Virtual reality for pain management during extracorporeal lithotripsy
A randomized pilot study
DOI:
https://doi.org/10.5489/cuaj.9571Keywords:
Extra Corporeal Shockwave Lithotripsy, Virtual reality, Pain, Kidney stone, pilot studyAbstract
Introduction: Virtual reality (VR) creates an immersive environment that may alleviate pain and improve tolerance of extracorporeal shockwave lithotripsy (SWL). This randomized pilot trial evaluated feasibility and explored the effects of a pre-procedural VR session on pain, anxiety, and opioid use during SWL.
Methods: Thirty patients undergoing their first SWL for kidney stones were randomized (2:1 minimization) to VR or control. The VR group received 20 minutes of audiovisual stimulation via headset before SWL, while controls rested quietly in a calm room. Pain during SWL was measured using a verbal rating scale, anxiety with the State-Trait Anxiety Inventory (STAI), and fentanyl consumption was recorded.
Results: The study took place between November 2022 and May 2024, with an eligibility rate of 25.8% (69/267) and a recruitment rate of 43% (30/69). Eighteen patients were allocated to VR and 12 to control (mean age 57, range 21−82). All patients completed the VR session except for one, who interrupted the session after experiencing mild distress. SWL pain intensity was significantly lower in the VR group (3.8/10 vs. 5.9/10, p=0.043). No differences were found in STAI scores and opioid consumption. Principal limitations of the study include its small sample size and selection bias.
Conclusions: The implementation of an adequately powered randomized controlled trial may face low recruitment rates if restricted to first SWL experience. VR showed promising outcomes for SWL-induced pain, although opioid consumption and anxiety were not reduced. Future studies with larger sample sizes are required to confirm these preliminary findings.
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