As one of the diagnostic and therapeutic procedures, endoscopy (especially colonoscopy) is often performed on patients with gastrointestinal problems, for example, those suspected of having colorectal cancer or inflammatory bowel disease. However, colonoscopy procedures also provide anxiety for patients. Often, patients experience stress and discomfort both before and during the procedure, especially in conscious sedation.

Review Study About Benefits of Using Music During Colonoscopy
Illustration Using Music During Colonoscopy
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Applying music during medical procedures has been widely used in various medical fields, such as radiology, gynecology, urology, and pulmonology. There have been many randomized controlled studies investigating these effects. Heath RD, et al. conducted a meta-analysis that examines the impact of applying music and without music during colonoscopy procedures from various randomized controlled trial (RCT) data.

A meta-analysis study of the benefits of using music during the sedation process during colonoscopy examines the impact of music played during a colonoscopy on a patient's perspective and sedation needs.

Method: Searching on large databases is carried out aggressively (until November 2018). All clinical trials comparing music with no music during colonoscopy in adult patients were included in the analysis. Pooled estimate calculations for sedative drug doses, total procedure time, patient experience, desire to repeat the procedure, and pain scores were performed using odds ratios (OR) and mean differences (MD) with random-effects models.

Results: Eleven RCT studies were included in the analysis (n = 988). The use of music during a colonoscopy showed statistically significant results for a reduction in total procedure time (MD: -2.3 minutes; 95% CI: -4.13 to -0.47; p = 0.01) and patient pain (MD: - 1.26; 95% CI: -2.28 to -0.24; p = 0.02), while improving patient experience (MD: -1.11; 95% CI: -1.7 to -0.53) ; p <0.01) when compared to the method without music. No statistically significant differences were found for midazolam doses, meperidine, or the patient's desire to repeat colonoscopy.

Conclusion: The use of music during a colonoscopy seems to improve the overall patient experience, reduce procedure time and patient pain. Therefore, music as a non-invasive intervention is highly recommended for use during a colonoscopy procedure.

Research Methods Review Use of music during colonoscopy: An updated meta-analysis of randomized controlled trials.

Heath RD, Parsa N, Kome MLM, Buescher V, Samiullah S, Nguyen DL, Tahan V, Ghouri YA, Puli SR, Bechtold ML. World J MetaAnal, 2019. 7(9): 428435. DOI: 10.13105/wjma.v7.i9.428

The author conducted an RCT database search on Medline, PubMed, Scopus, Cumulative Index for Nursing and Allied Health Literature, Cochrane Central Register of Controlled Trials, and Embase. Only RCT studies in adult patients comparing music and no music during colonoscopy with moderate sedation were included in the analysis. RCT data were assessed by applying the Cochrane Collaboration Risk of Bias Tool.

The effect of music on patients during colonoscopy was analyzed by calculating the combined estimates for sedative drug doses (meperidine and midazolam), the procedure's total time, the patient's pain score, the patient's experience, and the patient's desire to repeat the colonoscopy.

Review of Research Results

Of the 177 articles obtained, only 11 RCTs met the inclusion criteria, with 988 patients. Pooled estimation analysis found statistically significant results for the superiority of music application during colonoscopy in reducing the duration of the procedure (mean difference of -2.3), patient pain, and improvement of the patient experience. However, no statistically significant differences were found regarding the dose of sedation used or the patient's desire to repeat the colonoscopy.

Research Advantages

The advantage of this research is the method applied. This meta-analysis applies inclusion criteria that focus on one type of sedation and only includes RCTs, so it helps reduce the risk of selection bias. The RCT data also came from the latest global research data and had passed the Cochrane Bias Tool assessment and I2 test for heterogeneity data assessment. These were quite significant in reducing the risk of publication bias.

Research Limitations

There are many limitations to this meta-analysis. First, the RCT data included were relatively heterogeneous. Secondly, related to the heterogeneity of data collected, this meta-analysis did not subanalysis aspects of the time when the music starts to be applied (whether at the beginning of the procedure or in the middle of the procedure, before sedation or after sedation), aspects of the music media used (whether using headphones or radio or stereo devices), also the type of music used during the procedure (classical music or easy listening pop). Additionally, music choices may be different for each patient and for medical personnel who do the colonoscopy. These variables could affect the final results of the analysis is included. This analysis data is only focused on adult patients, thereby limiting the application of the results in certain populations.

Heath RD, Parsa N, Kome MLM, Buescher V, Samiullah S, Nguyen DL, Tahan V, Ghouri YA, Puli SR, Bechtold ML. World J MetaAnal, 2019. 7(9): 428435. doi: 10.13105/wjma.v7.i9.428