Music does not reduce alfentanil requirement during patient-controlled analgesia (PCA) use in extracorporeal shock wave lithotripsy for renal stones

To evaluate the impact of music on opioid requirements and pain levels duri ng renal lithotripsy using alfentanil patient-controlled analgesia (PCA), w e conducted a prospective, blinded, randomized controlled trial. Patients u ndergoing lithotripsy were instructed in PCA use and asked to rate their an xiety and select their preferred type of music. They were then premedicated with morphine and ketorolac and randomly allocated into two groups. Group 1 (n = 97) had music started 10 min before the procedure and maintained unt il 10 min after its conclusion. Group 2 (n = 96) had music begun at the con clusion of lithotripsy and contributed for 10 min. Pain intensity, alfentan il requirement, side effects, quality of analgesia, patient satisfaction, a nd acceptance of the technique were evaluated. Demographics, alfentanil req uirement, pain levels, side effects, quality of analgesia, and patient sati sfaction were similar in both groups. The addition of music did not provide any benefit. This result raises the possibility that some nonpharmacologic therapies have minimal impact in setting where the painful stimulus is mod erate to severe and adequate pharmacotherapy is available. (C) U.S. Cancer Pain Relief Committee, 1998.