Impact of Virtual Reality on Anxiety in Patients Undergoing Interventional Procedures

Summary

Periprocedural anxiety is a common problem for patients who undergo interventional pain procedures. Virtual Reality (VR) is an immersive experience that has gained acceptance in the medical field as a tool for reducing anxiety and pain for patients.Research Aim: To evaluate the effect of immersive virtual reality (VR) on periprocedural anxiety related to therapeutic cervical epidural steroid injections (ESI). The investigators hypothesize that immersive virtual reality will result in a clinically meaningful anxiety reduction, defined as the proportion of participants with \> 50% reduction in Numeric Rating Scale (NRS) anxiety scores when compared to participants in the non-treatment group who will have standard preprocedural waiting time conditions in clinic, but no VR experience. Similarly, the investigators hypothesize a significant reduction in objective sympathetic tone as measured by skin sympathetic nerve activity (SKNA).

Eligibility

Inclusion Criteria:

* Age 18-80 years old at day of enrollment
* Neck pain patient deemed to be a candidate for pain control treatment with interventional fluoroscopically guided cervical epidural steroid injection as determined by their pain medicine provider based on history, physical exam, and radiographic findings
* Willingness to undergo pre-procedural intervention of VR viewing experience or equivalent pre-procedural wait time
* No history of prior epidural steroid injections
* Did not receive sedatives prior to or during procedure

Exclusion Criteria:

* Refusal / inability to participate or provide consent
* Contraindications to injection (anticoagulated states, allergy to components of injection, local infection at injection site, current infectious process or treatment of antibiotics for current infection)
* Uncontrolled anxiety disorder or untreated/inadequately treated psychiatric disorder
* History of Alzheimer's, dementia, or cognitive dysfunction
* Patient currently taking benzodiazepines
* Severe motion sickness
* Seizure disorder
* Vision loss
* Non-English speaking patients

Conditions1

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