Sarah Hladky, Charles Egloff, Violaine Peyronnet, Laurent Mandelbrot, Olivier Picone
Virtual reality hypnosis did not significantly reduce pain during CVS and amniocentesis. However, within the CVS subgroup, its use appeared to reduce anxiety, particularly among patients with higher baseline anxiety.
INTRODUCTION: Amniocentesis and chorionic villus sampling (CVS) are perceived by patients as stressful and moderately painful. Few approaches improve their experience. This study assesses whether virtual reality-assisted medical hypnosis reduces procedural pain during these procedures, and examines its effects on anxiety, comfort, and satisfaction MATERIALS AND METHODS: We conducted a prospective, open-label cohort study including all patients undergoing amniocentesis or CVS at Louis Mourier Hospital (AP-HP) between August 2022 and August 2023. Use of the VR headset was left to the patient's discretion. Baseline anxiety (STAI-Y2) and pre-procedural anxiety were collected before the procedure. After the procedure, patients rated pain intensity, perception, discomfort along with procedural anxiety and overall satisfaction. The primary outcome was procedural pain intensity; secondary outcomes included other pain dimensions, anxiety, satisfaction, and procedural parameters. We also explored how pre-procedure anxiety relates to patient experience, identified responsive subgroups, and collected practitioners' feedback. Comparative tests and regression models were used.
RESULTS: Among 97 patients, 67 used the VR headset. Baseline characteristics were similar, except for higher pre-procedural anxiety in VR users (p = 0.0085). Pain intensity was comparable in both groups (p = 0.693), as were anxiety levels (p = 0.06). Stratified analyses by pre-procedural anxiety showed no differences across outcomes. VR appeared to reduce procedural anxiety in the CVS subgroup, particularly among anxious patients, but not in the amniocentesis subgroup.
CONCLUSION: Virtual reality hypnosis did not significantly reduce pain during CVS and amniocentesis. However, within the CVS subgroup, its use appeared to reduce anxiety, particularly among patients with higher baseline anxiety.