Gastroenterology Unit and Endoscopy Service, "V. Cervello" Hospital, Via Trabucco 180, 90 146 Palermo, Italy.
Dig Liver Dis. 2010 Dec;42(12):871-6. doi: 10.1016/j.dld.2010.03.016. Epub 2010 May 7.
Several methods have been reported to minimize patient discomfort during colonoscopy, none are currently recommended by clinical practice guidelines. We performed a single-blind randomized controlled trial to assess the efficacy of music for colonoscopy.
109 patients were randomized to music-delivering or mute headphones before and during colonoscopy. Physicians were blinded to the trial. Sedation was given on demand. Primary outcome was pain measured on linear analogue scale from 0 to 10. Secondary endpoints were the difficulty of the procedure, need of sedation, overall patient satisfaction and willingness to repeat the procedure.
Mean pain score was 5.9±2.2 in the control group vs. 3.8±1.9 in the music group (p<0.00001); correspondingly overall satisfaction and willingness to repeat the procedure were significantly improved by music and the difficulty perceived by physicians was significantly reduced. Total administered midazolam was 36mg in the control group vs. 13 in the music group (p<0.007), pethidine was 860mg vs. 465mg (p=0.07) and patients requiring sedation were 22 vs. 9, respectively (p=0.003). A multivariable analysis to adjust treatment effect for potential confounding factors confirmed the significant beneficial effect of music.
Music significantly reduces discomfort and should be routinely offered to patients undergoing colonoscopy.
已有多种方法被报道可以减轻结肠镜检查过程中的患者不适，但目前临床实践指南均未推荐。我们进行了一项单盲随机对照试验，以评估音乐在结肠镜检查中的效果。
109 名患者在结肠镜检查前和检查期间被随机分配到听音乐耳机或静音耳机组。医生对试验不知情。按需给予镇静。主要结局是使用 0 到 10 的线性模拟量表测量疼痛。次要终点是操作难度、镇静需求、总体患者满意度和重复操作的意愿。
对照组的平均疼痛评分为 5.9±2.2，音乐组为 3.8±1.9（p<0.00001）；相应地，音乐显著提高了总体满意度和重复操作的意愿，医生感知到的难度显著降低。对照组中咪达唑仑的总用量为 36mg，音乐组为 13mg（p<0.007），哌替啶的用量为 860mg 比 465mg（p=0.07），需要镇静的患者分别为 22 例和 9 例（p=0.003）。多变量分析调整潜在混杂因素的治疗效果后，确认音乐具有显著的有益效果。
音乐显著减轻了不适，应常规提供给接受结肠镜检查的患者。
