Korean J Pain.  2021 Jun;34(3):304-314. 10.3344/kjp.2021.34.3.304.

Effectiveness of virtual reality immersion on procedure-related pain and anxiety in outpatient pain clinic: an exploratory randomized controlled trial

Affiliations
  • 1Department of Anesthesiology and Pain Medicine, CHA Ilsan Medical Center, CHA University School of Medicine, Goyang, Korea
  • 2Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Korea
  • 3Department of Anesthesiology and Pain Medicine, Chung-Ang University Hospital, Seoul, Korea
  • 4Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul, Korea

Abstract

Background
The study investigated virtual reality (VR) immersion in alleviating procedure-related pain in patients with chronic pain undergoing fluoroscopy-guided minimally-invasive intervention in a prone position at an outpatient clinic.
Methods
In this prospective randomized controlled study, 38 patients undergoing lumbar sympathetic ganglion block were randomized into either the VR or the control group. In the VR group, procedure-related pain was controlled via infiltration of local anesthetics while watching a 30-minute VR hypnotic program. In the control group, the skin infiltration alone was used, with the VR device switched off. The primary endpoint was an 11-point score on the numerical rating scale, indicating procedure-related pain. Patients’ satisfaction with pain control, anxiety levels, the need for additional local anesthetics during the procedure, hemodynamic stability, and any adverse events were assessed.
Results
Procedure-related pain was significantly lower in the VR group (3.7 ± 1.4) than in the control group (5.5 ± 1.7; P = 0.002). Post-procedural anxiety was lower in the VR group than in the control group (P = 0.025), with a significant reduction from pre-procedural anxiety (P < 0.001). Although patients’ satisfaction did not differ significantly (P = 0.158) between the groups, a higher number of patients required additional local anesthetics in the control group (n = 13) than in the VR group (n = 4; P = 0.001). No severe adverse events occurred in either group during the study.
Conclusions
VR immersion can be safely used as a novel adjunct to reduce procedural pain and anxiety during fluoroscopic pain intervention.

Keyword

Ambulatory Care Facilities; Anxiety; Autonomic Nerve Block; Chronic Pain; Ganglia; Sympathetic; Hypnotics and Sedatives; Minimally Invasive Surgical Procedures; Pain Perception; Pain; Procedural; Virtual Reality; Virtual Reality Exposure Therapy
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