Background/Objectives:Audio and audiovisual distraction can be effective additive tools to reduce anxiety and pain in patients receiving outpatient procedures (OP). Audiovisual distraction tools already showed positive effects on pain perception in some urological procedures. To identify the effects of audio and audiovisual distraction on pain and anxiety in patients receiving perineal prostate biopsy (PPB), we performed a prospective randomized controlled study.Methods: We recruited 168 male patients undergoing PPB which were randomized into three groups: a control group (CG), an audio distraction group (ADG) and an audiovisual distraction group (AVDG). The CG received no intervention, while the ADG received audio distraction and the AVDG received audiovisual distraction while PPB was performed. The primary endpoint was pain perception, measured in the Numeric Rating Scale (NRS) and Visual Analogue Scale (VAS). Secondary endpoints were subjective and objective procedure time (SPT/OPT), heart rate, blood pressure, cortisol blood levels and scores in the State-Trait Anxiety Inventory (STAI) questionnaire.Results: Demographics of each group were similar (CG = mean age (a) = 69.5; ADG a = 67 years; AVDG a = 67). We did not find any significant difference regarding our primary endpoint, pain perception (p= 0.384). In contrast, we examined a highly significant difference between SPT and OPT, comparing AVDG to CG (p< 0.001) and AVDG to ADG (p< 0.001), but not for ADG to CG (p= 0.348). There was no significant difference in the secondary endpoints, heart rate, blood pressure, STAI scores and willingness to repeat the procedure.Conclusions: Our study shows that audiovisual distraction can significantly shorten SPT for patients receiving PPB, which may represent their comfort throughout the procedure. To accelerate the wider implementation of audiovisual distraction as a cost-efficient tool in outpatient urological procedures, further studies should examine its effect on different OPs with a more heterogeneous patient group.
背景/目的：音频与视听分散注意力可作为有效的辅助手段，降低门诊手术患者的焦虑与疼痛感。已有研究表明视听分散注意力在某些泌尿外科操作中对疼痛感知具有积极作用。为探究音频与视听分散注意力对接受经会阴前列腺穿刺活检患者疼痛及焦虑的影响，我们开展了一项前瞻性随机对照研究。 方法：研究共纳入168例接受经会阴前列腺穿刺活检的男性患者，随机分为三组：对照组、音频分散注意力组和视听分散注意力组。对照组不接受干预，音频组在活检过程中接受音频干预，视听组接受视听联合干预。主要终点指标为采用数字评分量表和视觉模拟量表评估的疼痛感知。次要终点包括主客观操作时长、心率、血压、皮质醇血液浓度及状态-特质焦虑量表评分。 结果：各组人口学特征相似（对照组平均年龄69.5岁，音频组67岁，视听组67岁）。主要终点指标疼痛感知未见显著组间差异（p=0.384）。然而，在主观操作时长方面，视听组较对照组（p<0.001）及音频组（p<0.001）均呈现高度显著差异，而音频组与对照组间无显著差异（p=0.348）。次要终点指标心率、血压、状态-特质焦虑量表评分及手术重复接受意愿均无显著组间差异。 结论：本研究表明视听分散注意力能显著缩短经会阴前列腺穿刺活检患者的主观操作时长，这可能反映了患者在操作过程中的舒适度改善。为推动视听分散注意力作为经济高效的工具在门诊泌尿外科手术中的广泛应用，后续研究应在更具异质性的患者群体中探索其对不同门诊手术的干预效果。
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