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Biophilic virtual reality on children's anxiety and pain during circumcision: A randomized controlled study
Wenjun Luo1, Chunqu Chen2, Weijian Zhou2
1School of Medicine, Ningbo University, Ningbo, Zhejiang, China; Department of Anesthesia, The Affiliated Hospital of Medical School of Ningbo University, Ningbo, Zhejiang, China.
Insights
Biophilic virtual reality (BVR) significantly reduced pain and anxiety in children undergoing circumcision compared to standard care. This innovative approach offers a noninvasive method for managing pediatric procedural distress.
Area of Science:
- Pediatric surgery
- Pain management
- Virtual reality applications
Background:
- Circumcision is a common pediatric procedure associated with pain and anxiety.
- Non-pharmacological interventions are sought to mitigate procedural distress in children.
Purpose of the Study:
- To evaluate the efficacy of biophilic virtual reality (BVR) in reducing pain and anxiety during pediatric circumcision.
- To compare BVR with indoor virtual reality (IVR) and a control group.
Main Methods:
- A randomized controlled trial involving 106 children undergoing circumcision.
- Assessed anxiety using the modified Yale Preoperative Anxiety Scale (CmYPAS) and Anxiety index (Ai).
- Measured pain using the Visual Analogue Scale (VAS) and Faces Pain Scale-Revised (FPS-R).
Main Results:
- Both BVR and IVR groups showed significantly lower CmYPAS, VAS, and FPS-R scores compared to the control group.
- Pain index (Pi) and Anxiety index (Ai) were significantly lower in the BVR and IVR groups.
- A significant correlation was found between Ai and CmYPAS scores.
Conclusions:
- Biophilic virtual reality (BVR) is an effective noninvasive method for reducing intraoperative pain and anxiety in children undergoing circumcision.
- VR interventions show promise for managing pediatric procedural pain and anxiety.
- Pain and Anxiety indices can serve as valuable tools for assessing subjective patient experiences.
Introduction:
The aim of this study was to evaluate the effects of the biophilic virtual reality (BVR) method on children's pain and anxiety undergoing circumcision.
Materials And Methods:
This randomized controlled study used a parallel trial design guided by the CONSORT checklist. A total of 106 children were included in the analysis. Intraoperative anxiety was assessed by using the simplified Chinese version of the modified Yale Preoperative Anxiety Scale (CmYPAS), Visual Analogue Scale (VAS), heart rate (HR), and Anxiety index (Ai). Intraoperative pain was assessed by using the Faces Pain Scale-Revised (FPS-R), and Pain index (Pi). The Pearson correlation analysis was used to analyze the relationship between Ai and the CmYPAS. The primary outcomes were CmYPAS, VAS, and FPS-R, which were analyzed using the Kruskal-Wallis test.
Results:
Baseline variables were not significantly different between the BVR group (34 patients), the indoor virtual reality (IVR) group (36 patients), and the blank control group (36 patients). The CmYPAS scores during surgery were significantly lower in the BVR group and the IVR group versus the blank control group (25.0[22.9-29.2], 22.9[22.9-29.2], 33.3[33.3-38.5] respectively; P < 0.001). The VAS scores during surgery were significantly lower in the BVR group and the IVR group versus the blank control group (5.0[3.0-7.0], 3.0[2.0-5.0], 6.0[5.0-8.8] respectively; P < 0.001). The FPS-R scores during surgery were significantly lower in the BVR group and IVR group versus the blank control group (2.0[1.8-4.2], 3.0[2.0-4.8], 5.5[5.0-8.0], respectively; P < 0.001). At removal of the foreskin, Pi were significantly lower in the BVR group and IVR group versus the blank control group (6.9[4.1], 7.7[3.3], 9.8[6.2] respectively; P = 0.033). The Ai scores at each time point were significantly lower in the BVR group and IVR group versus the control (P = 0.015, P = 0.006 respectively). The correlation analysis of Ai (at removal of the foreskin) and CmYPAS scores in children showed that the Pearson correlation coefficient was 0.194 (P = 0.046).
Discussion:
This is the first RCT to investigate the effects of BVR in children undergoing circumcision. This study demonstrates a reduction in pediatric intraoperative pain and anxiety with the use of virtual reality (VR).
Conclusion:
Intraoperative VR may be an effective noninvasive modality for reducing pain and anxiety during circumcision. Pi and Ai might be used to assess subjective pain and anxiety in patients.
