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Mozart for Reducing Patient Anxiety During Colposcopy

A Randomized Controlled Trial

Hilal, Ziad, MD; Alici, Ferizan, MD; Tempfer, Clemens B., MD; Rath, Katrin, MD; Nar, Kirnjit; Rezniczek, Günther A., PhD

doi: 10.1097/AOG.0000000000002876
Contents: Dysplasia: Original Research

OBJECTIVE: To test whether music by Mozart reduces anxiety among patients undergoing colposcopy.

METHODS: In a randomized multicenter trial, we measured the reduction of the situation-specific anxiety of women hearing Mozart’s Symphony No. 40 during colposcopy compared with women not hearing music using the State-Trait Anxiety Inventory. Secondary endpoints were reduction of heart rate (beats per minute), pain during and 10 minutes after colposcopy, general unpleasantness, anxiety during colposcopy, and overall satisfaction (11-item visual analog scales). Analysis was by intention to treat. A sample size of 104 per group (N=208) was calculated to achieve 80% power to detect a difference of 4.8 with a SD of 12.3 in anxiety scores.

RESULTS: Between February 2017 and May 2018, 212 women were randomized. The mean anxiety reduction was −9.4±10.8 SD in 103 women in the music group and −9.0±10.6 in 102 women in the control group (P=.40). The secondary endpoints reduction of heart rate (−16.3±16.9 vs −15.4±17.1; P=.37), pain during procedure (median 2 [interquartile range 1–4] vs 2 [1–3.5]; P=.80), pain 10 minutes after examination (1 [0–1.75] vs 1 [0–2]; P=.42), general unpleasantness (3 [1–5.75] vs 4 [1–5.5]; P=.35), anxiety during examination (2 [1–5] vs 2 [1–6]; P=.28), and overall satisfaction (10 [9–10] vs 10 [9–10]; P=.81) were also not different between the two study groups.

CONCLUSION: Mozart’s Symphony No. 40 does not reduce anxiety in women undergoing colposcopy.


Patients who hear Mozart during colposcopy do not experience reduced anxiety.

Department of Obstetrics and Gynecology, Ruhr-Universität Bochum, Bochum, Germany.

Corresponding author: Günther A. Rezniczek, PhD, Department of Obstetrics and Gynecology, Ruhr-Universität Bochum, Marien Hospital Herne, Hölkeskampring 40, 44625 Herne, Germany; email:

The study was funded by the authors’ institutional funds.

Financial Disclosure The authors did not report any potential conflicts of interest.

Each author has indicated that he or she has met the journal’s requirements for authorship.

Received May 30, 2018

Received in revised form July 05, 2018

Accepted July 20, 2018

© 2018 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.