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Randomized Controlled Trial
. 2022 May 11:49:e20223138.
doi: 10.1590/0100-6991e-20223138-en. eCollection 2022.

Virtual Reality as a distraction therapy during cystoscopy: a clinical trial

[Article in English, Portuguese]
Diego Inácio Goergen  1 , Daniel Melecchi DE Oliveira Freitas  1   2
Affiliations
Randomized Controlled Trial

Virtual Reality as a distraction therapy during cystoscopy: a clinical trial

[Article in English, Portuguese]
Diego Inácio Goergen et al. Rev Col Bras Cir. .

Abstract
in English, Portuguese

Objectives: to investigate whether virtual reality (VR) experience is associated with decreased pain sensation among patients who undergo rigid cystoscopy under local anesthesia.

Methods: we performed a prospective, randomized, controlled study of 159 patients who were aleatorily enrolled into two groups: VR and control. VR experience intervention consisted of using a headset with a smartphone adapted to a virtual reality glasses where an app-video was played during the procedure. Main outcomes analyzed were pain, discomfort, heart rate variability, difficulty and duration of the cystoscopy. Statistical analyses were performed using a Student's t test, Mann-Whitney test and Chi-square test. A P<0.05 was considered to be statistically significant.

Results: among 159 patients studied (VR group=80 patients; control group=79 patients), the mean age was 63,6 years and 107 (67,3%) were male. There was no statistically significant difference in baseline characteristics between the 2 groups. VR was significantly associated to decreased heart rate variability (6,29 vs 11,09 bpm, P<0,001) and lower duration of the procedure (5,33 vs 8,65 min, P<0,001). Also, when cystoscopies due to double-J extraction were excluded, VR experience was associated with reduced pain on the visual analog score of pain (3,26 vs 4,33 cm, P=0,023).

Conclusions: the use of VR as a distraction therapy while performing outpatient cystoscopies is safe, has no side effects, is associated with less pain and discomfort, and reduces length of procedure.

Objetivos:: investigar se a experiência de realidade virtual (RV) está associada à diminuição da dor em pacientes submetidos à cistoscopia rígida sob anestesia local.

Métodos:: foi realizado um estudo prospectivo, randomizado e controlado de 159 pacientes que foram alocados aleatoriamente em dois grupos: RV e controle. A intervenção da experiência de RV consistiu no uso de óculos de realidade virtual com smartphone adaptado e fones de ouvido, onde um vídeo foi reproduzido durante o procedimento. Os principais desfechos analisados foram dor, desconforto, variabilidade da frequência cardíaca, dificuldade e duração da cistoscopia. As análises estatísticas foram realizadas com o teste t de Student, o teste de Mann-Whitney e o teste do qui-quadrado. Um P<0,05 foi considerado como estatisticamente significativo.

Resultados:: entre os 159 pacientes estudados (grupo RV=80; grupo controle=79), a média de idade foi 63,6 anos e 107 (67,3%) eram do sexo masculino. Não houve diferença estatisticamente significativa nas características basais entre os grupos. A RV foi significativamente associada à menor variabilidade da frequência cardíaca (6,29 vs 11,09 bpm, P<0,001) e menor duração do procedimento (5,33 vs 8,65 min, P<0,001). Além disso, quando cistoscopias devido à extração de duplo J foram excluídas, a RV foi associada à redução da dor na escala visual analógica (3,26 vs 4,33cm, P=0,023).

Conclusões:: o uso da RV como terapia de distração durante a realização de cistoscopias ambulatoriais é seguro, não tem efeitos colaterais, está associado a menos dor e desconforto e reduz a duração do procedimento.

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Conflict of interest statement

Conflict of interest: no.

Figures

Figure 1
Figure 1. Screenshot of the app.
Figure 2
Figure 2. Visual analog scale.
See this image and copyright information in PMC

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