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Newo
~ Abstract Brain ~
Spain
2674 Posts |
 Posted - 02/09/2007 : 06:25:04
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I notice you've been slacking on the smileyface front lately. I hope you're feeling okay.
   
   
   
   
   
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Gravy boat! Stay in the now! |
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Carl
- A 'Fifth' Catholic -
Ireland
11546 Posts |
Posted - 02/09/2007 : 12:02:47
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Yeah, you're right about .
We've run the full gamut....that should keep us going for a while!
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Edited by - Carl on 02/09/2007 12:03:50 |
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floop
= Wannabe Volunteer =
Mexico
15297 Posts |
Posted - 02/09/2007 : 12:34:42
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i think we should all post articles in a tribute to Carl.
here's one from the Indian Journal Of Gastroenterology:
Year : 2006 | Volume : 25 | Issue : 1 | Page : 3-5
Listening to music decreases need for sedative medication during colonoscopy: A randomized, controlled trial
Harikumar R, Raj Mehroof, Paul Antony, Harish K, Kumar Sunil K, Sandesh K, Asharaf Syed, Thomas Varghese
Department of Gastroenterology, Medical College Hospital, Kozhikode 673 008, Kerala, India
Correspondence Address:
Thomas Varghese
Department of Gastroenterology, Medical College Hospital, Kozhikode 673 008, Kerala
India
Abstract
Background : Music played during endoscopic procedures may alleviate anxiety and improve patient acceptance of the procedure. A prospective randomized, controlled trial was undertaken to determine whether music decreases the requirement for midazolam during colonoscopy and makes the procedure more comfortable and acceptable. Methods: Patients undergoing elective colonoscopy between October 2003 and February 2004 were randomized to either not listen to music (Group 1; n=40) or listen to music of their choice (Group 2; n=38) during the procedure. All patients received intravenous midazolam on demand in aliquots of 2 mg each. The dose of midazolam, duration of procedure, recovery time, pain and discomfort scores, and willingness to undergo a repeat procedure using the same sedation protocol were compared. Results: Patients in Group 2 received significantly less midazolam than those in Group 1 (p=0.007). The pain score was similar in the two groups, whereas discomfort score was lower in Group 2 (p=0.001). Patients in the two groups were equally likely to be willing for a repeat procedure. Conclusion: Listening to music during colonoscopy helps reduce the dose of sedative medications and decreases discomfort experienced during the procedure.
How to cite this article:
Harikumar R, Raj M, Paul A, Harish K, Kumar SK, Sandesh K, Asharaf S, Thomas V. Listening to music decreases need for sedative medication during colonoscopy: A randomized, controlled trial. Indian J Gastroenterol 2006;25:3-5
How to cite this URL:
Harikumar R, Raj M, Paul A, Harish K, Kumar SK, Sandesh K, Asharaf S, Thomas V. Listening to music decreases need for sedative medication during colonoscopy: A randomized, controlled trial. Indian J Gastroenterol [serial online] 2006 [cited 2007 Feb 9];25:3-5. Available from: http://www.indianjgastro.com/article.asp?issn=0254-8860;year=2006;volume=25;issue=1;spage=3;epage=5;aulast=Harikumar
Use of music to promote relaxation has a long history in medicine.[1],[2] Ancient Indian treatises like Samaveda refer to the therapeutic utility of music. Role of music as an adjunct to standard treatment has been studied in several disorders.[3],[4] Some studies suggest that music alleviates anxiety and improves patient tolerance during gastrointestinal (GI) endoscopy.[5],[6]
This randomized, controlled trial was designed to determine whether music could help decrease the need for midazolam during colonoscopy and improve the acceptability of this procedure by patients.
Methods
Between October 2003 and February 2004, 78 patients scheduled for elective colonoscopy agreed to participate in the study. Patients aged below 15 or above 60 years, those hard of hearing due to any cause, patients with overt or borderline psychiatric illness, and those with considerable cardiopulmonary morbidity were excluded. Patients were allocated into two groups using computer-generated random numbers.
Patients in both Group 1 (n=40) and Group 2 (n=38) received 2 mg intravenous boluses of midazolam on demand; no dose was given when the procedure was begun. Patients in Group 2 were in addition allowed to listen to music of their choice from among six types - popular film songs based on carnatic classical ragas, classical music, devotional songs, folk songs, soft instrumental music, and bioacoustics. Bioacoustics is a soothing admixture of soft instrumental music along with nature sounds. Music was played using a Walkman (Sony, Japan) and headphones. Patients in Group 1 had headphones placed over their ears but no music was played. Randomization and placement of headphones were done by a trainee physician who was not involved in further evaluation.
