Virtual Reality for Pain Management During Anesthesia

Overseen By Janelle Burskey, RN

Age: 18 - 65

Sex: Any

Trial Phase: Academic

Sponsor: Cedars-Sinai Medical Center

Disqualifiers: Visual impairment, Epilepsy, Dementia, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 2 Jurisdictions This treatment is already approved in other countries

Compensation: Varies

Number of Visits: 3

80 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to determine if virtual reality can help manage pain and anxiety for patients receiving regional anesthesia before surgery. Participants will be randomly assigned to one of two groups: one using a virtual reality headset (Virtual Reality with Oculus Go headset) during the procedure and one without. Suitable candidates include those scheduled for elective surgery at Cedars-Sinai Medical Center and receiving regional anesthesia. As an unphased trial, this study provides a unique opportunity to explore innovative pain management techniques.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that virtual reality is safe for pain management during anesthesia?

Research shows that using virtual reality (VR) to manage pain in medical settings is generally safe. Studies have found that VR can help control pain during medical procedures, such as surgeries, where patients might experience discomfort.

A review of multiple studies found that VR has been successfully used for both short-term and long-term pain relief. Specifically, one study focused on using VR during anesthesia for hand surgery and found it did not increase pain levels, indicating that VR is well-tolerated.

While VR might work differently for each person, the technology itself has not shown any major safety issues. Its current use in healthcare further supports its safety. Overall, patients can feel confident about using VR to help manage pain and anxiety. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about using Virtual Reality (VR) for pain management during anesthesia because it offers a unique, non-drug approach to reducing discomfort. Unlike traditional methods like sedatives or pain relievers, VR immerses patients in a calming, distracting environment, which can help manage pain by diverting their attention away from the procedure. This technique could potentially reduce the need for medication and its side effects, making it a safer option for patients. The use of an Oculus Go headset makes this method accessible and easy to integrate into medical settings.

What evidence suggests that virtual reality is effective for pain management during anesthesia?

Research has shown that virtual reality (VR) can help manage pain during medical procedures. In this trial, participants in the experimental group will receive VR during the regional anesthesia procedure. Studies have found that using VR alongside regular pain relief methods can make pain feel less intense and unpleasant. VR effectively distracts patients, reducing the pain and anxiety experienced during treatments like regional anesthesia. However, some research found that VR doesn't always reduce pain during certain procedures, such as ultrasound-guided nerve blocks. Overall, VR appears promising as a tool to help manage pain and anxiety in medical settings. ^{2 3 4 6 7}

Who Is on the Research Team?

Mary Vijjeswarapu, MD

Principal Investigator

CSMC Department of Anesthesiology

Are You a Good Fit for This Trial?

This trial is for elective pre-operative patients aged 18-64 at Cedars-Sinai Medical Center who are scheduled to receive regional anesthesia and can consent to participate. It excludes those with epilepsy, dementia, cognitive or visual impairments, pregnant women, and anyone outside the age range.

Inclusion Criteria

Patient must be able to provide informed consent

I am scheduled for surgery at Cedars-Sinai and will receive regional anesthesia.

Exclusion Criteria

I have been diagnosed with epilepsy, dementia, or cognitive issues.

I have trouble seeing.

You are pregnant.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

1-2 weeks

Pre-operative Assessment

Participants complete a questionnaire to assess anxiety and pain levels prior to regional anesthesia

1 hour

1 visit (in-person)

Regional Anesthesia Procedure

Participants undergo regional anesthesia with or without VR, and complete a questionnaire to assess anxiety and pain levels during the procedure

1 hour

1 visit (in-person)

Post-procedure Assessment

Participants complete a questionnaire to assess anxiety and pain levels after the regional anesthesia procedure

1 hour

1 visit (in-person)

What Are the Treatments Tested in This Trial?

Interventions

• Virtual Reality with Oculus Go headset

Trial Overview The study investigates how using Virtual Reality (VR) via an Oculus Go headset affects pain and anxiety management in patients undergoing regional anesthesia before surgery.

How Is the Trial Designed?

