Virtual Reality for Analgesia During Intrauterine Device Insertion: Randomized Controlled Trial

Area of Science:

• Gynecology
• Medical Technology
• Pain Management

Background:

• Intrauterine devices (IUDs) are effective long-acting reversible contraceptives and treatments for gynecological conditions.
• Patient discomfort during IUD insertion limits their use, with limited consensus on effective pain management strategies.
• Virtual reality (VR) shows promise for acute pain management and has been explored in outpatient gynecological procedures.

Purpose of the Study:

• To evaluate the effectiveness of VR in mitigating pain and anxiety during outpatient IUD insertion.
• To assess patient satisfaction and procedural outcomes associated with VR use during IUD insertion.

Main Methods:

• A randomized controlled trial comparing VR headset use to standard care during IUD insertion.
• VR delivered via smartphone and headset, offering a 3D immersive environment.
• Outcomes included patient-reported pain, anxiety, satisfaction, and clinician-reported ease and duration of insertion.

Main Results:

• No significant difference in pain scores (VR: 5.5 vs. Control: 4.3, P=.15) or anxiety scores (VR: 4 vs. Control: 4.8, P=.37) between groups.
• Preprocedural anxiety was a significant predictor of pain and reduced the benefit derived from VR.
• High patient satisfaction and recommendation rates for VR use were reported, with no significant adverse effects.

Conclusions:

• VR did not significantly reduce pain or anxiety during IUD insertion but was associated with high patient satisfaction.
• Preprocedural anxiety negatively impacts pain perception and VR effectiveness, highlighting its importance.
• VR may offer benefits beyond pain and anxiety reduction, warranting further investigation for improving patient experience in gynecological procedures.