Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Meta-Anal. Nov 28, 2019; 7(9): 428-435
Published online Nov 28, 2019. doi: 10.13105/wjma.v7.i9.428
Use of music during colonoscopy: An updated meta-analysis of randomized controlled trials
Ryan D Heath, Nasim Parsa, Michelle L Matteson-Kome, Victoria Buescher, Sami Samiullah, Douglas L Nguyen, Veysel Tahan, Yezaz A Ghouri, Srinivas R Puli, Matthew L Bechtold
Ryan D Heath, Nasim Parsa, Michelle L Matteson-Kome, Victoria Buescher, Sami Samiullah, Veysel Tahan, Yezaz A Ghouri, Matthew L Bechtold, Division of Gastroenterology, University of Missouri School of Medicine, Columbia, MO 65212, United States
Douglas L Nguyen, Division of Gastroenterology, Heart of the Rockies Regional Medical Center, Colorado Springs, CO 80907, United States
Srinivas R Puli, Division of Gastroenterology, University of Illinois–Peoria, Peoria, IL 61604, United States
Author contributions: Heath RD and Parsa N contributed equally to this work; Heath RD, Bechtold ML, and Parsa N designed research; Heath RD, Parsa N, Matteson-Kome ML, Buescher V, and Bechtold ML performed research; Matteson-Kome ML, Nguyen DL, and Puli SR contributed new reagents/analytic tools; Tahan V, Ghouri YA, Samiullah S, and Bechtold ML analyzed data; and Heath RD, Parsa N, Nguyen DL, Tahan V, Ghouri YA, Puli SR, and Bechtold ML wrote the paper.
Conflict-of-interest statement: The authors deny any conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Matthew L Bechtold, AGAF, FACG, FACP, FASGE, MD, Professor, Division of Gastroenterology and Hepatology, Department of Medicine, University Hospital and Clinics CE405, 5 Hospital Drive, Columbia, MO 65212, United States.
Telephone: +1-573-8821013 Fax: +1-573-8844595
Received: October 2, 2019
Peer-review started: October 2, 2019
First decision: October 23, 2019
Revised: October 26, 2019
Accepted: November 15, 2019
Article in press: November 15, 2019
Published online: November 28, 2019

Music seems to be beneficial in multiple clinical areas. Colonoscopy is a stressful event for patients, especially with conscious sedation. Music during colonoscopy has been evaluated in multiple randomized controlled trials (RCTs) with varied results. Even meta-analyses on the subject over the years have yielded inconsistent conclusions. Therefore, we conducted an up-to-date meta-analysis regarding music during colonoscopy.


To assess the effects of music played during colonoscopy on patients’ perspectives and sedation requirements.


Multiple large databases were aggressively searched (November 2018). RCTs comparing music to without music during colonoscopy on adult patients were included. Pooled estimates were calculated for sedative medication doses, total procedure time, and patients’ experience, willingness to repeat procedure, and pain scores using odds ratio (OR) and mean difference (MD) with random effects model.


Eleven studies (n = 988) were included. Music during colonoscopy showed a statistically significant reduction in procedure times (MD: -2.3 min; 95%CI: -4.13 to -0.47; P = 0.01) and patients’ pain (MD: -1.26; 95%CI: -2.28 to -0.24; P = 0.02) while improving patients’ experience (MD: -1.11; 95%CI: -1.7 to -0.53; P < 0.01) as compared to no music. No statistically significant differences were observed between music and no music during colonoscopy for midazolam (MD: -0.4 mg; 95%CI: -0.9 to 0.09; P = 0.11), meperidine (MD: -3.06 mg; 95%CI: -10.79 to 4.67; P = 0.44), or patients’ willingness to repeat the colonoscopy (OR: 3.89; 95%CI: 0.76 to 19.97; P = 0.1).


Music appears to improve overall patient experience while reducing procedure times and patient pain. Therefore, music, being a non-invasive intervention, should be strongly considered during colonoscopy.

Keywords: Colonoscopy, Music, Relaxation, Meta-analysis

Core tip: Music during stressful events has been shown to improve patient experience. Colonoscopy is a stressful event for many patients. Music during colonoscopy has been studied by many randomized controlled trials and meta-analyses with varying results. Therefore, given new studies available for analysis, we performed an updated meta-analysis. This meta-analysis demonstrated that music during colonoscopy reduces patients’ pain while improving patients’ experience and procedure times. With these results and extremely limited adverse effects of music, music should be strongly considered during colonoscopy.