Group I: Experimental Group (VR) Experimental Treatment 1 Intervention

Patients will be randomly allocated to the the experimental group, which receives VR during the regional anesthesia procedure.

Group II: Control Group (no VR) Active Control 1 Intervention

Patients will be randomly allocated to the control group, which receives no Virtual Reality (VR) during the regional anesthesia procedure.

Who Is Running the Clinical Trial?

Cedars-Sinai Medical Center

Lead Sponsor

Trials

523

Recruited

165,000+

Published Research Related to This Trial

A study involving 42 laboring women found that immersive virtual reality (VR) significantly increased patient satisfaction during labor, with a high mean satisfaction score of 87.7 out of 100, and 95% of participants expressing a desire to use VR in future labors.

The use of VR also led to a notable reduction in pain scores during early labor, decreasing from a mean of 2.6 to 2.0 on a visual pain rating scale, indicating its potential as an effective pain relief tool in labor settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Immersive virtual reality on childbirth experience for women: a randomized controlled trial. Carus, EG., Albayrak, N., Bildirici, HM., et al.[2022]

Virtual Reality (VR) shows promise as a noninvasive therapy for both acute and chronic pain, potentially offering an alternative to traditional analgesics that often have side effects or are insufficient for chronic pain management.

Mechanisms of pain relief through VR include distraction and cognitive behavioral changes, with immersive experiences enhancing effectiveness, making it a viable option for conditions like complex regional pain syndrome and phantom limb pain.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Use of Virtual Reality as a Component of Acute and Chronic Pain Treatment]. Lindner, S., Latoschik, ME., Rittner, H.[2020]

A study involving 32 patients undergoing head and neck surgery found that different virtual reality (VR) experiences did not significantly differ in their effectiveness for reducing perioperative anxiety and pain, suggesting that both preoperative gaming and postoperative mindfulness VR can be equally beneficial.

Patients reported high satisfaction with both VR interventions, and there were no adverse events, indicating that VR is a safe and effective tool for managing anxiety and pain in surgical settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Use of Perioperative Virtual Reality Experiences on Anxiety and Pain: A Randomized Comparative Trial. Pandrangi, VC., Low, G., Slijepcevic, A., et al.[2023]

Over the past 20 years, there has been a notable decrease in adverse events related to sedation outside of operating rooms, highlighting improvements in patient safety during procedures.

Immersive virtual reality (VR) is emerging as an effective non-pharmacologic technique to distract patients from anxiety and pain during various medical procedures, with its application expected to grow as technology advances and costs decrease.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Emerging Role of Virtual Reality as an Adjunct to Procedural Sedation and Anesthesia: A Narrative Review. Hitching, R., Hoffman, HG., Garcia-Palacios, A., et al.[2023]

Using a virtual reality application, Oculus Rooms, helped reduce anxiety in a 10-year-old boy during his transportation to the operating room and while being induced for anesthesia.

This approach allows for a virtual connection with parents, which may help calm children without the potential complications of having parents physically present in the operating room.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Use of Virtual Reality as a Surrogate for Parental Presence During Anesthetic Induction: A Case Report. Gupta, A., Joseph Thomas, J.[2021]

This study is evaluating the effectiveness of guided relaxation-based virtual reality (VR-GR) compared to distraction-based VR (VR-D) and a passive control (360 video) in managing pain for 90 children and adolescents undergoing surgery, with a focus on pain intensity and related psychological factors.

The trial aims to determine if VR-GR can provide more lasting pain relief than traditional distraction methods, potentially reducing the need for opioid and benzodiazepine medications post-surgery.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Guided relaxation-based virtual reality versus distraction-based virtual reality or passive control for postoperative pain management in children and adolescents undergoing Nuss repair of pectus excavatum: protocol for a prospective, randomised, controlled trial (FOREVR Peds trial). Olbrecht, VA., Williams, SE., O'Conor, KT., et al.[2021]

A case study demonstrated that immersive virtual reality (VR) significantly reduced pain intensity by 43% and anxiety by 43% during the removal of external fixator pins in a conscious patient, compared to standard care without VR.

