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Virtual Reality for Alleviation of Peripheral IV Placement-Associated Discomfort

Not Applicable
Conditions
Procedural Pain
Procedural Anxiety
Perioperative Care
Interventions
Device: Virtual reality
Procedure: Peripheral intravenous catheter placement
Registration Number
NCT03740607
Lead Sponsor
Brooke Army Medical Center
Brief Summary

Immersive virtual reality (iVR) has been used successfully to manage pain with distraction. It is a non-invasive treatment modality unassociated with worrisome well-known side effects typically seen when opioids and NSAIDS are used, and has previously been used safely in place of analgesia during dressing changes and burn care. This study investigates whether iVR can be useful as a stand-alone option to manage the pain associated with placement of peripheral intravenous (PIV) catheters in adults.

Detailed Description

This is a prospective study of the effect of immersive virtual reality on the perception of pain during peripheral IV (PIV) placement. Adult patients who require PIV placement for elective surgery will be consented for intervention while in the peri-operative suites (PS). The VR intervention will consist of a headset and immersive VR software that allows the patient to engage in a virtual world during PIV placement. Subjects will be queried immediately after PIV placement using the validated graphic rating scale regarding the sensory, cognitive, and affective aspects of discomfort they experienced with PIV placement (Appendix A). They will also be asked two validated questions concerning patient satisfaction (Dexter et al 1997). A control group of patients will undergo a similar assessment with slightly different wording after receiving PIV placement without iVR.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
100
Inclusion Criteria

Brooke Army Medical Center patients age 19-89 undergoing peripheral intravenous catheter placement in preparation for elective surgery will be eligible for participation.

Exclusion Criteria

Patients will be excluded with head wounds/head bandages preventing the use of a headset, active nausea/vomiting, history of seizure, dementia, psychosis, mania, vertigo, or motion sickness, if the patient is pregnant or incarcerated on the day of surgery, and if the patient is unable to consent self.

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Virtual reality during PIV placementPeripheral intravenous catheter placementRandomized consented adult subjects will participate in a six-minute healthcare virtual reality software program via Samsung Gear virtual reality headsets while receiving 18 or 20-gauge peripheral intravenous catheter placement in peri-operative suite in preparation for surgery. They will be asked to rate their pain and discomfort afterwards using a graphic rating scale. They will be asked several questions about satisfaction, in order to elicit clinical significance of this intervention. Demographic information will be collected, and baseline vital signs upon arrival to OR will be abstracted retrospectively.
Standard PIV placementPeripheral intravenous catheter placementAdult control arm subjects will receive 18 or 20-gauge peripheral intravenous catheter placement according to current standard protocol, without virtual reality distraction .They will be asked to rate pain and discomfort afterwards using a graphic rating scale. Demographic information will be collected, and baseline vital signs upon arrival to OR will be abstracted retrospectively.
Virtual reality during PIV placementVirtual realityRandomized consented adult subjects will participate in a six-minute healthcare virtual reality software program via Samsung Gear virtual reality headsets while receiving 18 or 20-gauge peripheral intravenous catheter placement in peri-operative suite in preparation for surgery. They will be asked to rate their pain and discomfort afterwards using a graphic rating scale. They will be asked several questions about satisfaction, in order to elicit clinical significance of this intervention. Demographic information will be collected, and baseline vital signs upon arrival to OR will be abstracted retrospectively.
Primary Outcome Measures
NameTimeMethod
Discomfort associated with peripheral IV placementThis outcome will be measured immediately after peripheral IV placement

Subject experiences will be measured using a validated graphic rating scale (GRS) which enquires about the extent to which the experience was unpleasant.

Secondary Outcome Measures
NameTimeMethod
ClaustrophobiaThis outcome will be measured immediately after peripheral IV placement

The subject will be asked to answer a question about the extent to which they felt claustrophobic for any reason during IV placement

Clinical significanceThis outcome will be measured immediately after peripheral IV placement

the subject will be asked if they would want to have their IV placed this way again

Degree to which subject felt immersed in virtual realityThis outcome will be measured immediately after peripheral IV placement

The subject will answer a question regarding the extent to which they felt they went "inside" the computer-generated world

NauseaThis outcome will be measured immediately after peripheral IV placement

Subject will answer a question regarding extent to which nausea was experienced during IV placement

Satisfaction scoreThis outcome will be measured immediately after peripheral IV placement

The subject will be asked if they were satisfied with IV placement

Physiological parametersInitial vital signs at start of anesthesia care will be abstracted retrospectively. This reading will likely occur within an hour of the initial intervention, as start times for anesthesia cases are within an hour of initiation of peri-operative care

Baseline vital signs- continuous variables

Fun factorThis outcome will be measured immediately after peripheral IV placement

Subject will describe the extent to which they found the experience to be fun, on a scale of 1-10

Magnitude of pain severityThis outcome will be measured immediately after peripheral IV placement

Subjects will rate their worst pain during the IV placement on a scale of 1-10 out of 10 possible points

Time spent thinking about painThis outcome will be measured immediately after peripheral IV placement

Subject will describe the amount of time spent thinking about pain during IV placement, as a proportion.

Trial Locations

Locations (1)

Brooke Army Medical Center

🇺🇸

San Antonio, Texas, United States

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