Impact of a Multisensory Clinical Environment on Pain and Patient Experience During Office Hysteroscopy: The VISION-HYST Randomized Controlled Pilot Trial

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Background:Pain and anxiety remain major barriers to the tolerability and widespread adoption of office hysteroscopy, despite advances in minimally invasive techniques and the use of nitrous oxide (N2O) analgesia. Non-pharmacological interventions targeting the clinical environment may offer a complementary strategy to improve patient experience. To evaluate the preliminary effect of a multisensory clinical setting, incorporating visual environmental distraction, on pain perception during operative office hysteroscopy.Methods:This randomized, parallel-group pilot trial enrolled 50 women undergoing operative office hysteroscopy in an outpatient setting. Participants were allocated to standard care with N2O (control group) or N2O combined with a multisensory intervention consisting of a wall-mounted virtual window displaying relaxing visual content (intervention group). The primary outcome was procedural pain assessed on a 10-point scale. Secondary outcomes included referral to the operating room and procedural feasibility. Between-group differences were analyzed using Welch’s t-test.Results:50 patients were randomized (25 per group), and all completed the study. Mean pain scores were significantly lower in the intervention group than in the control group (3.1 ± 1.5 vs. 5.8 ± 1.9; p < 0.001). The reduction in pain was observed across different hysteroscopic techniques and appeared more pronounced among multiparous women. No significant between-group differences were observed in secondary outcomes, including referral to the operating room (20% vs. 12%; p = 0.702). No adverse events related to the intervention or N2O were reported.Conclusions:In this pilot randomized trial, the addition of a simple visual environmental distraction to standard N2O analgesia was associated with reduced pain during operative office hysteroscopy. These findings suggest that non-pharmacological, environment-based strategies may complement existing analgesic approaches to enhance patient experience. Larger, adequately powered studies are needed to confirm these preliminary findings.Clinical Trial Registration:This study is registered on the ClinicalTrials.gov (registration number: NCT07473206).

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