///2019 Abstract Details
2019 Abstract Details2019-07-13T07:45:15-05:00

Development of a Virtual Reality Tool to Decrease Pain and Anxiety During Labor and Delivery

Abstract Number: F3A-401
Abstract Type: Original Research

Lindsey Ralls MD1 ; Brendan Carvalho MBBCh, FRCA2; Thomas Caruso MD, MEd3; Maria Menendez BA4; Samuel Rodriguez MD5

Background:

Labor and peripartum medical procedures including epidural anesthesia can provoke significant anxiety and pain. Virtual reality (VR) technology has shown promising results for relieving anxiety and pain during various procedures, including wound care, IV placement, chemotherapy and dental procedures(1), but its role in the labor and delivery setting has not been well elucidated. The aim of this study was to develop VR technology for pregnant and laboring women.

Methods:

IRB-approved prospective cohort study of three cohorts: nonpregnant women having previously undergone labor epidural (Group NP); non-laboring pregnant (2nd or 3rd trimester) women (Group P); and laboring women undergoing epidural placement (Group L). All participants completed a survey recalling pain and anxiety during their most recent labor epidural (if applicable), willingness to try VR and tendency toward motion sickness. Group L completed additional questions about their pre-epidural anxiety and pain. Participants were given a VR headset and guided through VR scenery; group L used the headset during epidural placement. After VR use all participants completed a feedback survey regarding their experience, including if they felt any nausea or discomfort, how helpful they felt VR would be for reducing pain and anxiety during future epidural placement or pain relief during labor, likelihood to use VR during future epidural placement, and preferred types of VR scenery. Group L also completed additional questions regarding their post-epidural anxiety and pain. Question responses were scaled using a 5-point Likert-type scale (for example, ranging from very unhelpful to very helpful); pain and anxiety were scored on a 0 to 10 scale.

Results:

20 women in each of the 3 groups participated in the study (n=60). Most women reported that VR would be helpful for decreasing anxiety (64%) and pain (51%) during future epidural placement, 76% said they would like to use the VR epidural relaxation experience during a future epidural placement, and 62% reported that VR would be helpful for labor pain management. In Group L, there was a significant reduction in pain (p=0.0009) and anxiety (p=0.0007) after VR use during epidural placement. Nausea was reported by 9% of participants; other side effects noted were discomfort from headset (headache, neck ache, heaviness of headset), fogging of mask, and difficulty focusing on images. Most desired VR scenes were underwater/ocean (75%), beach (66%), and waterfall (54%) versus mountains (32%), forest (31%), abstract patterns (2%) and “other” (3%).

Conclusions:

VR appears to be helpful to alleviate pain and anxiety and was well-tolerated by patients. Most women felt that VR would be helpful during labor or epidural placement, and for labor pain management. Future investigations are required to determine if VR can reduce pain and anxiety during labor and delivery.

Reference:

1. Pain Manag. 2011 Mar; 1(2): 147–157

SOAP 2019