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As a part of the current rheumatological practice skills, epidural injections through the sacrococcygeal hiatus take part in the strategy for managing radicular diseases. This technical act is easily performed in an outpatient context since it is a brief procedure, performed under clinical and ultrasound control, with good tolerance. Nevertheless, epidural injections by the way of the sacrococcygeal hiatus can be responsible of anxiety for the patient and meet the definition of pain induced by treatment. Among the non-pharmacological methods that can be offered to the patient in this context, hypnosis and distraction allow psycho-corporal support acting on certain factors influencing the painful experience of the gesture: duration of the gesture, calm and pleasant environment, etc... That is the context in which the use of virtual reality is of interest. Its use in supporting procedures generating induced pain has already been evaluated in several studies, in particular in the fields of surgery and anaesthesiology. The use of a virtual reality device also seems suitable in the context of epidural injections, but this theoretical and plausible interest remains to be demonstrated. To our knowledge, the literature on the use of a virtual reality headset to support invasive procedures in rheumatology remains poorly developed. The objective of this study is therefore to assess the interest of using a virtual reality headset in the support of pain relief and the management of peri-procedural anxiety when performing epidural injections through the sacrococcygeal hiatus.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Using the virtual reality headset for the first injection | Experimental | Performing the first ultrasound-guided epidural injection through the sacrococcygeal hiatus using the virtual reality headset, then the second injection following the usual conditions of care without the device |
|
| Using the virtual reality headset for the second injection | Experimental | Performing the first ultrasound-guided epidural injection through the sacrococcygeal hiatus following the usual conditions of care, then the second injection using the virtual reality headset |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Virtual reality headset for first injection | Device | Performing the first ultrasound-guided epidural injection through the sacrococcygeal hiatus using the virtual reality headset |
| Measure | Description | Time Frame |
|---|---|---|
| Evaluation of peri-procedural anxiety when performing epidural injections through the sacrococcygeal hiatus | Peri-procedural anxiety was measured with State and Trait Anxiety Index (STAI) | Day 7 |
| Measure | Description | Time Frame |
|---|---|---|
| Assessment of the patient's anxiety | Assessment of the patient's peri-procedural anxiety using the French version of the APAIS | Immediately after intervention |
| Measure of the duration of the intervention |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Christelle JADEAU | Contact | +33244710781 | cjadeau@ch-lemans.fr |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Centre Hospitalier Du Mans | Recruiting | Le Mans | 72000 | France |
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| Virtual reality headset for second injection | Device | Performing the second ultrasound-guided epidural injection through the sacrococcygeal hiatus using the virtual reality headset |
|
| Immediately after intervention |
| Assessment of patient's pain | Evaluation of maximum periprocedural pain on a numerical scale from 0 to 10 | During intervention |
| Evaluation of the patient satisfaction | Evaluation of the patient satisfaction with the virtual reality device on a 4-level scale, with values of 1, 2, 3 and 4 (quantitative variable). | Immediately after intervention |
| Evaluation of the practitioner satisfaction | Evaluation of the practitioner satisfaction with the virtual reality device on a 4-level scale, with values of 1, 2, 3 and 4 (quantitative variable) | Immediately after intervention |
| Evaluation of lumbar and radicular pain | Assessment of lumbar pain on a numerical scale from 0 to 10 and of radicular pain on a numerical scale from numerical scale from 0 to 10 | Before intervention |
| Tolerance and Comfort Questionnaire | Immediately after intervention |
| Record of undesirable events | Before intervention |
| ID | Term |
|---|---|
| D011843 | Radiculopathy |
| D000377 | Agnosia |
| ID | Term |
|---|---|
| D010523 | Peripheral Nervous System Diseases |
| D009468 | Neuromuscular Diseases |
| D009422 | Nervous System Diseases |
| D010468 | Perceptual Disorders |
| D019954 | Neurobehavioral Manifestations |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
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