Colonoscopic examinations were performed by endoscopists with experience of performing at least 200 full-length colonoscopic procedures. During the procedure the pulse rate and systolic (SBP) and diastolic (DBP) blood pressure were monitored using an electronic wristwatch blood pressure recorder ( NAIS Blood Pressure Watch ; Matsushita, Tokyo, Japan). After the procedure, patients were monitored in the recovery room.
Outcome measures included dose of midazolam, duration of procedure, recovery time, pain score, discomfort score, and willingness to undergo the procedure under the same sedation protocol. In addition, occurrence of hypertension (defined as SBP >140 mmHg or DBP >90 mmHg or both), hypotension (SBP <90 mmHg), tachycardia (heart rate >100/min) and bradycardia (heart rate <60/min) were recorded.
Recovery time was defined as the time until the patient was oriented in time, place and person and was able to serially subtract 6 from 100, which was assessed by the recovery-room nurse who was unaware of the group allocation. Pain and discomfort scores were assessed using 0-10 visual analog scales (0: none, 10: extreme pain or discomfort).
The study protocol was approved by the ethics committee of our hospital. All patients provided written informed consent. The sample size was estimated based on a pilot study that included 20 patients; it was calculated that at least 40 patients were needed in each limb of the study to detect a 25% reduction in the dose of sedative medication with p value of 0.05 and study power of 80%.
Statistical analysis
Intergroup comparison was done using the non-parametric Mann-Whitney U test. The results are expressed as median and range.
Results
Patients in the two groups were comparable in age, gender distribution, and educational and social status. Most (n=75) underwent diagnostic colonoscopy for various indications [Table - 1]; three (control group - 1, music group - 2) underwent polypectomy. The endoscope was advanced up to the cecum in 69 cases. Three patients (control group - 2, music group - 1) had malignant strictures that precluded full examination. The procedures had to be abandoned midway due to extreme non-cooperation from three patients (control group - 1, music group - 2); all three had irritable bowel syndrome with recent change in pattern of symptoms. Three patients who underwent polypectomy had previously undergone full-length colonoscopy.
Most patients opted for popular film songs (n=26), followed by bioacoustics (n=18), soft instrumentals (n=8), folk songs (n=16), classical music (n=5) and devotional songs (n=5). The proportions of patients developing tachycardia (Group 1 - 57.9% vs. Group 2 - 55%), bradycardia (Group 1 - 12.8% vs. Group 2 - 14.3%), hypertension (Group 1 - 13.1% vs. Group 2 - 15.4%) and hypotension (Group 1 - 7.3% vs. Group 2 - 5.8%) were comparable in the two groups. The mean pain scores were similar in the two groups (p=0.128) while the mean discomfort score was higher in Group 1 (p=0.001) [Table - 2]. There was no difference in the duration of procedure between the two groups, whereas recovery time was longer in Group 1 [Table - 2]. Group 1 patients received a higher dose of midazolam than those in Group 2 [Table - 2]. Equal proportions of patients in the two groups were willing to undergo repeat procedure using the same sedation protocol (21 in group 1, 17 in group 2).
Discussion
Colonoscopy is an uncomfortable and painful endoscopic procedure.[7] Administration of sedatives and analgesics during colonoscopy carries the risk of arterial hypotension and respiratory depression. Most centers administer small doses of mild short-acting sedatives like midazolam. In our study, a reduction in the dose of midazolam was noted in the music group. Although pain scores were not significantly different between the groups, discomfort scores were less in the music group.
Beneficial effects of music therapy have been recognized previously. Music has positive psychological and physiological effects; hence it has been used for relieving stress associated with medical procedures and interventions.[1],[6], In particular, Palakanis et al[6] and Bampton[5] found that music alleviated anxiety and improved patient tolerance during GI endoscopy. Unfortunately, most studies on the effect of music during GI endoscopy had shortcomings like small sample sizes, non-random allocation, lack of observer blinding and assessment of subjective parameters.[9],[10],[11] Moreover, many studies used investigator-selected music; in view of individual preferences in perception of music, use of patient-selected music may be more apt.[11] Our study avoided several of these pitfalls.
