Virtual reality for pain and anxiety reduction during venous puncture procedures : A within-subject clinical...

Venous puncture is a routine procedure in extracorporeal photopheresis (ECP) and may be associated with pain and anxiety. Virtual reality (VR) distraction has been shown to reduce distress in pediatric and acute settings. This study investigated if immersive VR can reduce pain and anxiety during venous puncture in ECP patients.

A prospective, single-center clinical study with a within-subject crossover design was conducted at the University Hospital Innsbruck. A total of 21 adult patients underwent 2 consecutive ECP sessions, first with standard care and then with immersive VR distraction. Subjective pain and anxiety were assessed using numerical rating scales (NRS). The physiological parameters heart rate (HR), heart rate variability (HRV), respiratory rate (RR) and galvanic skin response were continuously monitored.

The NRS pain scores were significantly lower with VR compared to standard care with a median of 1.00 (interquartile range, IQR 0.00-2.00) in both conditions (p = 0.031). Without vs. with VR, 23.8% vs. 4.8% of patients rated their pain > 2 during puncture. The NRS anxiety scores were not significantly reduced with a median of 0.00 (0.00-1.00) without VR vs. 0.00 (0.00-0.00) with VR (p = 0.066). Without vs. with VR, 23.8% vs. 14.3% of patients rated their anxiety > 1 during puncture and 48% of patients preferred VR for future treatment, while 38% preferred standard care.

The findings support the feasibility and potential benefit of VR as a supportive, nonpharmacological intervention, regarding pain reduction. Larger trials in more diverse patient populations are warranted to confirm these results.