Virtual reality for procedural pain management
Abstract:
Purpose: To assess the analgesic and anxiolytic effects of virtual reality (VR) augmentation in patients undergoing peripherally inserted central catheter (PICC) or fine-needle aspiration (FNA) thyroid biopsy.
Materials and methods: This is a prospective single center RCT with 107 patients enrolled. Patients were randomly assigned to receive standard of care (SOC) or SOC+VR during PICC or thyroid biopsy procedures. Pain and anxiety were individually measured using the Visual Analogue Scale (VAS) before and after the procedure. Vital signs including heart rate, systolic and diastolic blood pressure were also recorded. One-way Analysis of Variance (ANOVA) testing with Games-Howell post hoc analysis were utilized to assess effect size and statistical significance between SOC and SOC+VR measures.
Results: The PICC cohort consisted of 59 patients (33 in SOC+VR and 26 in SOC), with a median age of 53.1 years (IQR = 38.3-62.7). The thyroid biopsy cohort consisted of 48 patients (26 in SOC+VR and 22 in SOC), with a median age of 60.1 years (IQR = 49.0-67.2). One-way analysis of individuals receiving thyroid biopsies with adjunctive virtual reality revealed an effect size of -1.74 points (S.E. = 0.71, p = 0.02) on VAS pain scale when compared to standard of care. Analysis of individuals receiving PICC placements revealed an effect size of -1.60 points (S.E. = 0.81, p = 0.05) on VAS anxiety when compared to standard of care.
Conclusion: VR as a non-pharmacological adjunct reduced some procedure-related pain and anxiety without increasing the procedural duration.
Reference:
Schaake R, Leopold I, Sandberg A, Zenk B, Shafer L, Yu D, Lu X, Theingi S, Udongwo A, Cohen GS, Maresky HS. Virtual Reality for the Management of Pain and Anxiety for Interventional Radiology Procedures: A Prospective, Randomized, Pilot Study on Digital Sedation. J Vasc Interv Radiol. 2024 Mar 12:S1051-0443(24)00210-0. doi: 10.1016/j.jvir.2024.03.004. Epub ahead of print. PMID: 38484911.