In our study, a reduction in the dose of midazolam was noted in the music group. It may be argued that this could partly be due to the 'Hawthorne effect' (special interest that the investigator takes on the treatment arm), but chances of this are less since the endoscopist who makes the decision on administering sedative medication in conjunction with the patient's request was blinded. Although pain scores were not significantly different between the groups, discomfort scores were found to be less in the music group. Chances of bias playing a role in this final assessment are unlikely since the final assessor (recovery-room nurse) was also blinded to which study limb the patient belonged to.
The neurobiological basis of the effect of music on patient tolerance of GI endoscopic procedures remains unclear, although a recent trial showed reduction in salivary cortisol level when music was played during colonoscopic examination.[12]
In conclusion, our study showed that music can decrease the dose requirement of sedative medication for colonoscopy and reduce patient discomfort. Since it is readily available, noninvasive and without any side effects, music may be recommended as an adjunct to sedatives for patients undergoing elective colonoscopy.
References
1. Hanser SB. Music therapy and stress reduction research. J Music Ther 1985;22:193-206.
2. Rorke MA. Music therapy in the age of enlightenment. J Music Ther 2001;38:66-73. [PUBMED]
3. Standley JM. Music research in medical/dental treatment: meta-analysis and clinical applications. J Music Ther 1996;23:55-122.
4. Guzetta CE. Effects of relaxation and music therapy on patients in coronary unit with presumptive acute myocardial infarction. Heart Lung 1989;18:609-16.
5. Bampton B, Draper B. Effect of relaxation music on patient tolerance of gastrointestinal endoscopic procedures. J Clin Gastroenterol 1997;25:343-5.
6. Palakanis KC, DeNobile JW, Sweeny WB, Blankenship CI. Effect of music therapy on anxiety state in patients undergoing flexible sigmoidoscopy. Dis Colon Rectum 1994;37:478-81.
7. Rex DJ, Imperiale TF, Portish V. Patients willing to try colonoscopy without sedation: associated clinical factors and results of a randomized controlled trial. Gastrointest Endosc 1999;49:554-9.
8. Kaempf G, Amodei ME. The effects of music on anxiety. A research study. AORN J 1989;50:112-8. [PUBMED]
9. Shiemann V, Gross M, Reuter R, Kellman H. Improved procedure of colonoscopy under accompanying music therapy. Eur J Med Res 2002;7:131-4.
10. Binek J, Sagmeister M, Borovicka J, Knierim M, Magdeburg B, Myenburg C. Perception of gastrointestinal endoscopy by patients and examiners with and without background music. Digestion 2003;68:5-8.
11. Smolden D, Topp R, Singer L. The effect of self selected music during colonoscopy on anxiety, heart rate and blood pressure. Appl Nurs Res 2002;15:126-36.
12. Uedo N, Ishikawa H, Morimoto K, Ishihara R, Narahara H, Akedo I, et al . Reduction in salivary cortisol level by music therapy during colonoscopic examination. Hepatogastroenterology 2004;51:451-3.
Tables
[Table - 1], [Table - 2] |
Edited by - floop on 02/09/2007 12:35:12 |
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PixieSteve
> Teenager of the Year <
Poland
4698 Posts |
Posted - 02/09/2007 : 12:58:30
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Carl was enjoying a good old Google session for news articles
What's this, one about someone in a band who mentioned the Pixies once!?
... And no one's posted it on FB.net yet!?
"Carl, thanks for posting this article. You're amazing!"
oh i wanted to use them all, in order, but i quickly got bored..
FAST_MAN RAIDER_MAN - June 19th |
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Carl
- A 'Fifth' Catholic -
Ireland
11546 Posts |
Posted - 02/10/2007 : 09:22:13
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Okay, so my exact-as-possible replicas of Pixies articles are probably a waste of time.... |
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darwin
>> Denizen of the Citizens Band <<
USA
5454 Posts |
Posted - 02/10/2007 : 10:41:53
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| floop's public display of his jealousy of your cut-and paste skills is embarrassing. |
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kfs
= Cult of Ray =
USA
889 Posts |
Posted - 02/13/2007 : 08:44:51
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Hey, Carl...I appreciate what you do!
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coastline
> Teenager of the Year <
USA
3111 Posts |
Posted - 02/13/2007 : 08:56:37
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quote:
Originally posted by darwin
floop's public display of his jealousy of your cut-and paste skills is embarrassing.
