Immersive Virtual Reality Treatment Does Not Alleviate Maternal Anxiety During Spinal Anesthesia Procedure: A Randomized Controlled Trial

Abstract Background Spinal anesthesia is the preferred technique for cesarean delivery, yet it can provoke anxiety and pain in parturients. Video-watching can alleviate these symptoms to some extent. However, whether immersive virtual reality (VR), as a novel distraction technique, is more effective remains inconclusive. We hypothesized that VR would provide superior relief for anxiety and pain during the procedure compared to video. This randomized controlled trial aimed to determine the superiority of immersive VR over video distraction in reducing maternal anxiety. Methods This randomized controlled trial allocated 146 parturients to receive either VR gaming or video-watching during spinal anesthesia puncture. The change in maternal anxiety scores (before vs. during the procedure) was the primary outcome. Secondary outcomes encompassed pain scores, satisfaction, distraction efficacy, and anesthesiologist - reported anxiety. Results There was no significant difference in the change in anxiety score ( P = 0.100) between the two groups. However, compared with the iPad group, the VR group reported significantly less pain ( P = 0.011), greater satisfaction ( P = 0.029), and better distraction effects ( P = 0.003). The anesthesiologist - reported maternal anxiety score was also significantly lower in the VR group ( P = 0.006). Conclusion No significant difference in anxiety scores was observed between the VR and iPad groups during anesthetic puncture. Trial registration: ChiCTR2400081158, 24/2/2024