Virtual reality for acute pain in outpatient hysteroscopy: a randomised controlled trial

Deo, Nandita; Khan, Khalid S.; Mak, Jonathan; Allotey, John; Carreras, FJ Gonzalez; Fusari, Gianpaolo; Benn, Jonathan

doi:10.1111/1471-0528.16377

Cited by 48 publications

(38 citation statements)

References 38 publications

(68 reference statements)

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“…We have read with interest the study by Deo et al published in BJOG: An International Journal of Obstetrics and Gynaecology. 1 We noted that although the control and the virtual reality (VR) group were 'comparable' regarding previous hysteroscopies, differences in baseline pain expectation scores between patients with a previous hysteroscopy and patients without previous hysteroscopy were not given. Each patient has an individual pain experience during hysteroscopy: some may not experience any pain at all, whereas others feel pain during cervical manipulation, distension of the uterus or pipelle biopsy, or delayed pain as a result of the release of prostaglandins.…”

Section: Sirmentioning

confidence: 98%

Re: Virtual reality for acute pain in outpatient hysteroscopy: a randomised controlled trial

Mirza

Hanif

Khan

et al. 2020

BJOG

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Section: Sirmentioning

confidence: 98%

Re: Virtual reality for acute pain in outpatient hysteroscopy: a randomised controlled trial

Mirza

Hanif

Khan

et al. 2020

BJOG

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“…It is a computer-generated representation of an immersive environment viewed through a headset. VR is effective in reducing pain and anxiety during outpatient hysteroscopy [19].…”

Section: Virtual Realitymentioning

confidence: 99%

Hysteroscopy, the Window into the Uterine Cavity

Naor-Revel¹,

Goldstone²,

Revel³

2022

Advances in Minimally Invasive Surgery

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Hysteroscopy, is a technique by which we can look into the uterine cavity entering through the cervix and is today the most applied minimally invasive technique in Gynecology. Indications for hysteroscopy include infertility investigation, abnormal uterine bleeding, and evaluation of suspicious sonographic findings. Nowadays we approach the uterus via vaginoscopy with no anesthetic. Once inside the uterus, we remove polyps or stringless IUD and take a biopsy. These procedures are often referred as “see and treat”. Operative hysteroscopy under GA or sometimes cervical block, uses larger instruments to resect myomas, cut a septum (metroplasty) or separate intrauterine adhesions (Asherman’s). As Glycine is no more used in hysteroscopy it has become quite a safe procedure. Use of disposable scopes will enable this tool to be part of every gynecologic clinic.

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“…In a non-randomized controlled study recruiting patients undergoing colposcopy (cervical examination), Vasquez et al showed that patients assigned to VR group reported reduced pain scores post-VR intervention [20]. Another prospective randomized controlled trial in an outpatient hysteroscopy setting showed that the use of VR during the procedure resulted in significantly decreased average pain score and anxiety when compared to controls [21]. Nevertheless, there are limited studies conducted in a gynecological population, and no formal sample size calculations were performed to study the expected clinical effect size related to pre-operative anxiety.…”

Section: Introductionmentioning

confidence: 99%

The use of pre-operative virtual reality to reduce anxiety in women undergoing gynecological surgeries: a prospective cohort study

et al. 2020

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Background Pre-operative anxiety is common and is associated with negative surgical outcomes. Virtual reality (VR) is a promising new technology that offers opportunities to modulate patient experience and cognition and has been shown to be associated with lower levels of anxiety. In this study, we investigated changes in pre-operative anxiety levels before and after using VR in patients undergoing minor gynecological surgery. Methods Patients who underwent elective minor gynecological surgeries in KK Women’s and Children’s hospital, Singapore were recruited. The VR intervention consisted of 10-min exposure via a headset loaded with sceneries, background meditation music and breathing exercises. For the primary outcome of pre-operative anxiety, patients were assessed at pre- and post-intervention using the Hospital Anxiety and Depression Scale (HADS). Secondary outcomes of self-reported satisfaction scores and EuroQol 5-dimension 3-level (EQ-5D-3L) were also collected. Results Data analysis from 108 patients revealed that HADS anxiety scores were significantly reduced from 7.2 ± 3.3 pre-intervention to 4.6 ± 3.0 post-intervention (p < 0.0001). Furthermore, HADS depression scores were significantly reduced from 4.7 ± 3.3 pre-intervention to 2.9 ± 2.5 post-intervention (p < 0.0001). Eighty-two percent of the patients self-reported VR intervention as ‘Good’ or ‘Excellent’. EQ-5D-3L showed significant changes in dimensions of ‘usual activities’ (p = 0.025), ‘pain/discomfort’ (p = 0.008) and ‘anxiety/ depression’ (p < 0.0001). Conclusions For patients undergoing minor gynecological procedures, the VR intervention brought about a significant reduction in pre-operative anxiety. This finding may be clinically important to benefit patients with high pre-operative anxiety without the use of anxiolytics. Trial registration This study was registered on clinicaltrials.gov registry (NCT03685422) on 26 Sep 2018.

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Virtual reality for acute pain in outpatient hysteroscopy: a randomised controlled trial

Abstract: Objective To evaluate the effectiveness of virtual reality as a distraction technique in the management of acute pain and anxiety during outpatient hysteroscopy. Design Parallel group, prospective randomised controlled trial.

Cited by 48 publications

References 38 publications

Re: Virtual reality for acute pain in outpatient hysteroscopy: a randomised controlled trial

Re: Virtual reality for acute pain in outpatient hysteroscopy: a randomised controlled trial

Hysteroscopy, the Window into the Uterine Cavity

The use of pre-operative virtual reality to reduce anxiety in women undergoing gynecological surgeries: a prospective cohort study

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