Table I.
Characteristics of included studies.
| Sample size | Mean age | Male sex (%) | Number of shock waves | ESWL power settings | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Author/Year | Inclusion criteria | Exclusion criteria | Study | Control | Study | Control | Study | Control | Media distraction | Study | Control | Study | Control | Analgesia during procedure |
| Cepeda et al (25), 1998 | Age: 15-65 years First ESWL | Serum creatinine >1.5 mg/dl History of opioid use | 97 | 96 | 40.7 | 41 | 49.4 | 48.9 | Patient selected classical, Caribbean, soft rock, and jazz music via headphones started 10 mins before procedure and continued up to 10 mins post- procedure | NR | NR | All patients reached 17 V | Morphine 10 mg SC with ketor olac 30 mg IV + alfentanil PCA (0.25 mg dose with 1 min lockout interval) | |
| Koch et al (23), 1998 | NR | NR | 21 | 22 | 54 | 53 | 80 | 44 | Any music pf patients choice via headphone during procedure | NR | NR | NR | NR | Midazolam and Alfentanil 10 µg/kg PCA |
| Yilmaz et al (26), 2003 | Age: 19-68 years | NR | 48 | 50 | 40.8 | 39.3 | 60.4 | 64 | Relaxing, slow rhythm sedative music via headphones during procedure | 3043± 110.42 | 3016± 64.22 | 21.96± 0.54 kV | 21.03± 0.48 kV | 15 g emla cream over flank, 25 mg fentanyl IV given to patients reporting pain. Midazolam 2 mg in control group only |
| Marsdin et al (22), 2012 | Elective outpatient ESWL patients | Ureteric stents Emergency patients | 61 | 57 | 51.7 | 53.5 | 54 | 56 | 32-inch television with 30 different DVDs of 30-min programs provided with wireless headphones | 3948± NR | 3764± NR | NR | NR | Pethidine 100 mg IM and diclofenac 75 mg IM |
| Akbas et al (27), 2016 | Age: >18 y No preoperative pain No analgesic use before the procedure No ureteral stent inserted Radio-opaque stone | Not completed procedure Development of complications Refusing to listen to music Not completing the second session | 200 | 200 | - | - | - | - | Turkish folk, classical, popular music during procedure | 2724± 492 | 2710± 551 | 17.71± 2.59 J | 17.04± 2.07 J | None |
| Karalar et al (28), 2016 | Radio- opaque renal stone | Prior ESWL Ureteric stents Renal colic | S1: 28 S2: 29 | 32 | S1: 47.8 S2: 47.7 | 48.2 | S1: 61 S2: 62 | 59 | S1: Turkish classical music by noise cancellation headphones during procedure S2: Turkish classical music via non noise cancellation headphones during procedure | 2913± 444 | 2828± 272 | 20.1± 1.1 kV | 19.9± 1.3 kV | Diclofenac 75 mg IM |
| Cakmak et al (29), 2017 | Age: >18 y Radio-opaque renal stone Located in upper/middle calices, renal pelvis: <20 mm in diameter Proximal ureter: <10 mm in diameter | Prior ESWL Ureteric stents Hearing disorders Uncontrolled hypertension History of psychiatric disease and antidepressant drug use | 95 | 105 | NR | NR | NR | NR | Turkish folk, classical, popular, relaxing or slow rhythm music via headphones during procedure | 2764.5± 699.1 | 2777.9± 724.9 | 17.4± 5.3 kV | 17.5± 5.5 kV | NR |
| Jurado et al (30), 2017 | Age: 18-80 y | Prior ESWL Hearing loss Analgesia prior to procedure Regularly taking painkillers | 42 | 53 | 52.6 | 52 | 54.8 | 69.8 | Patient selected classical, chill out, pop, jazz music via by noise cancellation headphones during procedure | NRa | NR | NRa | NR | Pethidine 20 mg IV and paracetamol 1 g IV. 10 cc (max 50 cc) of pethidine given to patients reporting pain. |
| Gezginci et al (31), 2018 | Age: >18 y First ESWL BMI: <30 kg/m2 No contradiction for ESWL | Analgesic before procedure Renal colic before procedure Ureteric stents | 40 | 40 | NRa | NR | 33.3 | 35.2 | Patient selected Turkish (folk, art, arabesque, pop) music, foreign pop music, rock and classical music via headphones during procedure | Targeted 3,000 per session | NR | NR | None | |
| El-Khoury et al (32), 2020 | Adult patients | NR | AV media: 33 Music: 30 | 31 | AV media: 52.4 Music: 51.5 | 52.6 | AV media: 70 Music: 90 | 71 | AV media: music videos using Apple iPad Music: Any music/local radio Both delivered by noise cancellation headphones during procedure | AV media: 3205.9± 545.3 Music: 3175.1± 434.1 | 3150.4± 424.5 | AV media: 74.3± 10 kV Music: 74.3± 9.1 kV | 70.4±16 kV | NSAID suppository offered to all patients. Breakthrough pain treated by Fentanyl IM |
| Çift et al (24), 2020 | Age: >18 years Radiopaque stone 10-20 mm in diameter localized in the renal pelvis or ureteropelvic junction Absence of renal colic before the procedure | Previous ESWL history Ureteral stent Hearing deficit, Uncontrolled hypertension Antidepressant drug usage | S1: 30 S2: 30 S3: 30 | C1: 30 C2: 30 | S1: 37.7 S2: 36.3 S3: 36.4 | C1: 38.4 C2: 39.2 | S1: 83.3 S2: 70 S3: 73.3 | C1: 53.3 C2: 56.7 | S1: Turkish art music S2: Western classical music S3: Patient selected any type of music. All delivered via headphones during procedure C1: No headphones, no music C2: Headphones on, no music | S1: 2851.5 (2685.7-3000) S2: 2842.5 (2437.2-2958.7) S3: 2800 (2500-2925) | C1: 2700 (2500-2900) C2: 2725 (2500-2900) | S1: 92 (82-101.25) S2: 90 (64.25-103.5) S3: 94 (79.75-96.25) | C1: 80 (74.75-92.5) C2: 85 (65.0-93.25) | None |
Data presented as the mean ± SD.
aNo difference between the two groups for number of shock waves and energy, but data not reported as the mean ± SD. AV, audiovisual; ESWL, extracorporeal shock wave lithotripsy; PCA, patient controlled analgesia; SC, subcutaneous; IM, intramuscular; IV, intravenous; BMI, body mass index; S1, study group 1; S2, study group 2; S3, study group 3; C1, control group 1; C2, control group 2; NR, not reported; V, volts; kV, kilovolts; J, Joules.