The Effect of Audiovisual Distraction on Pain Perception During Reduction of Distal Radial Fractures: A Dual Center Randomized Controlled Trial.

BACKGROUND

Adequate pain management is a challenge in the Emergency Department (ED). This study explores whether audiovisual distraction (AVD) has a positive effect on pain perception.

OBJECTIVE

We aimed to compare the influence of AVD on reported pain, anxiety and satisfaction using a commercial AVD device as an adjunct to standard care in patients undergoing distal radial fracture reduction in the ED.

METHODS

This randomized controlled, dual-center study, conducted in the ED of 2 Level-1 trauma centers, included a total of 36 adult patients with a distal radial fracture requiring reduction in the ED. Patients were randomly assigned to either standard of care or the use of AVD in addition to standard of care. The primary outcome was reported pain after fracture reduction using a standardized verbal Numerical Rating Scale (v-NRS).

RESULTS

No significant differences were found between groups in pain (difference: 0.8; 95% CI, -1.2 to 2.8), anxiety (difference: 0.6; 95% CI, -1.6 to 2.8) or satisfaction (difference: 0.1; 95% CI, -0.7 to 1.0). However, the majority (>80%) of the patients, nurses and physicians stated they would recommend the use of AVD for future procedure.

CONCLUSION

This study was unable to demonstrate the added value of using audiovisual immersion as a distraction tool to standard care, in terms of lowering perceived pain or anxiety in adults undergoing a wrist fracture reduction in the ED. Nevertheless, patients and healthcare providers appeared to be satisfied and would recommend the use of the AVD device.