# Impact of virtual reality distraction during colonoscopy vs intravenous deep sedation: Results of a single-center randomized controlled trial

## TL;DR

This study compared using virtual reality distraction during colonoscopies to traditional sedation and found similar success rates but higher pain and lower comfort with virtual reality.

## Contribution

The study is one of the first to evaluate virtual reality distraction as an alternative to intravenous sedation in colonoscopies.

## Key findings

- Cecal intubation rates were similar between virtual reality and intravenous sedation groups.
- Patients using virtual reality had a lower propofol dose when rescue sedation was needed.
- Virtual reality users reported higher pain and lower comfort during the procedure.

## Abstract

Colonoscopy is associated with discomfort that requires intravenous sedation (IVS). The aim of this randomized controlled trial (RCT) was to explore the feasibility of virtual reality distraction (VRD) for colonoscopy using two primary endpoints: cecal intubation rate and the rate of rescue with IVS.

Patients scheduled for elective colonoscopy with IVS were randomized in a 2:1 ratio in favor of VRD, with rescue IVS by propofol if needed. VRD involved use of a device providing a visual and auditive experience similar to clinical hypnosis.

Ninety patients were included (VRD:60, IVS: 30). Cecal intubation rate was similar in both groups (92.8% for VRD vs 100% for IVS,
P
=0.3). The rate of rescue IVS in the VRD group was 63.6%. There was a decrease in median total dose of propofol per patient in the VRD group (1.15 mg/kg for VRD and 4.41 mg/kg for IVS,
P
<0.001) and in the subgroup of VRD patients who received IVS rescue (3.17 mg/kg for VRD and 4.41 mg/kg for IVS,
P
=0.003). The median level of pain was higher and the median level of comfort was lower in the VRD group (respectively 3 vs 0,
P
<0.001 and 7 vs 10,
P
<0.001).

This RCT provides preliminary data to better understand the feasibility of VRD for colonoscopy. We have not identified differences in procedure outcomes compared with conventional IVS, but nevertheless, higher pain and lower comfort scores were reported.