The Effect of Music Listening on Pain in Adults Undergoing Colonoscopy: A Systematic Review and Meta-Analysis

Audio Distraction for Traction Pin Insertion: A Prospective Randomized Controlled Study

BACKGROUND

Insertion of a skeletal traction pin in the distal femur or proximal tibia can be a painful and unpleasant experience for patients with a lower-extremity fracture. The purpose of this study was to determine whether providing patients with audio distraction (AD) during traction pin insertion can help to improve the patient-reported and the physician-reported experience and decrease pain and/or anxiety during the procedure.

METHODS

A prospective randomized controlled trial was conducted at 2 level-I trauma centers. Patients ≥18 years of age who were conscious and oriented and had a medical need for skeletal traction were included. Patients were randomized to receive AD or not receive AD during the procedure. All other procedure protocols were standardized and were the same for both groups. Surveys were completed by the patient and the physician immediately following the procedure. Patients rated their overall experience, pain, and anxiety during the procedure, and physicians rated the difficulty of the procedure, both on a 1-to-10 Likert scale.

RESULTS

A total of 54 patients met the inclusion criteria. Twenty-eight received AD and 26 did not. Femoral fractures were the most common injury (33 of 55, 60.0%). Baseline demographic characteristics did not differ between the 2 groups. The overall patient-reported procedure experience was similar between the AD and no-AD groups (3.9 ± 2.9 [95% confidence interval (CI), 3.1 to 4.7] versus 3.5 ± 2.2 [95% CI, 2.9 to 4.1], respectively; p = 0.55), as was pain (5.3 ± 3.2 [95% CI, 4.4 to 6.2] versus 6.1 ± 2.4 [95% CI, 5.4 to 6.8]; p = 0.28). However, anxiety levels were lower in the AD group (4.8 ± 3.3 [95% CI, 3.9 to 5.7] versus 7.1 ± 2.8 [95% CI, 6.3 to 7.9]; p = 0.007). Physician-reported procedure difficulty was similar between the groups (2.6 ± 2.0 [95% CI, 2.1 to 3.1] versus 2.8 ± 1.7 [95% CI, 2.3 to 3.3]; p = 0.69).

CONCLUSIONS

AD is a practical, low-cost intervention that may reduce patient anxiety during lower-extremity skeletal traction pin insertion.

LEVEL OF EVIDENCE

Therapeutic Level I . See Instructions for Authors for a complete description of levels of evidence.

Listening to Remotely Monitored Home-based Preferred Music for Pain in Older Black Adults with Low Back Pain: A Pilot Study of Feasibility and Acceptability

BACKGROUND

Low back pain (LBP) is a complex condition that is widespread among older Black adults. Nonpharmacologic interventions are recommended as first-line therapy, but their use in practice is limited, possibly due to misunderstanding of their analgesic characteristics.

AIM

To determine the feasibility and acceptability of listening to preferred music at home to relieve pain in older Black adults aged 65 years or older with LBP.

METHOD

We recruited 20 community-dwelling older adults (≥65 years) with LBP to use noise-isolating headphones to listen to their preferred music for 20 minutes twice daily for four days via the MUSIC CARE® app. Feasibility was determined using enrollment, adherence, and attrition rates, and acceptability was determined using the Treatment Acceptance and Preference (TAP) scale. Average pain scores were self-reported using the Numeric Rating Scale (NRS) after the second intervention of the day. Pain scores were evaluated using paired sample t test and repeated-measures ANOVA.

RESULTS

Enrollment, adherence, and attrition rates were 95.25%, 100.00%, and 0.00%, respectively. Most participants rated the TAP scale at ≥3, indicating acceptance. Pain scores decreased significantly from baseline (M = 46.90, SD = 21.47) to post-intervention (M = 35.70, SD = 16.57), t (19) = 2.29, p = .03. Repeated measures ANOVA showed a significant decrease in mean pain scores over time [F (2.36, 44.88) = 5.61, p = .004, η2 = .23].

CONCLUSIONS

Listening to preferred music for 20 minutes twice a day is a feasible and acceptable intervention that can considerably reduce pain in older Black adults with LBP.

Effects of light music played by piano intervention on satisfaction, anxiety, and pain in patients undergoing colonoscopy: A randomized controlled trial

BACKGROUND

Colonoscopy is the main kind of way to detect and treat diseases about large intestine, but during the examination and preparation, these 2 processes are able to lead abdominal pain, abdominal distention and other discomfort feel, which will cause patients to refuse the examination and become anxious. Painless and sedative endoscopy may reduce discomfort of patients, but there is a risk of adverse effects. Many studies have shown that playing music during colonoscopy can reduce discomfort and increase acceptance of colonoscopy, but the conclusion remains controversial. The 3 approaches of random, single-blind, controlled method were used to investigate the interventions effects of piano light music on satisfaction, anxiety and pain in patients undergoing colonoscopy.

METHODS

A total of 216 patients were randomly divided into piano music group (n = 112, piano music played during colonoscopy) and control group (n = 104, no music during colonoscopy) to compare patients satisfaction, anxiety score, pain score, vital signs, endoscopic difficulty score, and willingness to undergo colonoscopy again.

