Effect of Virtual Reality Distraction on Pain and Anxiety During Peripheral Arterial Angioplasty: A Randomised Prospective Study

Ann Vasc Surg. 2026 Feb 13:S0890-5096(26)00087-7. doi: 10.1016/j.avsg.2026.02.011. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the effect of virtual reality (VR) distraction on pain, anxiety, agitation, and physiological stress during awake peripheral arterial angioplasty.

DESIGN: Prospective, triple-blind, randomized controlled trial.

METHODS: Adult patients undergoing elective lower-extremity angiography with planned balloon angioplasty under local anesthesia were randomized 1:1 to VR distraction or standard care. All participants wore the same headset; the control group viewed a static neutral panorama, whereas the VR group received immersive nature-based audiovisual content. Pain (VAS), anxiety (STAI-6), agitation (positive RASS), heart rate and blood pressure, and satisfaction were assessed during the procedure. Blinding was maintained for participants, outcome assessor, and analyst.

RESULTS: A total of 120 patients were analyzed (60 per group). VR significantly reduced intra-procedural pain (VAS 6.23±0.91 vs 8.03±0.94; p<.001) and anxiety (STAI-6 47.60±7.42 vs 67.97±9.95; p<.001). Heart rate (p=.002) and systolic (p=.045) and diastolic (p=.011) blood pressures were lower in the VR group. Agitation was reduced (pRASS 0.97±0.80 vs 1.32±0.83; p=.022). No adverse events requiring discontinuation occurred after randomization.

CONCLUSION: VR is a safe, well-tolerated, non-pharmacological adjunct that reduces pain, anxiety, agitation, and physiological stress during awake peripheral arterial angioplasty and may enhance patient cooperation without sedatives.

PMID:41692166 | DOI:10.1016/j.avsg.2026.02.011