Effect of Virtual Reality Distraction on Pain and Anxiety During Peripheral Arterial Angioplasty: A Randomized...

To evaluate the effect of virtual reality (VR) distraction on pain, anxiety, agitation, and physiological stress during awake peripheral arterial angioplasty. Prospective, triple-blind, randomized controlled trial.

Adult patients undergoing elective lower-extremity angiography with planned balloon angioplasty under local anesthesia were randomized 1:1 to VR distraction or standard care. All participants wore the same headset; the control group viewed a static neutral panorama, whereas the VR group received immersive nature-based audiovisual content. Pain (visual analog scale (VAS)), anxiety (State-Trait Anxiety Inventory (STAI)-6), agitation (positive Richmond Agitation-Sedation Scale (RASS)), heart rate and blood pressure, and satisfaction were assessed during the procedure. Blinding was maintained for participants, outcome assessor, and analyst.

A total of 120 patients were analyzed (60 per group). VR significantly reduced intraprocedural pain (VAS 6.23 ± 0.91 vs 8.03 ± 0.94; P < 0.001) and anxiety (STAI-6 47.60 ± 7.42 vs. 67.97 ± 9.95; P < 0.001). Heart rate (P = 0.002) and systolic (P = 0.045) and diastolic (P = 0.011) blood pressures were lower in the VR group. Agitation was reduced (positive RASS 0.97 ± 0.80 vs 1.32 ± 0.83; P = 0.022). No adverse events requiring discontinuation occurred after randomization.

VR is a safe, well-tolerated, nonpharmacological adjunct that reduces pain, anxiety, agitation, and physiological stress during awake peripheral arterial angioplasty and may enhance patient cooperation without sedatives.