Clinical Research Article

Korean J Pain 2021; 34(3): 304-314

Published online July 1, 2021 https://doi.org/10.3344/kjp.2021.34.3.304

Copyright © The Korean Pain Society.

Effectiveness of virtual reality immersion on procedure-related pain and anxiety in outpatient pain clinic: an exploratory randomized controlled trial

Young Joo1 , Eun-Kyung Kim2 , Hyun-Gul Song2 , Haesun Jung3 , Hanssl Park2 , Jee Youn Moon2,4

1Department of Anesthesiology and Pain Medicine, CHA Ilsan Medical Center, CHA University School of Medicine, Goyang, Korea
2Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Korea
3Department of Anesthesiology and Pain Medicine, Chung-Ang University Hospital, Seoul, Korea
4Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul, Korea

Correspondence to:Jee Youn Moon
Departmentof Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea
Tel: +82-2-2072-2467
Fax: +82-2-747-5639
E-mail: jymoon0901@gmail.com

Handling Editor: Rohit Aiyer

*These authors contributed equally to this work as co-first authors.

Previous presentation at conferences
This article was presented at the 66th Korean Pain Society Scientific Meeting & Training Course on May 26, 2018, in Changwon Exhibition Convention Center, Changwon, Korea.

Received: March 22, 2021; Revised: April 16, 2021; Accepted: April 19, 2021

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background: The study investigated virtual reality (VR) immersion in alleviating procedure-related pain in patients with chronic pain undergoing fluoroscopy-guided minimally-invasive intervention in a prone position at an outpatient clinic.
Methods: In this prospective randomized controlled study, 38 patients undergoing lumbar sympathetic ganglion block were randomized into either the VR or the control group. In the VR group, procedure-related pain was controlled via infiltration of local anesthetics while watching a 30-minute VR hypnotic program. In the control group, the skin infiltration alone was used, with the VR device switched off. The primary endpoint was an 11-point score on the numerical rating scale, indicating procedure-related pain. Patients’ satisfaction with pain control, anxiety levels, the need for additional local anesthetics during the procedure, hemodynamic stability, and any adverse events were assessed.
Results: Procedure-related pain was significantly lower in the VR group (3.7 ± 1.4) than in the control group (5.5 ± 1.7; P = 0.002). Post-procedural anxiety was lower in the VR group than in the control group (P = 0.025), with a significant reduction from pre-procedural anxiety (P < 0.001). Although patients' satisfaction did not differ significantly (P = 0.158) between the groups, a higher number of patients required additional local anesthetics in the control group (n = 13) than in the VR group (n = 4; P = 0.001). No severe adverse events occurred in either group during the study.
Conclusions: VR immersion can be safely used as a novel adjunct to reduce procedural pain and anxiety during fluoroscopic pain intervention.

Keywords: Ambulatory Care Facilities, Anxiety, Autonomic Nerve Block, Chronic Pain, Ganglia, Sympathetic, Hypnotics and Sedatives, Minimally Invasive Surgical Procedures, Pain Perception, Pain, Procedural, Virtual Reality, Virtual Reality Exposure Therapy.