Study objective:
Invasive medical procedures are commonly performed in the emergency department (ED) and cause pain and anxiety. Distraction is a nonpharmacological strategy that reduces procedural pain and anxiety. The analgesic and anxiolytic efficacy of distraction provided by 3D virtual reality was compared with 2D distraction during minor ED procedures.
Methods:
This randomized controlled study conducted in the ED of a teaching hospital included patients aged 18 or older who needed an invasive procedure. Patients watched the same computer-generated world either in a virtual reality head-mounted display (intervention) or on a laptop screen (control). Our primary outcomes were pain and anxiety levels during the procedure assessed on a 100-mm visual analog scale (VAS). Secondary outcomes included the global impression of presence in the computer-generated world (telepresence) measured with the IGroup questionnaire score and cybersickness.
Results:
One hundred seventeen patients were included in the final analysis. Maximal median procedural pain and anxiety levels were: 50 (IQR 26;67) vs. 47mm (19;70) (P=0.61) and 36 (15;62) vs. 32mm (7;51) (P=0.20) in the control and intervention groups, respectively. The IGroup scores were 2.0 (1.0;4.0) vs. 4.0 points (2.0;5.0) (P=0.002) and the proportion of cybersickness 53% vs 49% (P=0.71) in the same respective groups.
Conclusions:
Distraction provided with viewing of a 3D virtual world in a head-mounted display was well tolerated and resulted in a higher sense of telepresence. However in our adult ED population, it did not result in greater procedural analgesia or anxiolysis than viewing a 2D projection of the same virtual world.