; D000701:Analgesics, Opioid / Q000008:administration & dosage; D003113:Colonoscopy; D016292:Procedural Sedation; D003975:Diazepam / Q000008:administration & dosage; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*; D008297:Male; D008614:Meperidine / Q000008:administration & dosage; D008875:Middle Aged; D009146:Music; D010147:Pain Measurement; D017060:Patient Satisfaction; D015742:Propofol / Q000008:administration & dosage; D011446:Prospective Studies; D012064:Relaxation Therapy
D000701:Analgesics, Opioid; D006993:Hypnotics and Sedatives; D015760:Alfentanil; D008614:Meperidine; D003975:Diazepam; D015742:Propofol