I thought the eight-ball smiley embedded in the article was genius.
Please pardon me, for these my wrongs. |
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Frog in the Sand
-+ Le premiere frog +-
France
2715 Posts |
Posted - 02/13/2007 : 09:03:35
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quote:
Originally posted by kfs
Hey, Carl...I appreciate what you do!
Ditto!
-----
BLACKOLERO le only Frank Black / Pixies site 100% in français |
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cassandra is
> Teenager of the Year <
France
4233 Posts |
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fbc
-= Modulator =-
United Kingdom
4903 Posts |
Posted - 02/13/2007 : 09:31:20
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coastline
> Teenager of the Year <
USA
3111 Posts |
Posted - 02/13/2007 : 09:53:41
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| That's me, front row, second from the right. |
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fbc
-= Modulator =-
United Kingdom
4903 Posts |
Posted - 02/13/2007 : 10:44:39
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this  is me out back taking a break. Shh! don't tell Carl. |
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floop
= Wannabe Volunteer =
Mexico
15297 Posts |
Posted - 02/13/2007 : 10:53:07
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quote:
Originally posted by kfs
Hey, Carl...I appreciate what you do!
that's not an article |
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fbc
-= Modulator =-
United Kingdom
4903 Posts |
Posted - 02/13/2007 : 11:37:10
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Good point.
http://www.scottmccloud.com/comics/carl/3b/cyoc.html
Boston -
Carl, Co-Founder and former Chairman & CEO of Biopure,
to Help Clients Accelerate Time to New Drug Application and Commercial Launch
Waltham, MA, February 12, 2007 – Maxiom Consulting Group, Inc., a leading strategic business and IT consulting firm exclusively serving the life sciences industry, today announced that biopharmaceutical pioneer Carl has joined the company as Executive Director. Carl will help clients navigate through the complex journey from product development to commercial launch. Formerly the co-founder, Chairman and CEO of Biopure Corporation, Carl extends Maxiom Group’s comprehensive capability to help transform life sciences companies throughout the various stages of their business life cycle.
“As a true industry pioneer, Carl brings extensive global knowledge and expertise across the entire process of drug development, regulatory filings and launch,” said Scott Chizzo, President and CEO of Maxiom Group. “Carl is already applying innovative business practices with clients that will substantially reduce their time to submission and commercial launch.”
Carl has been a prominent and successful executive in the biotechnology and biopharmaceutical industries for 25 years. Among his many accomplishments, he was co-founder of Biopure Corporation where he obtained multiple FDA and EMEA trial authorizations, managed the successful completion of over 170 pre-clinical and clinical trials, and negotiated several industry partnerships on a global scale.
“Maxiom Group is helping life sciences companies solve issues at the very heart of their business,” said Rausch. “Together, we’re applying proven, innovative business models to help Maxiom Group clients scale without having to make large investments in their infrastructure.”
About Maxiom Group
Maxiom Group is a leading strategic business and IT consulting firm exclusively serving the life sciences industry. We help transform emerging, established and mature biotechnology, pharmaceutical and medical device companies at each stage of their life cycle by solving mission critical business issues. From drug discovery and development, to clinical trials, to commercial launch and sustained market leadership, Maxiom Group clients rely on our unique focus, insight and approach. For more information please visit www.maxiomgroup.com.
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s_wrenn
* Dog in the Sand *
Ireland
1851 Posts |
Posted - 02/13/2007 : 11:56:54
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When I’m not busy making papier-mâché Carl heads or cutting myself while smelling clippings of Carls hair, I like to read his in-depth coverage posted throughout the forum.
I hope you never leave this forum Carl…cause if you do…I’ll fucking skullfuck your hard-drive into a pulp and then ram your keyboard into your firewire port (IEEE 1394). Then I’ll eat all your flash drives and sd cards like corn flakes.
Stalk ya later, Carlinator.
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kfs
= Cult of Ray =
USA
889 Posts |
Posted - 02/16/2007 : 11:42:48
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Where in the world is Carl?
I think he's missing too! |
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coastline
> Teenager of the Year <
USA
3111 Posts |
Posted - 02/16/2007 : 12:33:31
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FBC hasn't posted much lately either. I SWEAR the cool people have gone over to the new forum without the rest of us: Brian, Dean, Carl, FBC ... and yet none of them had the decency to let blckfrncs himself know about it. He posts all the time here now.
