Introduction
Performance of diagnostic and operative procedures for gynaecological conditions in the consultation room setting, is becoming increasingly commonplace in order to reduce risks of general anaesthetic, decrease health care costs and increase convenience for both patient and provider1. Such procedures are usually well tolerated (reference), can be associated with acute pain and anxiety2 3,45 6. Pain relief options include sedation, local anaesthetic, analgesics and distraction techniques, though no consistent good quality evidence exists to underpin practice7 8 910 11 12.
Virtual reality, a relatively new intervention, has been studied as a distraction technique for non-pharmacological pain relief. Put simply, it is a computer-generated representation of an immersive environment viewed through a headset 13. The cost, quality and accessibility of virtual reality devices has significantly improved in recent years and offered novel application in the medical field. Virtual reality for managing pain has been studied in paediatrics, dentistry, burns treatment, chronic pain, labour, episiotomy and phobias14–22 23 24. Although a metaanalysis suggested that VR may have a role in reducing pain scores in acutely painful procedures, it was found to be effective only in needles and burns physical therapy. The studies of VR on pain and anxiety however were limited by clinical and statistical heterogeneity14 25Nonpharmacological options of pain relief have not explored the role of virtual reality in reducing pain and improving patient experience in outpatient hysteroscopy 26. To our knowledge, there are no publications studying the effects of Virtual Reality in the management of pain during office gynaecological procedures7
We conducted a randomised controlled trial of virtual reality intervention as a distraction technique, versus standard care, in managing acute pain and anxiety during outpatient hysteroscopy.