Virtual Reality for Colonoscopy Sedation?
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Virtual Reality for Colonoscopy Sedation?

Douglas K. Rex, MD, MASGE, reviewing Friedman M, et al. Endosc Int Open 2021 Feb 18.

In this study, a virtual reality program playing nature and animal scenes was tested in 27 patients who had previously undergone moderate sedation for colonoscopy using average doses of 4 mg of midazolam and 100 µg of fentanyl. Of these patients, 26 (96.3%) completed colonoscopy without requesting sedation. Six subjects considered asking for sedation, but their pain was not severe or quickly subsided. When reporting pain levels, 42% of patients said the pain was similar to that of their previous colonoscopy, and another 42% said they had more pain. On a scale of 1 to 10 (10=best), satisfaction was rated as 7.3, and 18 patients (69%) said they would ask for virtual reality again, whereas 7 patients indicated they might request virtual reality again, and 1 said no. Endoscopists rated their overall experience as 8.6 out of 10 (10=excellent), but they gave it a rating of only 5 among 3 procedures that were ranked difficult.

Douglas K. Rex, MD, FASGE

COMMENT

These data suggest that virtual reality could be an adjunct to sedation, but patients participating in studies like this tend to overestimate the benefit. The tool may be useful in motivated patients who do not want sedation in the first place, but for the rest, controlled study is needed.

Note to readers: At the time we reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made.

CITATION(S)

Friedman M, Rand K, Patel T, et al. A pilot study of virtual reality as an alternative to pharmacological sedation during colonoscopy. Endosc Int Open. 2021;09:E343-E347. (doi: 10.1055/a-1339-0724)

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