Virtual reality fails to ease pain during operative hysteroscopy: Study

Virtual reality (VR) techniques are applied to combine sound and visual perception techniques to ease pain during clinical procedures. It is reported that pain ratings drop significantly lower when patients were immersed in Virtual reality (VR) however lack of data to back up its reliability. 34.8% of patients who undergo diagnostic hysteroscopy without anesthesia reported severe pain.

A randomized trial by Yuval Fouks and team has revealed that Visual and acoustic virtual reality (VR) doesn't help in reducing pain during an outpatient operative hysteroscopy.

The findings of the study are published in European Journal of Pain.

The objective of the study was to evaluate the effectiveness of VR as a distraction technique in the management of acute pain during operative hysteroscopy in the outpatient setting.

The study was a prospective, open-label, randomized control trial conducted in a tertiary university-affiliated medical center between April to August 2020. Overall, 82 women were randomly allocated to undergo operative hysteroscopy either with the use of VR (n = 44, study group) or with standard treatment (control group, n = 38). VR was applied throughout the procedure and no anesthesia was given. The primary outcome measures included self-reported intraoperative pain. Other objectives included vital parameters as pulse rate (PR) and respiratory rate (RR) before and during the first 3 minutes of the procedure. Pain and anxiety outcomes were measured as numeric rating scores.

The results of the study were

• The baseline parameters were similar between groups. The mean duration for the procedure was 8.1 ±3.2 vs. 7.3± 6.0 minutes for the study and the control groups (p = 0.23).

• There were no statistically significant differences between the reported pain scores during the procedure [median (interquartile range) 5.0 (3.0-7.2) vs 5.0 (3.0-8.0), respectively; P = .67].

• While neither intraoperative heart rate nor respiratory rate differed between groups [14.0 (13.0-16.0) vs 14.0 (11.0-16.5); P = .77)], the increase of heart rate was found greater in the VR group [+7.0 (8.5) vs. +1.0 (12.2); P = .01].

Fouks and team concluded that "VR was not effective in reducing pain during an outpatient operative hysteroscopy."

Reference: doi: 10.1002/ejp.1882.