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World J Gastrointest Endosc. Oct 16, 2026; 18(10): 126271
Published online Oct 16, 2026. doi: 10.4253/wjge.126271
Patient-selected music reduces propofol requirements during combined upper gastrointestinal endoscopy and colonoscopy: A prospective single-center study (MUSICENDO)
Gildas Rousseau, Frederic Berthier, Sorina-Dana Mihailescu, Rémi Basile, Nicolas Rijo, Corinne Zapulla, Luc Diez, Antoine Charachon, Atul Pathak
Gildas Rousseau, Rémi Basile, Corinne Zapulla, Department of Anaesthesiology and Intensive Care, Princess Grace Hospital, Monaco 98000, Monaco
Frederic Berthier, Department of Medical Information, Princess Grace Hospital, Monaco 98000, Monaco
Sorina-Dana Mihailescu, Nicolas Rijo, Department of Clinical Research, Princess Grace Hospital, Monaco 98000, Monaco
Luc Diez, Antoine Charachon, Department of Digestive Endoscopy, Princess Grace Hospital, Monaco 98000, Monaco
Atul Pathak, Department of Cardiovascular Medicine, ESH Excellence Center, Princess Grace Hospital, Monaco 98000, Monaco
Atul Pathak, Department of Cardiovascular Medicine, National Institute of Cardiology, Cardiac Surgery and Interventional Cardiology, Monaco 98000, Monaco
Author contributions: Rousseau G, Berthier F, Basile R, and Rijo N designed the study; Rousseau G, Basile R, and Zapulla C collected the data; Rijo N oversaw data monitoring; Berthier F and Mihailescu SD performed the statistical analyses and prepared the figures; Rousseau G, Berthier F, Mihailescu SD, Rijo N, Diez L, Charachon A, and Pathak A drafted the manuscript; all authors have read and approved the final version of the manuscript.
AI contribution statement: Portions of this manuscript were edited using AI tools solely for language refinement. The authors carefully reviewed and verified all AI-assisted outputs and take full responsibility for the scientific content of the manuscript.
Institutional review board statement: The study was approved by the institutional Clinical Research Steering Committee (COPIL), the hospital body responsible for the approval and oversight of clinical studies (approval No. 23-15). At the time of approval and according to local regulations, the study was classified by the COPIL as non-interventional because music was already part of routine practice at our institution and did not modify standard medical care. However, because participants were randomized to receive either music or no music, the study is considered an interventional randomized controlled trial from a methodological perspective.
Clinical trial registration statement: This study was retrospectively registered with ISRCTN (ISRCTN13545435).
Informed consent statement: Written informed consent was obtained from all participants.
Conflict-of-interest statement: The authors declare no conflicts of interest.
CONSORT 2010 statement: The authors have read the CONSORT 2010 statement, and the manuscript was prepared and revised according to the CONSORT 2010 statement.
Data sharing statement: Deidentified dataset and R code are available upon reasonable request to the Corresponding Author.
Corresponding author: Gildas Rousseau, MD, Principal Investigator, Department of Anaesthe
siology and Intensive Care, Princess Grace Hospital, 1 Avenue Pasteur, Monaco 98000, Monaco.
gildas.rousseau@chpg.mc
Received: July 30, 2026
Revised: September 15, 2026
Accepted: October 13, 2026
Published online: October 16, 2026
Processing time: 76 Days and 20.8 Hours
BACKGROUND
Gastrointestinal (GI) endoscopy is frequently performed under propofol sedation. Music is a lowrisk sensory intervention that may reduce anxiety and sedative requirements; however, its objectively measured sedativesparing effects during combined gastroscopy and colonoscopy remain uncertain.
AIM
To compare propofol consumption rates (mg/kg/minute) between patients receiving patient-selected music and those receiving standard care alone.
METHODS
An openlabel, singlecenter, parallelgroup randomized controlled trial involving adult outpatients scheduled for combined diagnostic gastroscopy and colonoscopy was conducted. Participants were randomized 1:1 to receive either patientselected music, initiated at least 10 minutes before anesthesia induction and continued throughout the procedure, in addition to standard care, or standard care alone. Propofol was the sole hypnotic agent via targetcontrolled infusion using the Schnider model. Among 89 randomized patients, 88 were included in the modified-intentiontotreat analysis and 82 in the perprotocol analysis.
RESULTS
The mean propofol consumption rate was significantly lower in the music group than in the standard-care group (0.18 ± 0.05 mg/kg/minute vs 0.26 ± 0.07 mg/kg/minute in the modified-intentiontotreat analysis; P < 0.0001), with consistent findings in the per-protocol analysis (0.19 ± 0.05 mg/kg/minute vs 0.26 ± 0.07 mg/kg/minute; P = 0.0009). The music group also received a lower total propofol dose (258.24 ± 57.52 mg vs 344.88 ± 86.86 mg; P = 0.0009) and required fewer propofol vials per procedure (0.52 ± 0.12 vs 0.69 ± 0.17; P = 0.0009). No between-group differences were observed in examination duration, total ambulatory stay, hemodynamic parameters, or preprocedural anxiety scores. No unplanned hospital admissions occurred.
CONCLUSION
Patientselected music administered before and during combined GI endoscopy significantly reduced propofol consumption under a standardized sedation protocol. These findings warrant further investigation of music as a simple, non-pharmacological adjunct to procedural sedation in larger, multicenter randomized controlled trials.
Core Tip: This trial investigated whether patient-selected music could reduce propofol requirements during combined gastroscopy and colonoscopy under target-controlled infusion. Compared with standard care alone, patient-selected music substantially reduced propofol consumption without increasing procedure duration or delaying discharge. No significant between-group differences were observed in hemodynamic parameters or adverse-event rates. The reduction in propofol requirements was also reflected in a practical measure of resource utilization, with fewer propofol vials required per procedure in the music group.
