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To determine whether music influences intraoperative sedative and analgesic requirements, two randomized controlled trials were performed.In phase 1, 35 adults undergoing urologic procedures with spinal anesthesia and patient-controlled intravenous propofol sedation were randomly assigned to hear favorable intraoperative music via headset or to have no music. In phase 2, 43 adults undergoing lithotripsy treatment of renal or ureteral calculi and receiving patient-controlled intravenous opioid analgesia were randomly assigned to either a music or no-music group. The effect of music on sedatives and analgesics requirements, recovery room duration, and adverse outcomes was assessed.In phase 1, patients in the music group required significantly less propofol for sedation than patients in the control group (0 [0–150] mg vs. 90 [0–240] mg, median[range]; P < 0.001). These findings persisted after adjusting for duration of surgery (0.3 +/- 0.1 mg/min vs. 1.6 +/- 0.4 mg/min; P < 0.001). Similarly, in phase 2, patients who listened to music had a significant reduction in alfentanil requirements (1,600 [0–4,250] [micro sign]g vs. 3,900 [0–7,200] [micro sign]g; P = 0.005). This persisted after adjusting for duration of surgery (52 +/- 9 [micro sign]g/min vs. 119 +/- 16 [micro sign]g/min, mean +/- SD, P < 0.001). Duration of stay in the postanesthesia care unit and the rate of adverse events was similar in both groups (P = NS).Use of intraoperative music in awake patients decreases patient-controlled sedative and analgesic requirements. It should be noted, however, that patients in the no-music group did not use a headset during operation. Thus, the decrease in sedative and analgesic requirements could be caused by elimination of ambient operating room noise and not by the effects of music.