Study: Music helps colonoscopy patients tune out test anxiety

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While few people will rank a colonoscopy as a favorite medical procedure, one statistic argues clearly in its favor: a 90 percent cure rate in colon cancers caught at an early stage.

Benjamin Krevsky, a professor of medicine at the School of Medicine and director of gastrointestinal endoscopy at Temple University Hospital, found that when patients undergoing a colonoscopy listened to music, they required less sedation. (Photo by Ryan S. Brandenberg / University Photography)

Still, patients often approach the test with a mixture of dread and anxiety. Despite sedation, people fear discomfort, and often put off the appointment.

To address this common problem, doctors have added an extra ingredient: music.

A new study reveals that patients who plug into their favorite tunes during a colonoscopy procedure may be able to relax enough to require less sedation, without sacrificing comfort. Results of the double-blind study by doctors at Temple University in Philadelphia were presented at this year’s American Society for Gastrointestinal Endoscopy national meeting.

Their findings align with other research that has shown music reduces anxiety before surgical procedures. Such promising results have led several hospitals around the country to begin studies on how music affects health.

In the colonoscopy study, researchers asked 44 female and 29 male subjects to either bring music from home or choose from a selection of available CDs. Before the procedure, ear buds were taped to all of the participants’ ears and volume set to be audible to only the patient.

After the patient received his or her initial dose of medication, an investigator opened a randomized envelope to see if the music selections would be played. Following the colonoscopy, the attending doctor, fellow and nurse evaluated pain, anxiety and comfort levels for each patient. A non-participating medical provider conducted a second, later interview.

Results revealed that those who listened to music required less sedation (3.8 mg of midazolam vs. 4.4 mg, and 87 mcg of fentanyl vs. 93 mcg) yet reported the same comfort levels as those receiving the higher amounts.

The reductions, equal to about one less dose of medication, are considered clinically significant, according to Benjamin Krevsky, M.D., M.P.H., the lead author of the study, who is a professor of medicine at Temple University School of Medicine and director of gastrointestinal endoscopy at Temple University Hospital.

“It’s true that many patients don’t like the procedure,” said Krevsky, “but many find that the preparation for the test is worse than the test itself.”

Co-investigator Kevin Skole, M.D., who was a gastroenterology fellow at Temple, had the original idea for the study. Krevsky too was inspired when a dentist handed him ear buds to listen to music during a dental procedure.

“Over all, colonoscopies are very, very safe,” Krevsky said. “And while the risks of sedatives are relatively small, in general, less medication is always better.”

Krevsky also notes the decreased drug dose may translate into reduced healthcare costs.

Most of the participants picked gospel tunes, but the type of music didn’t appear to make a difference.

“Offering music makes sense,” Krevsky said. “It has no downside, it may prove beneficial, and patients appear to be satisfied with the procedure.”

All of which may add up to less anxiety and more colonoscopies.

By Ilene Raymond

For Temple Health Sciences PR

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Surgery With Music: Fears about Surgery and Anesthesia

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Surgery With Music: Fears about Surgery and Anesthesia

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Plastic Surgery and criminology?

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This is a different kind of post, but I thought it was interesting and I would share it with you. Enjoy! Drug Kingpin who’d had Plastic Surgery nailed by computer voice recognition!

In a story that brings to mind John Woo’s “Face-off” which starred John Travola and Nic Cage as an FBI agent and drug dealer/terrorist who “switched faces” via plastic surgery comes this news off the wires.
Ramirez Abadia, a leader of Colombia’s biggest drug cartel who had his features deliberately altered by plastic surgery, was identified by Brazilian and American anti-drug agents using advanced voice recognition technology.

A write up can be found here from the Washington Post.

U.S. intelligence agencies have used voice recognition for decades, but the technology has become much more effective in recent years through improvements in software that rapidly analyzes vocal frequency patterns, said Jim Hunter, a partner in the Merlin Risks security firm in Sao Paulo.

“The way you use your voice is as individual as fingerprints,” Hunter explained. “If they have a sample of a known voice and they get an unknown sample of sufficient length, they then test the unknown against the known.”

The process is more complex than fingerprinting because peoples’ voices are different when they speak normally, yell or whisper _ but the software breaks down different frequencies and uses statistical analysis to make matches

Good plastic surgery should not be able to make you unrecognizable to family, friends, or intelligence agencies. How would you alter yourself to evade detection? Let’s look at Mr. Ramirez to get some ideas.

If you look at the difference between the “new & improved” drug dealer on the left with some old FBI stock photos on the right & you can see some rather obvious stigmata of plastic surgery.

