Visual distraction eases pain, anxiety during colonoscopy

Patients undergoing colonoscopy may benefit from visual/audiovisual distraction interventions, which have been shown to reduce pain and anxiety and improve satisfaction during the procedure, suggests a recent study.

A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted to examine the efficacy of visual/audiovisual distraction. Two investigators extracted and retrieved eligible studies via PubMed, Embase, WOS, Scopus, and Cochrane through June 2024.

Cohen’s d and risk ratio (RR) with 95 percent confidence interval (CI) were used to pool continuous and dichotomous outcome variables. Heterogeneity was also assessed using the χ2 test and I2 statistic.

Thirteen RCTs including 1,439 patients randomized to an active intervention (n=804) or usual care (n=635) met the eligibility criteria. Of the RCTs, only three were endoscopist-blinded studies, while the rest were open-label. The interventions used included playing nature scene videos, real-time videos of the colonoscopy, or movies preferred by the patients.

Active intervention correlated with a significant decrease in pain experienced during colonoscopy (Cohen’s d, ‒0.57, 95 percent CI, ‒0.79 to ‒0.35; p<0.0001) and colonoscopy-related anxiety (Cohen’s d, ‒0.66, 95 percent CI, ‒1.15 to ‒0.18; p=0.01) and with increased patient satisfaction (Cohen’s d, 0.65, 95 percent CI, 0.49‒0.80; p<0.0001) compared with usual care.

No significant between-group differences were observed in the willingness to re-undergo the procedure (RR, 1.11, 95 percent CI, 0.98‒1.25; p=0.09), analgesia use (Cohen’s d, ‒0.21, 95 percent CI, ‒0.42 to 0.0; p=0.05), or total procedure duration (Cohen’s d, ‒0.12, 95 percent CI, ‒0.24 to 0.0; p=0.06).

“These are promising interventions to improve patient compliance and quality of care during colonoscopy,” the investigators said.