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Variations of the Relative Parasympathetic Tone Assessed by ANI During Oocyte Retrieval Under Local Anaesthesia with Virtual Reality : A Randomized, Controlled, Monocentric, Open Study

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Abstract

Transvaginal oocyte retrieval is an outpatient procedure performed under local anaesthesia. Hypno-analgesia could be effective in managing comfort during this procedure. This study aimed to assess the effectiveness of a virtual reality headset as an adjunct to local anaesthesia in managing nociception during oocyte retrieval. This was a prospective, randomized single-centre study including patients undergoing oocyte retrieval under local anaesthesia. Patients were randomly assigned to the intervention group (virtual reality headset + local anaesthesia) or the control group (local anaesthesia). The primary outcome was the efficacy on the ANI®, which reflects the relative parasympathetic tone. Secondary outcomes included pain, anxiety, conversion to general anaesthesia rate, procedural duration, patient’s and gynaecologist’s satisfaction and virtual reality headset tolerance. ANI was significantly lower in the virtual reality group during the whole procedure (mean ANI: 79 95 CI [77; 81] vs 74 95 CI [72; 76]; p < 0.001; effect size Cohen’s d -0.53 [-0.83, -0.23]), and during the two most painful moments: infiltration (mean ANI: 81 +/- 11 vs 74 +/- 13; p < 0.001; effect size Cohen’s d -0.54[-0.85, -0.24]) and oocytes retrieval (mean ANI: 78 +/- 11 vs 74.40 +/- 11; p = 0.020; effect size Cohen’s d -0.37 [-0.67, -0.07]).There was no significant difference in pain measured by VAS. No serious adverse events related were reported. The integration of virtual reality as an hypnotic tool during oocyte retrieval under local anaesthesia in assisted reproductive techniques could improve patient’s comfort and experience.

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This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. CHU Rennes, Anesthesia and Intensive Care Department, F-35000, Rennes, France

    Florent Malard

  2. Clinique Mutualiste La Sagesse Rennes, Medically Assisted Procreation Department, F-35000, Rennes, France

    Ludovic Moy

  3. Clinique Mutualiste La Sagesse Rennes, Anesthesia and Intensive Care Department, F-35000, Rennes, France

    Vincent Denoual

  4. Univ Rennes, CHU Rennes, Inserm, CIC-1414, OSS 1242, Anesthesia and Intensive Care Department, F-35000, Rennes, France

    Helene Beloeil

  5. Rehabilitation Center, Pole Saint Helier, Department of Clinical Research, Rennes, France

    Emilie Leblong

  6. Pole Anesthésie-Réanimation Medecine Interne Geriatrie, CHU Rennes, 2 Avenue Henri Le Guillou, 35033, Rennes Cedex, France

    Helene Beloeil

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Contributions

HB had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. HB, FM, VD, LM contributed to the conception and design of the study. FM, VD, LM contributed to the acquisition, analysis and interpretation of the data. FM wrote the first draft of the manuscript. HB and VD critically revised the manuscript. EL was responsible for the statistical analysis. All authors approved the final version of the manuscript.

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Correspondence to Helene Beloeil.

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Malard, F., Moy, L., Denoual, V. et al. Variations of the Relative Parasympathetic Tone Assessed by ANI During Oocyte Retrieval Under Local Anaesthesia with Virtual Reality : A Randomized, Controlled, Monocentric, Open Study. J Med Syst 48, 39 (2024). https://doi.org/10.1007/s10916-024-02057-z

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