ACS 2019: Pain Reduction and Mood Improvement Using Supplementary Music Therapy Intervention During Flexible Cystoscopy Under Local Anesthesia

San Francisco, California ( Ilias Aizat Sabri, MD, Malaysia Ministry of Health, Kelantan, Malaysia, described a trial to decrease pain during cystoscopy. Flexible cystoscopy is a common urological procedure. Various anesthetic techniques have been used to reduce pain but somehow some patients would still experience pain and discomfort. Hence, an alternative method such as music therapy is needed to reduce the agony of the patients. 

This study was conducted from June 2016 to February 2017 in 2 centers. 76 male patients were randomised into music therapy (Group A) and non-music (group B). A lignocaine gel was instilled into the urethra before the procedure. A set of motivational music was chosen by the interventional group prior to the procedure. The subjects were listened to the music via a headphone continuously until the procedure completed. This is a single-blinded study, hence the other group wear a headphone without the music in order to blind the surgeon who conducts the procedure. A visual analog scale was used to evaluate pain perception score and mood evaluation before and after the procedure.

The mean pain score for group A was 2.66, and for group, B was 4.66 (p<0.001). Group A showed mood score improvement compared to group B with p<0.05 for tension, depression, fatigue, confusion and anger. The post-procedural heart rate for group A was 76.37 per minute while group B was 84.74 per minute (p=0.004). Mean systolic and diastolic blood pressure after the procedure for both groups did not show any statistically significant difference.

They concluded the intervention of music therapy during flexible cystoscopy was an easy, economical and harmless way to improve pain-related complications. The study was not powered, however, it does provide insight into how we may improve care to our patients undergoing cystoscopy in office.

Presented by: Ilias Aizat Sabri, MD, Malaysia Ministry of Health, Kelantan, Malaysia

Written by: Stephen B. Williams, MD, Medical Director for High Value Care; Chief of Urology, Associate Professor, Director of Urologic Oncology, Director Urologic Research, The University of Texas Medical Branch at Galveston, TX at the 2019 American College of Surgeons (ACS), #ACSCC19, October 27–31 in San Francisco, California