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Effectiveness of virtual reality in managing pain and anxiety in adults during periprocedural period: a systematic review and meta-analysis

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Abstract

Purpose

Patients undergoing medical procedures often experience pain and anxiety. These periprocedural outcomes can be overcome by providing a distraction using virtual reality (VR), decreasing their perception. VR has proved effective in reducing pediatric pain and anxiety; however, limited studies have confirmed its effectiveness in adults. We performed a systematic review and meta-analysis on the effectiveness of VR, as opposed to standard care, in reducing periprocedural pain and anxiety in adults.

Methods

A systematic search of randomized controlled trials was conducted using the databases of MEDLINE, Cochrane CENTRAL, and Scopus. Trials involving patients (> 18 years) undergoing elective medical procedures conducted with or without local anesthesia and participating in VR therapy were included. Primary outcomes were pre-procedural anxiety, post-procedural anxiety, and intra-procedural pain. Pre-procedural pain, post-procedural pain, and intra-procedural anxiety were secondary outcomes.

Results

Data from 10 studies shortlisted for inclusion revealed no significant association between the use of VR and lower pre-procedural anxiety compared to standard care (p > 0.05) (SMD = -0.02, 95% CI = -0.18 – 0.14, P = 0.81) but demonstrated that the use of VR was significantly associated with a reduction in post-procedural anxiety (SMD = -0.73, 95% CI = -1.08 – -0.39, P < 0.0001), intra-procedural pain (SMD = -0.61, 95% CI = -1.18 – -0.04, P = 0.04), and post-procedural pain (SMD = -0.25, 95% CI = -0.44 – -0.05, P = 0.01).

Conclusion

The use of VR caused a significant reduction in post-procedural anxiety, intra-procedural pain, and post-procedural pain in adults undergoing medical procedures, although the findings were insignificant concerning pre-procedural anxiety.

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Authors and Affiliations

  1. Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan

    Muhammad Suraim Kodvavi, Mustafa Ali Asghar, Rimmel Abdul Ghaffar, Ilsa Nadeem, Sunaina Bhimani, Varsha Kumari, Azkah Rabbani, Maham Iqbal, Raahim Naeem, Aqsa Muhammad Nasir & Syed Shayaan Hassan

  2. Department of Cardiology, Madinah Cardiac Centre, Medina, Saudi Arabia

    Muhammad Salman Ghazni

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  1. Muhammad Suraim Kodvavi
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Contributions

Study Conception and design: MSK, MAA; Acquisition of data: MSK, VK, SB, AR, IN, MI; Analysis and interpretation of data: MAA, RN, AMN, RAG, SSH; Drafting of manuscript: All authors; Critical revision of manuscript: All authors.

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Correspondence to Mustafa Ali Asghar.

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Kodvavi, M.S., Asghar, M.A., Ghaffar, R.A. et al. Effectiveness of virtual reality in managing pain and anxiety in adults during periprocedural period: a systematic review and meta-analysis. Langenbecks Arch Surg 408, 301 (2023). https://doi.org/10.1007/s00423-023-03046-5

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