RESULTS

There were no significant differences in vital signs, pre-colonoscopic state anxiety score, and trait anxiety score before and after colonoscopy, and willingness to undergo colonoscopy again between the 2 groups (P > .05). The difficulty of colonoscopy operation and the score of state anxiety after colonoscopy in the piano group were lower than those in the control group (P < .05), and the satisfaction of colonoscopy process, pain management and overall service satisfaction were better than those of the control group (P < .05), and they were more likely to listen to music in the next examination (P < .001).

CONCLUSION

The light music played by piano can relieve patients' anxiety, improve the satisfaction of colonoscopy process, pain management and service satisfaction, reduce the difficulty of colonoscopy, which have no obvious adverse reactions. Therefore, it is worthy of promotion.

The Effect of Music Therapy on Adult Patients’ Heart Rate: A Meta-Analysis

Background: Music can be used as a complementary intervention to bring about a positive effect on the quality of life. It has been widely employed in clinical practice as one of the earliest forms of treatment. Despite the fact that music therapy is widely utilized and practiced in clinical and educational contexts, it has received little attention in formal medical settings. In addition, contradictory findings about the effect of music deserve further investigation.Purpose: This meta-analysis is conducted to examine the effect of music therapy on heart rates among adult patients.Methods: The MEDLINE, CINAHL, PsycInfo, Cochrane Library, and PubMed databases were used for searching the literature. The literature review was conducted by two independent researchers using the following Medical Subject Headings terms: musicotherapy OR music therapy, AND heart rate OR vital signs AND clinical trials as the topic. Standard mean difference (SMD) with 95% confidence interval (CI) values was used to evaluate the effect of music therapy on heart rates.Results: Out of 194 studies, 12 studies were included with 1,118 patients. According to the results of the meta-analysis, the heart rates in the experimental groups in which music therapy was used with various diagnoses of adult patients were found to be significantly different in comparison with the control group (SMD=-0.450, 95% CI=-8.86 to -0.31, p=0.04).Conclusion:The results established that using music therapy for adult patients reduced their heart rates. However, the heterogeneity among the studies was high. Therefore, it is recommended that high-quality trials are warranted to confirm the benefits of music therapy interventions among adult patients. 

Effect of visual distraction on pain in adults undergoing colonoscopy: a meta-analysis

BACKGROUND

Pain is a contributing factor to the low compliance rate for performing a colonoscopy on screening for colorectal cancer.

PURPOSE

This meta-analysis aimed to evaluate the effect of visual distraction on adults undergoing colonoscopy.

METHODS

We searched PubMed, EMBASE, Web of Science, and Cochrane Library Database from their inception to February 2022. Randomized controlled trials comparing visual distraction with non-visual distraction were considered for inclusion. The fixed-effects and random-effects models were used to pool the data from individual studies and the Cochrane risk of bias assessment tool was used to determine the methodology quality.

RESULTS

This meta-analysis included four studies (N = 301) for pain level and total procedure time, three studies (N = 181) for satisfaction score, three studies (N = 196) for anxiety level, and four studie (N = 402) for willingness to repeat the procedure. The pooled analysis shown that significantly lower pain levels (SMD, - 0.25; 95% CI - 0.47 to - 0.02; P = 0.03), higher satisfaction score with the procedure (SMD, 0.63; 95% CI, 0.33 to 0.93; P < 0.0001), and higher willingness to repeat the procedure (OR, 2.66; 95% CI 1.70 to 4.17; P < 0.0001) in the visual distraction group than those in the non-visual distraction group, with no significant differences in total procedure time (SMD,- 0.07; 95% CI - 0.30 to 0.15; P = 0.53) or anxiety level (SMD,- 0.27; 95% CI - 0.55 to 0.01; P = 0.06).

CONCLUSIONS

Visual distraction improved the patient's pain, satisfaction, and willingness to repeat the procedure. Thus, visual stimulation is an effective way to reduce pain during colonoscopy and should be recommended.

Effect of music intervention in colonoscopy-naïve adults: a randomised controlled trial

BACKGROUND

Previous studies have evaluated music interventions before and during a colonoscopy, but the results are contradictory and inconclusive.

AIMS

The aims of the present study were to evaluate the effect of a music intervention with MusiCure music, both before and during colonoscopy.

METHODS

The study was a two-armed, prospective, randomised, controlled trial and 337 patients undergoing colonoscopy were included. Patients were allocated to receive relaxing music (MusiCure) before and during the colonoscopy or standard care (no music). Outcome measures included pain intensity, duration of the colonoscopy, consumption of alfentanil and midazolam, vital signs, patient satisfaction and caecal intubation rates (CIR).

FINDINGS

Men in the music group had a lower middle arterial blood pressure compared with men in the no music group. The majority of patients in the music group would prefer to listen to music if they need a colonoscopy in the future. No differences were found between groups regarding pain intensity, duration of the colonoscopy, consumption of alfentanil and midazolam, vital signs, patient satisfaction and CIR.

CONCLUSION

The researchers were unable to show an effect on the primary endpoints. However, a high patient satisfaction was found in the music group and a decrease in the blood pressure during the colonoscopy, indicating a reduced stress level. Music before and during a colonoscopy may improve the patient experience.