Procedure
cough, breathlessness, ®, pain
Demographic data was collected prior to randomization, which included (age, gender, ethnicity, BMI, comorbidities) and indications for FB. The investigator then randomized with a block of 4 with random permutations of 2 groups: intervention (VR) and controlled group without VR. Before bronchoscopy, both groups were given a VAS questionnaire to assess their pain, breathlessness, and cough (Fig. Visual analogue scales for pain, breathlessness, and cough anchored to 10 cmAfter completing the questionnaires, both groups received topical anesthesia administered intranasal and intra-pharyngeal. The anesthesia comprised of intranasal lignocaine HCL 2% jelly (XYLOCAINE® 2% JELLY) followed by Lignocaine Hydrochloride Spray 10% (XYLOCAINE® SPRAY). The bronchoscopy was done per standard protocol for participants in the control group.Participants in the interventional group were given the virtual reality (VR) device to wear, which was the Oculus Quest 2 (Oculus, China)—(Fig. Oculus Quest 2 Virtual Reality Device (Both groups were given sedation as per standard protocol pre-FB. Participants were given sedation of midazolam 1–2 mg, (3 min before FB), with a supplemental titrating doses of 1-2 mg midazolam as needed, and titrating doses of fentanyl from 12.5mcg upwards. For those in the intervention group, the sedations were administered 7 min into screening time (3 min before FB), and at the end of 10 min, bronchoscopy was performed. During FB both groups also received topical anesthesia of the airway using Lignocaine HCL INJECTION 2% (20 mg/ml; not exceeding 8 mg/kg body weight), which was administered via the working channel port of the bronchoscope. Throughout the procedure in both groups; constant communication were maintained between participants and bronchoscopy staff.The FB was performed by the same independent bronchoscopist with a 3-year experience in performing bronchoscopy; using the PENTAX Medical Video Bronchoscope EB-J10 (Pentax Medical, Japan). The FB was done via the anterior approach with the head of the bed propped up at 30Post-procedure, all participants were given VAS, STAI, and satisfaction questionnaires. These were completed by the participants at 4 h post FB. This was to ensure that there was no residual effect of sedation and that participants were fully conscious. The study design and CONSORT flow diagram, as shown in Fig. CONSORT flow diagram