Virtual reality noninferior to sedation for procedure-related pain, anxiety

During painful procedures, a virtual reality (VR) intervention appears to be as good as sedation in terms of alleviating pain and anxiety but is safer and associated with a shorter recovery period, according to a study.

The study included 146 patients (mean age 57 years, 65 percent female, 50 percent Asian) undergoing epidural steroid injections. They were randomly assigned to receive immersive VR plus local anaesthetic (VR, n=48), sedation with midazolam and fentanyl plus local anaesthetic (sedation, n=50), or local anaesthetic alone (control, n=48).

The primary outcome of procedure-related pain scores, which were recorded on a 0–10 scale, were markedly lower in both the VR and sedation groups than in the control group (mean, 3.7 and 3.2 vs 5.2), with no significant difference between the VR and sedation groups (mean difference, 0.5).

For the secondary outcomes, ability to communicate in the sedation group was reduced relative to the VR group (mean, 3.7 vs 4.1), but neither VR nor sedation was different than control. With regard to procedure-related anxiety and satisfaction, the results favoured VR and sedation over control, although the differences were not statistically significant.

Meanwhile, postprocedural recovery time was longer in the sedation group than in both the VR and control groups. Finally, no meaningful intermediate-term differences were observed across the intervention groups, with the exception of medication reduction being least in the control group.