Using VR as a non-pharmacologic analgesic not only improved patient satisfaction with pain management but also has the potential to lower opioid use and associated risks during outpatient orthopedic procedures.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Case Report: Virtual Reality Analgesia in an Opioid Sparing Orthopedic Outpatient Clinic Setting: A Case Study. Firoozabadi, R., Elhaddad, M., Drever, S., et al.[2021]

Virtual reality (VR) therapies have shown promise in effectively distracting patients from both acute and chronic pain, suggesting a new approach to pain management beyond traditional methods like opioids and physical therapy.

Clinical studies indicate that VR can be beneficial for various pain conditions, including fibromyalgia and phantom limb pain, by immersing patients in interactive environments that reduce their perception of pain.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Virtual Reality as a Clinical Tool for Pain Management. Pourmand, A., Davis, S., Marchak, A., et al.[2018]

A study involving 100 hospitalized patients showed that a one-time 3D virtual reality (VR) intervention significantly reduced pain more than a 2D distraction video, with an average pain reduction of -1.3 points compared to -0.6 points for the control group.

The VR intervention was not only effective, with 65% of patients experiencing a meaningful pain response, but it was also safe, as no adverse events were reported during the study.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Virtual Reality for Management of Pain in Hospitalized Patients: Results of a Controlled Trial. Tashjian, VC., Mosadeghi, S., Howard, AR., et al.[2020]

This umbrella review analyzed 21 systematic reviews and meta-analyses involving 17,680 patients, confirming that virtual reality is effective in managing various pain conditions, including chronic pain and pain related to medical procedures.

Virtual reality is a promising alternative therapy for pain management in both children and adults, showing benefits across multiple pain settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Virtual reality for pain management: an umbrella review. Viderman, D., Tapinova, K., Dossov, M., et al.[2023]

A study involving 77 healthy volunteers demonstrated that a High-Tech VR helmet significantly reduced procedural pain more effectively than a Low-Tech VR helmet, with participants reporting up to 34% less worst pain and 46% less pain unpleasantness.

The High-Tech VR helmet also led to a higher percentage of participants experiencing clinically significant pain reduction (65% vs. 29% in the Low-Tech group), emphasizing the importance of VR technology quality in pain management during medical procedures.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Virtual reality helmet display quality influences the magnitude of virtual reality analgesia. Hoffman, HG., Seibel, EJ., Richards, TL., et al.[2022]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11699224/

Effectiveness of Virtual Reality for Pain Management in ... VR shows potential for managing pain in MSK disorders, particularly knee conditions, with significant effectiveness using specialised non‐immersive VR.

2. rapm.bmj.com rapm.bmj.com/content/early/2025/05/31/rapm-2025-106418

Effect of virtual reality (VR) therapy on pain sensation in ... Our results show that the use of virtual reality therapy during ultrasound-guided regional anesthesia placement and hand surgery does not result in lower pain ...

3. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC3138477/

Virtual reality and pain management: current trends and future ... Sharar et al. reported results across three studies and concluded that VR in addition to standard analgesia reduced pain intensity, unpleasantness and time ...

4. bmcmedicine.biomedcentral.com bmcmedicine.biomedcentral.com/articles/10.1186/s12916-024-03266-6

Efficacy of virtual reality for pain relief in medical procedures Immersive VR technology offers effective pain control across various medical procedures, albeit statistical heterogeneity.

5. researchprotocols.org researchprotocols.org/2024/1/e52649

Effectiveness of Virtual Reality in Reducing Perceived Pain ... The purpose of this pilot project is to assess the efficacy of using VR as a distraction-based intervention for anxiety or pain management.

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC10382225/

Virtual reality for pain management: an umbrella review This umbrella review demonstrates successful application of virtual reality in pain control, including perioperative, periprocedural, and chronic pain settings.

7. sciencedirect.com sciencedirect.com/science/article/pii/S003960602400391X

Virtual reality for postsurgical pain management The aim of this explorative study is to investigate the initial effectiveness and feasibility of VR as an add-on treatment compared with standard care in ...