Hu W. et al., 2021: Effect of media distraction (audio-visual and music) for pain and anxiety control in patients undergoing shock-wave lithotripsy: A systematic review and meta-analysis
Hu W, Yang K, Zhang L, Lu X.
Department of Urology, The First Affiliated Hospital of Hunan Normal University, Changsha, Hunan 410000, P.R. China.
Department of Laboratory Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, Hunan 410000, P.R. China.
Audio-visual (AV) or music distraction may be used to reduce pain during several healthcare procedures. The present manuscript is a systematic review and meta-analysis to assess the effectiveness of media distraction in reducing pain and anxiety in extracorporeal shock wave lithotripsy (ESWL) patients. The PubMed, Embase, Scopus, BioMed Central, Ovoid and CENTRAL (Cochrane Central Register of Controlled Trials) databases were screened for studies assessing the role of media distraction (music/AV media) in reducing pain and anxiety of ESWL patients. Data were summarized using the mean difference (MD) with 95% confidence intervals (CI). A total of 11 randomized controlled trials were included. Pooled analysis indicated a statistically significant difference in pain outcomes with media distraction [mean difference (MD): -1.18; 95% CI: -2.35, -0.01; I2=96.8%)]. Subgroup analysis indicated that both AV media (MD: -2.94; 95% CI: -4.70, -1.17; I2=79.2%) and music (MD: -0.86; 95% CI: -1.37, -0.35; I2=62.5%), led to significant reduction in pain outcomes. Pooled analysis indicated a statistically significant reduction of anxiety scores with the use of media distraction (MD: -3.91; 95% CI: -6.44, -1.38; I2=77.7%). To conclude, the present review suggests that media distraction in the form of AV media or music may be beneficial in reducing the pain and anxiety of patients undergoing ESWL. Evidence is, however, weak considering the small effect size, confidence intervals being close to zero, and instability of the results on sensitivity analysis. In clinical practice, media distraction may be used during ESWL as a nursing intervention, but a clinically important reduction of pain and anxiety may not be expected.
Exp Ther Med. 2021 Jun;21(6):623. doi: 10.3892/etm.2021.10055. Epub 2021 Apr 14. PMID: 33936280. FREE ARTICLE
Like many other reports today, this article is a systematic review of RCTs that so far have been published on the influence of media distraction during SWL. Overall, there was a reduction of anxiety score (-3.9) and of pain score (-1.18). It is of note that noise-cancelling headphones were considered superior whwn compared with standard headphones. The bottom-line of this report is, however, that a clinically important reduction of pain an anxiety should not be expected.