Music in complex endoscopy: Effect of functional music on sedation requirements during endoscopic ultrasound and ERCP

Previous studies in esophagogastroduodenoscopy or colonoscopy have demonstrated positive effects of music on patient anxiety and comfort. This study prospectively evaluated the effect of functional music on sedation requirements and satisfaction during complex endoscopic procedures. A total of 144 patients undergoing endoscopic ultrasound or endoscopic retrograde cholangiopancreatography were prospectively randomized to either a functional music group or a control group without music. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) before the procedure. Sedation depth was monitored with bispectral index (BIS) monitoring. The primary endpoint was the amount of propofol required in mg/kg/min. Secondary endpoints included patient and staff satisfaction. Propofol requirements did not differ significantly between groups (music: 0.15 ± 0.05 mg/kg/min; control: 0.17 ± 0.08 mg/kg/min, P = 0.77). Mean BIS values were similar (music: 60.2 ± 8.4 vs. control: 61.0 ± 8.4, P = 0.74). However, patient satisfaction was markedly higher in the music group (mean value 4.6 ± 0.6 vs. 3.9 ± 0.8, P < 0.00001), as was staff satisfaction (4.8 ± 0.4 vs. 4.1 ± 0.7, P < 0.00001). No adverse events through music intervention occurred. Analysis of PSQI subgroups revealed a trend toward lower propofol use in patients with impaired sleep quality (PSQI > 5) exposed to music, suggesting a possible modulatory effect in this subset. Functional music during complex endoscopic procedures did not reduce propofol consumption but significantly improved satisfaction for both patients and staff. The findings justify implementation of music as a non-pharmacological adjunct to improve patient comfort in endoscopic suites.