Effects of Audiovisual Virtual Reality Stimulation on Pain, Anxiety, and Relaxation During Extracorporeal Shockwave Lithotripsy for Ureteral Stones : A Prospective Cohort Study

Abstract

Abstract Purpose We evaluate the effect of audiovisual virtual reality (AVVR) stimulation through a virtual reality (VR) device on pain, anxiety, and patient relaxation during SWL.Materials and Methods A total of 86 patients from a single institution who underwent SWL for ureteral stone were prospectively allocated. Patients with tolerable pain were randomized 1:1 two groups (SWL with or without AVVR stimulation groups). Anxiety, vital sign, renal colic pain represented the primary outcomes and were measured before and after SWL using STAI, visual analogue scale (VAS). Secondary outcomes were pain due to SWL and stone free rate.Results Thirty-nine and 37 patients were randomly assigned to the AVVR and Control groups, respectively. In pre and post-SWL, SBP, DBP, HR, STAI, and pain due to renal colic were not statistically different between the two groups, but pain due to SWL showed a statistical difference of 1.79 ± 1.32 in the VR group, and 2.54 ± 1.26 in the control group (p = 0.014). In the VR group, significant decreases were shown in SBP (-4.97 ± 5.87 mmHg, p < 0.001), DBP (-1.67 ± 6.06 mmHg, p < 0.016), and HR (-1.41 ± 3.49 beats/min, p < 0.008).Conclusions AVVR reduces procedure-related pain and increases patient relaxation. The application of VR may be an effective and non-pharmacological technique to replace additional pain control during SWL. Developing specialized software for VR will maximize the advantages of these new instruments.