An implantable catheter port, also called Port-a Cath, is placed in the upper part of the
thorax under the clavicle. Setting is performed in a surgical room, under ambulatory, by
a specialist, under local anesthesia. This Port-a Cath is set up to facilitate the
administration of certain anticancer drugs or to inject other treatments throughout the
course of care.
Setting a Port-a Cath is painful and stressful. In addition to local anesthesia, patients
are often offered a sedation: anxiolytics as premedication, hypnotics before or during
the Port-a Cath setting, inhalation of MEOPA (equimolar mixture of oxygen and nitrogen
protoxide, medicinal anxiolytic and analgesic gas , colorless and slightly odorous,
mainly used in a hospital environment).
Virtual reality technology allows a person to be immersed in a virtual environment using
a device consisting of headset audio and 3D display system. This is a non-invasive device
that has an effect on the anxiety and pain level of patients. Butterfly Therapeutics has
developed a Digital Therapeutics (DTx) called Bliss DTx which uses virtual reality
augmented by sound and visual stimuli. A first clinical study with Bliss DTx which was
released in 2021 showed that the pain level was not significantly different between
"Bliss DTx" arm and "MEOPA" arm when performing osteomedullary biopsy.
Bliss DTx is also used in everyday practice by many doctors, surgeons, anesthetists and
nurses, who do not observe significant pain difference between Bliss DTx and chemical
sedations during the acts, but note interesting differences from an organizational point
of view between the different methods.
A new evolution of Bliss DTx offers features that allow to increase winnings throughout
the course including installation of a Port-a Cath.
This study is therefore based on the hypothesis that Bliss DTx use would :
Be clinically equivalent to a standard protocol (use of hypnotics and/or anxiolytics
and/or MEOPA and/or hypnosis conversational) to manage pain during Port-a Cath
setting under local anesthesia
Reduce anxiety before setting a Port-a Cath
Provide greater satisfaction with the treatment process from patient point of view
Have organizational impacts, some of which could be economically valued,
contributing to optimization of the entire course care for patients with Port-a Cath
setting