Department of Emergency Medicine, Carl R. Darnall Army Medical Center, Fort Hood, TX 76544, USA.
Mil Med. 2023 Jul 22;188(7-8):e2467-e2471. doi: 10.1093/milmed/usac249.
To evaluate immersive virtual reality's (IVR) effectiveness as a distraction in reducing perceived pain and anxiety among adults undergoing intravenous (IV) blood draw.
In this randomized controlled trial, we recruited adult patients 18-50 years of age scheduled for routine blood draws at the phlebotomy lab and randomized them into experimental and control groups. The experimental group underwent IV blood draw with IVR, and the control group underwent IV blood draw with standard practice. Before the procedure, subjects rated their anxiety level and the pain they "expected" to experience during blood draw. Immediately afterward, the subjects rated their actual "perceived" pain level. We measured the "expected" and the "perceived" pain and anxiety scores using a 100 mm visual analog scale. The primary outcome was the difference in "perceived" pain scores (0-100) between the two cohorts. Secondary outcomes were differences between the anxiety scores and the "expected" and "perceived" pain between the two cohorts, as well as degree of satisfaction with IVR during the blood draw and willingness to use IVR in future procedures.
Fifty-nine subjects completed the study, 31 in the experimental group and 28 in the control group. For the primary outcome, the control group reported a perceived median pain score of 6.5 vs. the experimental group of 5; P = .55. For the secondary outcomes, the median anxiety scores were 22 (6.25-45.75) and 24 (2.00-35.00) for the control and the experimental groups, respectively, P = .44. The control group reported an expected median pain score of 20 vs. a perceived score of 6.5; P = .25, and the experimental group reported an expected median pain score of 22 vs. a perceived score of 5; P < .01. Median Likert scores were 5 (1-5) for satisfaction and preference for future use during painful procedures.
The results of our study demonstrated that there was no significantly lower perceived pain or anxiety when using IVR compared to standard practice in adults undergoing IV blood draw.
评估沉浸式虚拟现实（IVR）作为一种分散注意力的方法，以减轻接受静脉（IV）采血的成年人的感知疼痛和焦虑。
在这项随机对照试验中，我们招募了 18-50 岁的成年患者，他们在采血实验室接受常规采血，并将他们随机分为实验组和对照组。实验组在 IV 采血过程中使用 IVR，对照组则采用标准操作。在操作前，患者对自己的焦虑程度和采血过程中“预期”的疼痛程度进行评分。操作后，患者对自己的实际“感知”疼痛程度进行评分。我们使用 100mm 视觉模拟量表测量“预期”和“感知”疼痛和焦虑评分。主要结果是两组之间“感知”疼痛评分（0-100）的差异。次要结果是两组之间焦虑评分以及“预期”和“感知”疼痛之间的差异，以及在采血过程中对 IVR 的满意度以及在未来手术中使用 IVR 的意愿。
共有 59 名患者完成了研究，实验组 31 名，对照组 28 名。对于主要结果，对照组报告的感知中位数疼痛评分为 6.5，而实验组为 5；P=0.55。对于次要结果，对照组的焦虑中位数评分为 22（6.25-45.75），实验组为 24（2.00-35.00），P=0.44。对照组报告的预期中位数疼痛评分为 20，而感知评分则为 6.5；P=0.25，实验组报告的预期中位数疼痛评分为 22，而感知评分则为 5；P<0.01。在疼痛操作中，对满意度和未来使用偏好的中位数 Likert 评分为 5（1-5）。
我们的研究结果表明，与标准操作相比，在接受 IV 采血的成年人中，使用 IVR 并不能显著降低感知疼痛或焦虑。
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