Evaluation of the use of virtual distraction in paediatric cystography: a preliminary study

In children, pain and anxiety control during interventional procedures is achieved through multiple sedation techniques, ranging from topical to intravenous anaesthesia. More recently, virtual reality has been introduced as an effective, non-invasive modality to reduce preoperative anxiety in children during the induction of general anaesthesia. Virtual reality headsets provide the patient with a psychological intervention using relaxation software. The aim of this method, whether used alone or combined with other interventions, is to ensure patient comfort during medical procedures by reducing anxiety and pain perception. The aim of this preliminary study is to assess the efficacy of this non-pharmacological intervention to reduce anxiety in patients undergoing voiding urosonography or cystourethrography through the use of virtual reality headsets. We analysed the impact on the duration, vital signs, patient satisfaction and pain of the test.

A prospective study was conducted on 12 patients who agreed to use virtual reality headsets during bladder catheterisation and the performance of the voiding urosonography or cystourethrography. Informed consent was signed by parents or legal guardians once assent was obtained from the child. Patients, guardians, registered nurses, diagnostic radiographers and the radiologist filled out forms including questions designed to detect emotional changes in the patient during the procedure. The total duration of the test, the time spent on catheterisation, and the duration of the cystography until complete bladder emptying were recorded. These results were compared with a control group matched by age and sex who underwent the procedure without the use of virtual reality headsets.

The procedure was completed in 10 of the 12 patients who initially agreed to its use. Patient-reported pain during catheterisation was low, and satisfaction with the use of the device during the examination was high in most cases. There were no significant differences in catheterisation time or total procedure duration compared with the control group. A decrease in blood pressure was recorded during the procedure in those patients who were most satisfied with the test.

The use of virtual reality headsets during contrast-enhanced cystography in paediatric patients may be beneficial, without significantly hindering or prolonging the procedure. It effectively contributes to the humanisation of invasive procedures in radiology. Randomised studies with a larger number of patients are required to determine whether this intervention could reduce catheterisation time and overall examination duration (until complete bladder emptying), as well as to confirm the observed trend towards a reduction in vital sign values.