1st Unit of Obstetrics and Gynecology, Department of Interdisciplinary Medicine (Drs. Vitagliano, Dellino, D' Amato, Nicolì, Cicinelli, and Damiani), University of Bari, Bari, Italy.
1st Unit of Obstetrics and Gynecology, Department of Interdisciplinary Medicine (Drs. Vitagliano, Dellino, D' Amato, Nicolì, Cicinelli, and Damiani), University of Bari, Bari, Italy.
J Minim Invasive Gynecol. 2023 Nov;30(11):866-876. doi: 10.1016/j.jmig.2023.08.427. Epub 2023 Aug 29.
To summarize evidence from randomized controlled trials (RCTs) on the effectiveness of virtual reality technology (VRT), as used by patients, for reducing pain during outpatient hysteroscopy.
Electronic databases and clinical registers were searched until June 21, 2023. The review protocol was registered in PROSPERO before the data extraction (CRD42023434340).
We included RCTs of patients receiving VRT compared with controls receiving routine care during outpatient hysteroscopy.
TABULATION, INTEGRATION, AND RESULTS: The primary outcome was average pain during hysteroscopy. Pooled results were expressed as mean differences (MDs) with 95% confidence interval (CI). Sources of heterogeneity were investigated through sensitivity and subgroups analysis. Five RCTs were included (435 participants). The comparison between the intervention and control groups showed a borderline difference in perceived pain during hysteroscopy (MD -0.88, 95% CI -1.77 to 0.01). Subgroup analysis based on the type of VRT (active or passive) indicated that active VRT potentially reduced the perception of pain (MD -1.42, 95% CI -2.21 to -0.62), whereas passive VRT had no effect (MD -0.06, 95% CI -1.15 to 1.03).
Patients' use of active VRT may be associated with a reduction in pain during outpatient hysteroscopy (evidence Grading of Recommendations Assessment, Development, and Evaluation 2/4). Future research should focus on conducting methodologically robust studies with larger sample sizes and more homogeneous populations.
总结患者使用虚拟现实技术（VRT）减轻门诊宫腔镜检查疼痛的随机对照试验（RCT）的证据。
截至 2023 年 6 月 21 日，检索电子数据库和临床登记处。在提取数据前（CRD42023434340），审查方案在 PROSPERO 中进行了注册。
我们纳入了接受 VRT 的患者与接受常规护理的对照组在门诊宫腔镜检查期间的 RCT。
表格、综合和结果：主要结局是宫腔镜检查期间的平均疼痛。汇总结果以均数差值（MD）和 95%置信区间（CI）表示。通过敏感性和亚组分析调查了异质性的来源。纳入了 5 项 RCT（435 名参与者）。干预组与对照组比较显示，宫腔镜检查期间感知疼痛存在边缘差异（MD -0.88，95% CI -1.77 至 0.01）。基于 VRT 类型（主动或被动）的亚组分析表明，主动 VRT 可能降低疼痛感知（MD -1.42，95% CI -2.21 至 -0.62），而被动 VRT 没有效果（MD -0.06，95% CI -1.15 至 1.03）。
患者使用主动 VRT 可能与门诊宫腔镜检查期间疼痛减轻相关（证据分级评估、制定与评估 2/4）。未来的研究应侧重于开展方法学更稳健、样本量更大且人群更同质的研究。
