Yao Yongfang, Qiu Shanhu, Xue Youhua, Wang Boyuan, Zhang Yihan, Wang Xiaoyan
Nursing Department, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu Provence, China.
Department of General Practice, Zhongda Hospital, Institute of Diabetes, School of Medicine, Southeast University, Nanjing, Jiangsu Provence, China.
J Clin Nurs. 2025 Feb;34(2):332-344. doi: 10.1111/jocn.17579. Epub 2024 Dec 3.
Virtual reality is an emerging non-drug treatment for pain caused by endoscopy procedure. We conducted a meta-analysis to evaluate the effectiveness and safety of virtual reality based interventions for pain during endoscopy.
PubMed, EMBASE, Cochrane Library, Web of Science and Clinical Trials database were searched until 26 May 2024. Randomised controlled trials on the application of virtual reality in endoscopic examinations were included. The standardised mean difference (SMD) was calculated using random-effects models, and included studies were appraised using Cochrane Risk of Bias tool version 1. Meta- analysis was conducted using Stata Statistical Software version 17.0.
Overall, 21 studies enrolling 1721 participants were included. Our results demonstrated that the patients receiving the virtual reality intervention had lower pain scores than those receiving the usual care (SMD = -0.42; 95% CI = -0.65, -0.20). Subgroup analysis showed that real-time assessment of pain scores during the medical process had less heterogeneity (I = 20.2%, p = 0.257) and a smaller range of confidence intervals (95% CI = -0.43, -0.14) than retrospective assessment (95% CI = -0.75, -0.09). For different types of endoscopes, virtual reality was statistically significant for reducing pain during colonoscopy (SMD = -0.70; 95% CI = -1.12, -0.28), cystoscopy (SMD = -0.28; 95% CI = -0.53, -0.04) and laparoscopy (SMD = -0.54; 95% CI = -0.98, -0.10). Additionally, statistically significant improvements in relieving anxiety were reported when using virtual reality (SMD = -0.56; 95% CI = -0.78, -0.35).
The application of virtual reality can effectively relieve the pain and anxiety of endoscopy. The types of endoscopy and the way of retrospective evaluation of pain scores were the main sources of heterogeneity. More rigorous studies about the relationship between virtual reality and endoscopic pain relief will be needed.
The application effect of virtual reality technology on endoscopy was verified by summarising several randomised controlled trials. Patients and healthcare providers can be better informed about the use of such intervention to relieve pain.
Virtual reality is recommended as being potentially useful and practical for reducing the pain of endoscopy.
虚拟现实是一种新兴的用于缓解内镜检查所致疼痛的非药物治疗方法。我们进行了一项荟萃分析，以评估基于虚拟现实的干预措施在内镜检查期间缓解疼痛的有效性和安全性。
检索了截至2024年5月26日的PubMed、EMBASE、Cochrane图书馆、科学引文索引数据库和临床试验数据库。纳入了关于虚拟现实在内镜检查中应用的随机对照试验。使用随机效应模型计算标准化均数差（SMD），并使用Cochrane偏倚风险工具第1版对纳入的研究进行评估。使用Stata统计软件17.0进行荟萃分析。
总体而言，纳入了21项研究，共1721名参与者。我们的结果表明，接受虚拟现实干预的患者的疼痛评分低于接受常规护理的患者（SMD = -0.42；95%置信区间 = -0.65，-0.20）。亚组分析表明，与回顾性评估（95%置信区间 = -0.75，-0.09）相比，医疗过程中对疼痛评分的实时评估异质性较小（I = 20.2%，p = 0.257），置信区间范围较小（95%置信区间 = -0.43，-0.14）。对于不同类型的内镜检查，虚拟现实在降低结肠镜检查（SMD = -0.70；95%置信区间 = -1.12，-0.28）、膀胱镜检查（SMD = -0.28；95%置信区间 = -0.53，-0.04）和腹腔镜检查（SMD = -0.54；95%置信区间 = -0.98，-0.10）期间的疼痛方面具有统计学意义。此外，报告显示使用虚拟现实在缓解焦虑方面有统计学显著改善（SMD = -0.56；95%置信区间 = -0.78，-0.35）。
虚拟现实的应用可以有效缓解内镜检查的疼痛和焦虑。内镜检查类型和疼痛评分的回顾性评估方式是异质性的主要来源。需要更多关于虚拟现实与内镜检查疼痛缓解之间关系的严谨研究。
通过总结多项随机对照试验验证了虚拟现实技术在内镜检查中的应用效果。可以让患者和医疗服务提供者更好地了解使用这种干预措施来缓解疼痛的情况。
推荐虚拟现实对于减轻内镜检查疼痛可能是有用且实用的。
