The possible antinociceptive effect of hemispheric‐synchronised sounds, classical music and blank tape were investigated in patients undergoing surgery under general anaesthesia. The study was performed on 76 patients, ASA 1 or 2, aged 18–75 years using a double‐blind randomised design. Each of the three tapes was allocated to the patients according to a computer‐generated random number table. General anaesthesia was standardised and consisted of propofol, nitrous oxide 66%/oxygen 33%, isoflurane and fentanyl. Patients breathed spontaneously through a laryngeal mask and the end‐tidal isoflurane concentration was maintained near to its minimum alveolar concentration value of 1.2%. Fentanyl was given intravenously sufficient to keep the intra‐operative heart rate and arterial blood pressure within 20% of pre‐operative baseline values and the fentanyl requirements were used as a measure of nociception control. Patients to whom hemispheric‐synchronised sounds were played under general anaesthesia required significantly less fentanyl compared with patients listening to classical music or blank tape (mean values: 28 μg, 124 μg and 126 μg, respectively) (p < 0.001). This difference remained significant when regression analysis was used to control for the effects of age and sex.

Several different techniques for ear piercing have been described. They include (1) the use of an eyelet-type Teflon tube, 1 Inoue T Kurihara T Harashina T. Ear-piercing technique by using an eyelet-type Teflon piercer: (Eyelet-Piercer). Ann Plast Surg. 1993; 31: 159-161 Crossref PubMed Scopus (5) Google Scholar (2) an intravenous cannula stent or angiocatheter 2 Zackowski DA. An IV cannula stent for ear piercing. Plast Reconstr Surg. 1987; 80 ([letter]): 751 PubMed Google Scholar and magnetic earrings, 3 Matarasso SL Glogau RG. Surgical pearl: ear piercing facilitated by magnetic earrings. J Am Acad Dermatol. 1994; 31: 485-486 Abstract Full Text PDF PubMed Scopus (5) Google Scholar (3) a pair of surgical forceps that have been fashioned into an anvil, 4 Duffy MM. A simple instrument for ear piercing. Plast Reconstr Surg. 1967; 40: 92-93 Crossref PubMed Scopus (4) Google Scholar (4) a 14- or 16-gauge trocar needle antrum, 5 Goff WF. Ear piercing: By whom?. Eye Ear Nose Throat Mon. 1975; 54: 319 PubMed Google Scholar (5) piercing the ear from a posterior-to-anterior direction with the use of a needle 6 Bennett RG. Fundamentals of cutaneous surgery. in: CV Mosby, St Louis1988: 611-615 Google Scholar followed by placement of a wire loop, 7 Goldman L Kitzmiller KW. Earlobe piercing with needles and wires. Arch Dermatol. 1965; 92: 305-306 Crossref Scopus (4) Google Scholar and (6) the use of a spring-loaded piercing gun. Although each of these techniques is useful, they all have certain disadvantages. Some techniques require the use of special instruments that the dermatologic surgeon may not routinely have in the office. Others do not guarantee accurate placement of the earring either because of instrument interference with the surgeon’s view of the piercing site or from the use of the posterior-to-anterior piercing technique. Furthermore, the use of the spring-loaded ear-piercing guns is associated with embedded earrings. 8 Cockin J Finan P Powell M. A problem with ear piercing. Br Med J. 1977; 2: 1631 Crossref PubMed Scopus (6) Google Scholar , 9 Saleeby ER Rubin MG Youshock E Kleinsmith DM. Embedded foreign bodies presenting as earlobe keloids. J Dermatol Surg Oncol. 1984; 10: 902-904 Crossref PubMed Scopus (12) Google Scholar , 10 Muntz HR Pa CDJ Asher BF. Embedded earrings: a complication of the ear-piercing gun. Int J Pediatr Otorhinolaryngol. 1990; 19: 73-76 Abstract Full Text PDF PubMed Scopus (31) Google Scholar , 11 Cohen HA Nussinovitch M Straussberg R. Embedded earrings. Cutis. 1994; 53: 82 PubMed Google Scholar