The effect of music and distraction on discomfort and anxiety during colonoscopy: a systematic review and meta-analysis

Aims The role of music has demonstrated an established method in reducing pain and anxiety for patients undergoing colonoscopy. Distraction, which is a newer technique being implemented and has less evidence but has shown similar outcomes. This systematic-review and meta-analysis has to date the highest included studies for music. It is the first systematic-review and meta-analysis to date reporting on distraction techniques and their role in colonoscopy.

Methods A comprehensive literature search was conducted with outcome of mean pain and anxiety scores of Visual Analogue Score (VAS) pain score and Spielberger State-Trait Anxiety Inventory (STAI) anxiety score. The study was performed in line with Cochrane recommendations and PRISMA guidelines.

Results For music there was a significant (p<0.0005) weighted mean reduction of 1.47 for pain scores (95%CI 0.88–2.06). Also, a significant weighted mean reduction of 6.09 for anxiety scores with a (95%CI 2–10.19). For distraction there was a significant weighted mean reduction of 1.78 for pain scores) 95%CI 0.92 – 2.65). Also, a significant weighted mean reduction of 9.24 for anxiety scores (95%CI 4.37 – 14.10)

Conclusions This meta-analysis has demonstrated that there is a role for music and task distraction to improve pain and anxiety for patients undertaking a colonoscopy. It provides a safer and more cost-effective option for patients who may not be able to have sedation. Whilst evidence is still not directly comparable it is plausible for it to be used and established into daily clinical practice.

Publication History

Article published online:
27 March 2025