Hypnosis associated with 3D immersive virtual reality technology during bronchoscopy under local anesthesia

Abstract

Background: Patients undergoing flexible bronchoscopy under local anesthesia usually experience anxiety before and during the procedure. Different non-pharmacological techniques, including music and hypnosis, are used to distract patients' attention, and to reduce anxiety. The new technique "virtual reality hypnosis (VRH)", defined as a hypnotic induction suggestion delivered by personalized virtual reality software, can generate a simulation of a lifelike environment. No study has described the use of VRH during bronchoscopy. The objective is to investigate the anxiety reducing effect and the satisfaction of patients, physicians, and nurses using VRH during bronchoscopy Methods: VRH was proposed to all patients who experienced anxiety before undergoing flexible bronchoscopy under local anesthesia. Local anesthesia was performed using 5% lidocaine spray only. No sedation was used. After the procedure, patients, physicians and nurses filled a standardized satisfaction form.Results: Twenty consecutive patients who reported pre-procedure anxiety were included. The sex ratio was 16 women/4 men, the median age was 65 years. Eight patients (40%) had undergone a previous bronchoscopy under local anesthesia. The median duration of the procedure was 10 minutes, and all procedures were completed. The median level of anxiety of patients decreased from 9/10 before the procedure to 4/10 during the procedure. The median satisfaction rate regarding the use of VRH was 10/10. All patients agreed to use VRH again in case of a new bronchoscopy procedure.Conclusions: This preliminary report has shown that VRH was useful to reduce patients' anxiety during bronchoscopy under local anesthesia. VRH was easily implemented in the routine practice.

Virtual reality hypnosis prior to radiofrequency thermocoagulation for patients with chronic pain: an exploratory clinical trial

“…Nevertheless, no control groups were included in these studies preventing to draw any firm conclusions. However, a randomized controlled trial, including 100 participants scheduled for peripheral endovascular interventions (under local anesthesia), found similar results as Touil et al (2021) , Lachkar et al (2022) , and Gullo et al (2023) . Finally, the only study assessing anxiety reduction in participants with CP having to undergo fluoroscopy-guided lumbar sympathetic ganglion block also showed that the VRH group had greater anxiety decrease than the control group ( Joo et al, 2021 ).…”

“…Results coming from other studies have shown that VRH decreases anxiety and pain in the context of a medical procedure or a surgery which diverge from the present results. Lachkar et al (2022) proposed VRH to 20 participants having to undergo a bronchoscopy (with local anesthesia). The VRH device displayed slow motion movies from various natural landscapes alongside headphones transmitting a narrative of hypnosis with sequences of controlled breathing, cardiac coherence and hypnotic suggestions.…”

“…The interest of combining hypnosis and VR, as compared to VR alone or to hypnosis delivered by an external care giver, is to use a virtual 3D environment to immerse patients, while they are guided by hypnotic suggestions at the same time ( Rousseaux et al, 2020 ). The interest of VRH for the improvement of patients’ comfort has been evaluated in different medical contexts, such as trauma, pneumology or intensive care ( Patterson et al, 2004 ; Lachkar et al, 2022 ; Rousseaux et al, 2022a ). The present research focused on whether VRH can alleviate anxiety associated with an invasive procedure.…”

Satisfaction and tolerability using virtual reality (VR) as adjunctive treatment during flexible bronchoscopy: a randomized control trial

“…In a recent study published by Lachker et al, distraction in the form of virtual reality hypnosis was found to reduce patients anxiety during bronchoscopy under local anesthesia, with a high level of satisfaction from patients, physicians and nurses. They postulated that hypnosis allows patients to be focused on their inner world, by including cognitive and behavioral components that help to influence body sensations and perception, and thus reducing patient anxiety undergoing invasive procedures [ 15 ]. We believe that hypnosis can be use as an adjunctive treatment concomitantly with virtual reality as a method of reducing pain and anxiety of participants undergoing invasive procedure.…”

“…In Universiti Kebangsaan Malaysia Medical Centre (UKMMC), fentanyl and midazolam are used routinely as sedation during FB. There was a previous study using a combination of hypnosis and VR technology during flexible bronchoscopy [ 15 ]. However our study is unique as this is the first randomized control trial comparing VR to standard practice, as a method of distraction to reduce anxiety and improve satisfaction in a patient undergoing bronchoscopy.…”