Effect of virtual reality on pain and anxiety during colonoscopy: A randomized control trial

J Int Med Res. 2026 Jun;54(6):3000605261417213. doi: 10.1177/03000605261417213. Epub 2026 Jun 18.

ABSTRACT

Objective To evaluate the effect of virtual reality on pain and anxiety during sedation-free colonoscopy in adults aged 18-70 years.

Methods In this randomized controlled trial, patients were assigned to either a virtual reality group or a control group. The primary outcomes were pain, measured using the visual analog scale, and anxiety, assessed using the self-rating anxiety scale. Secondary outcomes included vital signs, procedural success and duration, patient satisfaction, virtual reality acceptability, and willingness to undergo future colonoscopies.

Results Compared with the control group, the virtual reality group showed significantly lower pain, anxiety, heart rate, and blood pressure during the procedure (all p < 0.05). No significant differences were observed in respiratory rate, cecal intubation time, or total procedure duration (p > 0.05). Insertion success rates were identical. Importantly, a higher proportion of virtual reality participants expressed willingness to undergo future colonoscopies (p < 0.05), a patient-centered outcome relevant to screening adherence.

Conclusion Virtual reality effectively reduces pain and anxiety during colonoscopy without compromising procedural outcomes. The inclusion of both subjective and physiological measures strengthens the evidence supporting the effects of virtual reality.

Trial registration: This randomized controlled trial was retrospectively registered in the Chinese Clinical Trial Registry (ChiCTR; registration number ChiCTR2400079076).

PMID:42315333 | DOI:10.1177/03000605261417213