Impact of Virtual Reality Distraction on Pain and Anxiety for Bedside Abdominal VAC Dressing Change (VIRPA) – A Randomized Controlled Clinical Trial

Abstract

Abstract Background Virtual reality (VR) distraction techniques are promising adjuncts to reduce pain and anxiety. Aims This study assessed the impact of VR distraction during bedside change of vacuum assisted closure (VAC) dressings. Methods In this non-blinded randomized superiority trial, patients scheduled for bedside change of a subcutaneous VAC dressing were allocated to receive distraction through VR masks in addition to a standardized pain protocol (intervention) or pain protocol alone (control). Primary endpoints were pain scores assessed by a visual analogue scale (VAS:0-10), secondary outcomes were anxiety (State Trait Anxiety Inventory (STAI-Y:20-80), VAS:0-10), hemodynamic parameters and satisfaction (VAS:0-10). Results Nineteen and twenty-one patients were randomized to receive intervention and control, respectively. Baseline characteristics were well balanced including age (61±11 vs. 62±17), sex (female: 9 vs. 13), American Society of Anesthesiologists (ASA) scores (≥3: 18 vs. 18, all non-significant). Pre- and postoperative pain levels were 2.2±2.2 vs. 2.0±2.1 (p=0.38) for the intervention group compared with 2.6±2.1 vs. 2.2±1.6 (p=0.26), with no significant difference between the groups (p=0.38). Similar findings for blood pressure and heart rates. Anxiety was reduced in both groups post VAC change in the intervention and control group: STAI 40±12 pre-VAC vs. 30±8 post VAC and 45±14 pre-VAC vs. 32±9 post VAC (both p<0.01), ΔVAS -2 (interquartile range IQR 0, -3) vs. -2 (IQR 0, -5), both p<0.01. Postinterventional satisfaction was 8.3±1.9 (intervention) vs. 7.5±2.4 (p=0.11). Conclusion In this study, pain and anxiety were well managed with a standardized pain protocol with or without adjunct VR distraction. Further studies will focus on patients with insufficient control of pain and anxiety with a standard protocol.