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Virtual reality is a potential alternative for pain prevention in bone marrow biopsy, as it is well-tolerated and associated with high patient and healthcare provider satisfaction.

Bone marrow biopsy is associated with high levels of pain, despite local analgesia using lidocaine. Inhalation of the mixture of nitrous oxide/oxygen (MEOPA) is relatively easy to use and is a standard for pain prevention in bone marrow biopsy; however, it has some adverse effects and lower efficacy compared to other drugs in use. This study demonstrated that virtual reality is well-tolerated among patients undergoing bone marrow biopsy and has a high satisfaction rate for both healthcare providers and patients. Virtual reality can serve as a potential alternative in cases where MEOPA is either poorly-tolerated or contraindicated. The study findings are published in the Journal of Medical Internet Research.

Virtual Reality and MEOPA Equally Effective in Reducing Pain and Anxiety

Therapeutic virtual reality during bone marrow biopsy improved pain intensity, blood pressure, and anxiety scores in the participants; however, these results were not statistically different from standard MEOPA, before and after bone marrow biopsy. Similarly, physicians, nurses, and patients were highly satisfied with virtual reality as the relaxation method during bone marrow biopsy, without significant differences between the two arms.

MEOPA and Virtual Reality Equally Effective in Managing Anxiety Levels

The fear of pain questionnaire and the revised State-Trait Anxiety Inventory (STAI) were utilized to evaluate the levels of anxiety in the study participants. Pre- and post-assessment comparisons revealed no noteworthy differences in anxiety scores between the two groups subjected to different interventions, namely MEOPA and VR. These findings suggest that both MEOPA and VR treatments were similarly effective in managing anxiety levels among the participants.

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MEOPA and Virtual Reality Show High Patient Satisfaction and Efficacy

The relaxation methods used during biopsy procedures effectively manage patient comfort and satisfaction, and 98.3% of patients reported satisfaction with the relaxation techniques. Physicians and nurses reported ease of use for both interventions. Furthermore, the study found no significant differences between the two interventions regarding patient satisfaction, pain, or stress.

Virtual Reality-Based Relaxation Method Was Well-Tolerated

It was observed that the virtual reality-based relaxation method was well-tolerated and highly satisfying for both patients and physicians. The study suggests that, in the future, patients can choose their own program and put the VR helmet on themselves without the need for medical monitoring or driving restrictions. Additionally, using this relaxation method may result in a shorter time for patients to be present, with potential socioeconomic benefits that will need to be evaluated.

One of the limitations of this study is that the investigators failed to compare the relaxation methods with each other. The patients in this study underwent bone marrow biopsy only once, with either virtual reality or standard MEOPA; therefore, the patient choice could not be recorded.

Relaxation induced by virtual reality during bone marrow biopsy was found to be comparable to standard MEOPA; therefore, virtual reality may be utilized in cases where MEOPA is not feasible.



Le Du, K., Septans, A. L., Maloisel, F., Vanquaethem, H., Schmitt, A., Le Goff, M., Clavert, A., Zinger, M., Bourgeois, H., Dupuis, O., Denis, F., & Bouchard, S. (2023). A New Option for Pain Prevention Using a Therapeutic Virtual Reality Solution for Bone Marrow Biopsy (REVEH Trial): Open-Label, Randomized, Multicenter, Phase 3 Study. Journal of Medical Internet Research, 25, e38619. https://doi.org/10.2196/38619

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