Does virtual reality technology reduce pain and anxiety during outpatient hysteroscopy? A randomised controlled trial

Objective To evaluate the effectiveness of virtual reality technology in reducing pain and anxiety during outpatient hysteroscopy. Design A prospective randomised controlled trial. Setting A London University Teaching Hospital. Population Women aged 18–70 years undergoing outpatient hysteroscopy procedures. Methods An unblinded randomised controlled trial was performed between March and October 2022 comparing standard outpatient hysteroscopy care with standard care with the addition of a virtual reality headset playing a virtual reality immersive scenario as a distraction technique. Main outcome measures Pain and anxiety numeric rating scores (NRS) from 0 to 11. Results Eighty‐three participants were randomly allocated to the control (n = 42) and virtual reality groups (n = 41). The virtual reality group experienced significantly less anxiety during the procedure than the control group (mean NRS 3.29 versus 4.73, mean difference 1.50; 95% confidence interval [CI] 0.12–2.88; P = 0.03). There was no difference in reported average pain (mean NRS 3.73. versus 4.24, mean difference 0.51; 95% CI −1.76 to 0.64; p = 0.41) or maximum pain scores (mean NRS 5.32 versus 5.07, mean difference 0.25; 95% CI −1.05 to 1.55; P = 0.71). Conclusions The use of virtual reality technology as an adjunct to standard care can reduce patient‐reported anxiety but not pain during outpatient hysteroscopy procedures. Continued improvements in the technology and the development of increasingly immersive environments may continue to increase the potential to improve the patient experience in this setting.