He apparently was once a handsome man who has been altered into a vaguely humanoid thing. It looks like he’s had

rhinoplasty – note the excessively narrowed upper part of the nose & I think you can see a red scar inside of the left nostril on the upper picture
Face lift & neck liposuction – his face is kind of globally distorted. On the underside of the neck there appears to be a “dent” which can be from sutures or liposuction. He’s also got a very prominent chin cleft which wasn’t evident (to me) on the old blurry photos.
blepharoplasty (eyelids) – he’s got a rounded eye and clear ectorpion or “scleral show” (scar contracture which pulls the lid down and shows more of the ‘white of the eye’) on his left lower lid which a not infrequent complication of lower eyelid surgery
facial implants – these are made from silastic (silicone rubber). I say this because his face has assumed all these weird geometries along the cheek, chin, and jawline. Facelifts and/or fat grafting can do this to some degree, but my money’s on implants.
Rob

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Is there a colonoscopy in your future?

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Considering that colonoscopies are the best way to catch colon cancer at its earliest stage, people still do whatever they can to put off this routine screening. While it is true that no one looks forward to a colonoscopy, perhaps a little music can help make the experience more pleasant.
That’s the indication of a new study, presented at the American Society for Gastrointestinal Endoscopy’s national meeting, which shows that patients who listened to music during their routine colonoscopy required less sedation for the procedure.
“Offering music makes sense,” said Dr. Benjamin Krevsky, lead author of the study and professor of medicine at Temple University School of Medicine. “It has no downside, it may prove beneficial and patients appear to be satisfied with the procedure.”
For the study, Krevsky and colleagues invited 73 men and women to bring music from home or choose from a selection of CDs with the understanding they may be played during their colonoscopy.
Ear buds were taped to the participants’ ears before each procedure and the volume was adjusted so the music was only audible to the patient. Then, after the initial dose of a sedative commonly used during a colonoscopy, it was randomly determined if the music would be played during the procedure itself. Further doses of the sedative were given if necessary.
After the procedure, each patient was asked about their discomfort and pain levels during the procedure and if they had any anxiety.
From their data, the researchers determined that those who listened to music during the colonoscopy needed approximately one less dose of the sedative mediation, while still reporting about the same levels of comfort as those who did not listen to music.
If music does indeed reduce the amount of sedation a patient needs for a colonoscopy, it could lead to reduced healthcare costs and greater satisfaction with the overall procedure.
“Over all, colonoscopies are very, very safe.” Krevsky said. “And while the risks of sedatives are relatively small, in general, less medication is better.”
The type of music the patients selected didn’t seem to matter. Krevsky even suggests toting along your mp3 player to your next colonoscopy. Your favorite tunes may make the procedure a little easier to bear. Karen Barrow 11/20/2006

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Why use music during surgery?

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The concept of using music for pain relief is ancient. People have literally been doing this for thousands of years. The concept of using music during surgery is a little bit newer. For 30 years or more, surgeons have been taking their own music into surgery, but for some reason, no one thought that patients should have their own music. The belief was that the patient was “asleep” and wouldn’t even hear it. What they did not understand was that the human body responds to music, even when asleep…not only the body, but also the mind and the spirit.
Through the process of “entrainment” the body responds to rhythmic music by synchronizing the heartbeat and breathing to that tempo of speed of the music. The mind also responds to slow, steady, soothing music by relaxing the body. The effect: when the body is relaxed, it requires less anesthesia in order to stay “asleep.” Less anesthesia means safer surgery, fewer side-effects and complications and a faster recovery! It’s so simple. If you want to try this, click on the link HERE. Best wishes!

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Randomized Controlled Trial Investigating the Effect of Music on the Virtual Reality Laparoscopic Learning Performance of Novice Surgeons – Abstract

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Interesting study…I don’t think the results are too surprising though, do you?
Friday, 09 January 2009
Department of Surgery, Triemli Hospital, Zurich, Switzerland
Findings have shown that music affects cognitive performance, but little is known about its influence on surgical performance. The hypothesis of this randomized controlled trial was that arousing (activating) music has a beneficial effect on the surgical performance of novice surgeons in the setting of a laparoscopic virtual reality task. For this study, 45 junior surgeons with no previous laparoscopic experience were randomly assigned to three equal groups. Group 1 listened to activating music; group 2 listened to deactivating music; and group 3 had no music (control) while each participant solved a surgical task five times on a virtual laparoscopic simulator. The assessed global task score, the total task time, the instrument travel distances, and the surgeons’ heart rate were assessed.
All surgical performance parameters improved significantly with experience (task repetition). The global score showed a trend for a between-groups difference, suggesting that the group listening to activating music had the worst performance. This observation was supported by a significant between-groups difference for the first trial but not subsequent trials (activating music, 35 points; deactivating music, 66 points; no music, 91 points; p = 0.002). The global score (p = 0.056) and total task time (p = 0.065) showed a trend toward improvement when participants considered the music pleasant rather than unpleasant.
Music in the operating theater may have a distracting effect on novice surgeons performing new tasks. Surgical trainers should consider categorically switching off music during teaching procedures.
Written by: Miskovic D, Rosenthal R, Zingg U, Oertli D, Metzger U, Jancke L. Are you the author?
Reference: Surg Endosc. 2008 Nov;22(11):2416-20 doi: 10.1007/s00464-008-0040-8
PubMed Abstract PMID: 18622551
UroToday.com Laparoscopic and Robotic Section
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