I have a SB128 installed in my Mediator and have been largely disappointed with it's performance. I get very noticeable slowdown when playing back Mp3 files (more so than with Paula, admittedly the quality is better though). Very few programs seem to have hardware independent sound output, but you could theoretically onnect the phono output into one of the Soundblaster's input feeds.
The only program I have gotten good results with is Sid4Amiga.