Virtual Reality Effects on Acute Pain during Office Hysteroscopy: A Randomized Control Trial

Abstract

<h3>Study Objective</h3> To evaluate the use of virtual reality (VR) as a noninvasive and nonpharmacologic analgesic during office hysteroscopy procedures. <h3>Design</h3> Single site, parallel group, unblinded randomized controlled trial. <h3>Setting</h3> Single academic outpatient minimally invasive gynecology surgery clinic. <h3>Patients or Participants</h3> Women over 18 years of age scheduled to undergo in office hysteroscopy were invited to participate in the study. 85 participants were approached, 50 consented to participate and were randomized using a computerized random number generator (n=25 in VR group and n=25 in standard group). <h3>Interventions</h3> Patients were randomized to VR intervention or standard of care from May to November 2020. The VR intervention consisted of listening to a 10-minute guided Zen meditation using The Guided Meditation VR App through an Oculus Go headset. <h3>Measurements and Main Results</h3> Primary outcome was peak pain score during the procedure based on a 100 mm visual analogue scale (VAS) score. The secondary outcomes were change in pain score (peak pain score minus baseline pain score) and change in participant's HR (average BPM before procedure – average BPM during procedure). Data was also collected to assess patient and surgeon satisfaction. The peak pain score during the procedure for the VR group was 35 [15, 60] vs 30 [9, 54] for the standard hysteroscopy group (P=0.317). Compared with the standard of care, VR had no significant effect on median heart rate change during the procedure (-4.6 [-0.5,11.1] vs +2.8 [0.1,7.7] P=0.327). Participants in the VR group had a positive experience with VR and 88% reported the music was very or slightly calming and 84% reported meditation was very or slightly helpful. No serious adverse events occurred. <h3>Conclusion</h3> This study found no statistically significant difference in pain scores or change in heart rate prior to, during, or after hysteroscopic procedures with VR compared to standard of care. Participants were satisfied with the VR intervention.