A pilot study of virtual reality as an alternative to pharmacological sedation during colonoscopy

Abstract

Background and study aims Conscious sedation is routinely administered for colonoscopy but is associated with risks and inconveniences. We sought to determine whether virtual reality (VR) may be a feasible alternative. Patients and methods Twenty-seven individuals scheduled for screening/surveillance colonoscopy participated. The VR device was activated throughout the colonoscopy, but subjects could opt out and request standard medications. Questionnaires were administered, and variables were assessed on a scale of 1 to 10. Results Cecal intubation was achieved in all cases without adverse events (AEs). Study colonoscopies were completed without pharmacological rescue in 26 of 27 patients (96.3 %) and procedure times were comparable to baseline. Subjects reported minimal pain, high satisfaction, and willingness to use VR for future colonoscopies to avoid narcotics and resume normal activities including driving. Conclusion Replacing pharmacological sedation with VR did not impact colonoscopy completion rates, procedure time, or AEs. Satisfaction was high and only one subject (3.7 %) chose to suspend VR. VR can be an effective alternative for patients undergoing colonoscopy who prefer to avoid narcotics.

State-of-the-Art Review on Immersive Virtual Reality Interventions for Colonoscopy-Induced Anxiety and Pain

“…The results showed that the one participant that requested medication had the lowest score of 1 (weakest motivation) to the question regarding the cause for using iVR as an alternative to sedation, compared with the other 26 participants that completed iVR colonoscopy without requesting medication averaging scores in the range of 8.5–9 out of 10. Therefore, they suggest that a strong motivation for choosing iVR might be related to the patient’s determination to avoid sedation medication [ 32 ].…”

“…The protocol of Çakır and Evirgen, 2021, was submitted to evaluate a Non-Interventional Clinical Research Ethics Committee [ 31 ]. Friedman et al, 2021 [ 32 ] eluded an Ethical Committee approval, motivated by the exclusion of participants with contraindications to conscious sedation, to ensure the possibility of eventual pharmacological rescue. As an emerging technology, iVR may be perceived as non-interventional.…”

Qualitative Validation of a Novel VR Program for Irritable Bowel Syndrome: A VR1 Study

“…VR has been used to treat anxiety, depression, and pain (6)(7)(8)(9)(10)(11). In gastroenterology, VR lowers endoscopic analgesia requirements and reduces pain from dyspepsia and sphincter of Oddi dysfunction (12)(13)(14)(15)(16)(17)(18)(19)(20). Although use of VR for IBS has been proposed (21), there are no IBS-specific programs nor any programs devoted to gut-directed CBT.…”