Please pardon me, for these my wrongs. |
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Carl
- A 'Fifth' Catholic -
Ireland
11546 Posts |
Posted - 02/16/2007 : 13:47:00
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Aw jeez, you guys are too good. I disappear for a mere couple of days and there's concern galore. I have something in my eye...*sniff*! Does anybody else feel like an orphaned child without Brian and Dean around?
Wrennster, I'd like to see those papier-mache heads. But please stop cutting yourself, and where are you getting those hair clippings? ;) |
Edited by - Carl on 02/16/2007 13:47:17 |
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s_wrenn
* Dog in the Sand *
Ireland
1851 Posts |
Posted - 02/16/2007 : 14:53:08
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quote:
Originally posted by Carl
and where are you getting those hair clippings? ;)
Did you know there is a large cavity under the drainpipe of your shower? Big enough to live in. DUN DUN DUNNNNNN!!
Oh, and stop using that lynx africa shower gel, it burns my eyes down here.
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coastline
> Teenager of the Year <
USA
3111 Posts |
Posted - 02/16/2007 : 14:56:33
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Don't say "cavity" to Carl. That's insensitive.
Please pardon me, for these my wrongs. |
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s_wrenn
* Dog in the Sand *
Ireland
1851 Posts |
Posted - 02/16/2007 : 15:01:09
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Could i live in a cavity of carls tooth? Dare i dream?
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pixiestu
> Teenager of the Year <
United Kingdom
2564 Posts |
Posted - 02/16/2007 : 18:05:54
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This thread is getting weird.
"The arc of triumph" |
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Carl
- A 'Fifth' Catholic -
Ireland
11546 Posts |
Posted - 02/17/2007 : 11:50:29
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| That's it-Wrenn is my dentist! The plot thickens.... |
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s_wrenn
* Dog in the Sand *
Ireland
1851 Posts |
Posted - 02/17/2007 : 14:37:54
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Your dentist...AND YOUR CHILDHOOD IMAGINARY PET LOGANBERRY
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Carl
- A 'Fifth' Catholic -
Ireland
11546 Posts |
Posted - 02/17/2007 : 14:52:06
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Hah! Caught you out! His name was Logonburry!!
And you didn't specify what type of pet it was! |
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s_wrenn
* Dog in the Sand *
Ireland
1851 Posts |
Posted - 02/18/2007 : 11:08:16
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it was a berry. a loganberry. I was i mean
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ded13
- FB Fan -
12 Posts |
Posted - 02/18/2007 : 13:06:39
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Hello here!
Do you want to find something HOT? Visit our free adult portal for sharing porn videos and pics! Enjoy with us here http://xxx-photo.t35.com |
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pixiestu
> Teenager of the Year <
United Kingdom
2564 Posts |
Posted - 02/18/2007 : 13:25:06
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Delete this guy.
"The arc of triumph" |
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s_wrenn
* Dog in the Sand *
Ireland
1851 Posts |
Posted - 02/18/2007 : 16:43:21
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Ah-ha! so that's where the penis goes
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Carl
- A 'Fifth' Catholic -
Ireland
11546 Posts |
Posted - 02/18/2007 : 17:16:33
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| You spam my thread, you ded! |
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fbc
-= Modulator =-
United Kingdom
4903 Posts |
Posted - 02/19/2007 : 09:23:29
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| He spammed mine too while I was away. Let's happy slap 'im. |
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floop
= Wannabe Volunteer =
Mexico
15297 Posts |
Posted - 02/19/2007 : 09:56:20
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| at least he provided a link to something, and some cut and pasted information |
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fbc
-= Modulator =-
United Kingdom
4903 Posts |
Posted - 02/19/2007 : 10:02:32
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| true. we'll just slap him instead. no happy. |
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Homers_pet_monkey
= Official forum monkey =
United Kingdom
17125 Posts |
Posted - 02/19/2007 : 10:05:55
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quote:
Originally posted by floop
at least he provided a link to something, and some cut and pasted information
Yeah he's Carl's spamming pseudonym.
 I'd walk her everyday, into a shady place
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s_wrenn
* Dog in the Sand *
Ireland
1851 Posts |
Posted - 08/17/2007 : 11:10:54
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Carl, do you have anything special planned for your 10000 post?
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Carl
