Music (plus lidocaine) soothes the savaged male

A small, randomized, pilot study has shown that music (along with some lidocaine) reduces the anxiety, pain, and dissatisfaction of men having a TRUS-guided biopsy compared to the lidocaine alone.

Between March 2013 and June 2014, Chang et al. randomized 76 patients in South Korea to either a rectal instillation of lidocaine and no music (Group I; n = 38 patients) or the lidocaine and classical music during the procedure (Group II; n = 38).

Here is what they found:

  • There were no significant differences in average (mean) age, procedure duration, and procedure indications between the two groups of patients.
  • Compared to men in Group I
    • The average (mean) anxiety level  was significantly lower in Group II (p = 0.001)
    • The average (mean) pain score was significantly lower in Group II (p = 0.003).
    • The average (mean) satisfaction score was significantly higher in Group II (p = 0.007).
  • Before the procedure, heart rate and systolic blood pressure were similar in Groups I and II.
  • After the procedure, compared to men in Group I,
    • Heart rates were significantly lower Group II (p = 0.014).
    • Systolic blood pressures were significantly lower in Group II (p = 0.011).

The authors conclude that

Listening to music during TRUS-guided prostate biopsy significantly reduced patients’ feelings of pain, discomfort and dissatisfaction. Music can serve as a simple, inexpensive, and effective adjunct to sedation during TRUS-guided prostate biopsy.

Sounds like we all ought to be taking an iPod and some nice soothing music with us when we have to go in for a biopsy! The paper’s abstract doesn’t tell us exactly what classical music was being used, but somehow we think it was more likely to be something by Debussy than Stavinsky! Of course here in America there are those who may prefer Tony Bennett, or even Leonard Cohen, or …. Chacun à son goût.

4 Responses

  1. Good idea! I passed the info on to local urologists.

  2. Having been through this, I find it hard to believe music would have helped at all. Here is my suggestion: Have someone drive the patient to the appointment; 45 minutes before the procedure begins, have the patient wash down 3 mg of lorazepam with two shots of well-aged Scotch. Without any clinical testing at all, I can guarantee this would greatly improve patient experience.

  3. As I wrote above, … chacun à son goût. However, the reason we do randomized clinical trials is to see whether things actually work. This trial showed that music worked (in these Korean men, given biopsies at this specific clinic, in this specific time frame).

    If you want to try Doug’s suggestion, you’d better be very sure before you do it that the doctor doing the biopsy knows that this is what is going on, or you might come to afterwards only to find that no biopsy was carried out because “the patient became non-responsive to questions and requests for cooperation”.

  4. Here are two works that helped reduce my anxiety and fear, when I had no idea if treatment would be in any sense successful .
    © Brahms – Ein Deutsches Requiem 1869 – DRSO – He…: . And Spem In Alium Thomas Tallis: . The effects are hard to describe. At certain points while hearing these live, my analytical abilities were unable to work on this music, and I was overwhelmed without knowing in detail what I was hearing. Nothing “spiritual,” just a useful, pleasurable failure of my mind to analyse while listening. Kant called this the “finite sublime,” a type of experience that psychologists are now studying. Note that it’s the experience that is sublime, not the music. So whatever works for another person need not work for me.

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