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VR reduces anxiety and need for sedatives during surgery

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Virtual reality (VR) helps reduce patient anxiety and the need for sedatives during hand surgery, according to a new study.

The research, published in the journal PLoS ONE, was led by Adeel Faruki, MD, MBA, an assistant professor of anaesthesiology in the University of Colorado School of Medicine.

Faruki said:

“We’re realising that a lot of the medications we’re giving patients, the intraoperative sedation, are safe but can carry side-effects ­– dropping blood pressure, slowed breathing.

“If VR can have a similar effect of managing patient anxiety without with the side effects associated with sedation, that’s something we should be studying.”

The research team randomised 40 participants who were having elective hand surgery into two groups.

One group received intraoperative monitored anaesthesia care (MAC) and the other received VR in addition to receiving MAC.

The researchers hypothesised that that intraoperative VR use would reduce sedative dosing during elective hand surgery without detracting from patient satisfaction as compared to just MAC.

Participants in the VR group viewed their choice of immersive programming via a head-mounted display during surgery.

As a primary outcome, Faruki and his co-researchers measured intraoperative dose of propofol, a common anaesthetic, every hour.

Secondary outcomes included patient-reported pain and anxiety, functional outcome, overall satisfaction and post-anaesthesia care unit (PACU) length of stay.

The VR patients received significantly less propofol per hour than the MAC control group.

While there were no significant differences between groups in overall satisfaction, PACU pain scores, or postoperative functional outcome, participants in the VR group had a significantly decreased PACU length of stay.

Faruki said:

“A number of participants in the VR group stated that they were very aware but comfortable.

“The beauty of this is, if you have an effective way to manage pain for a specific surgery, you can give patients VR headsets, get them in an immersive environment, and as long as the nerve block doesn’t wear off, they can very comfortably endure surgery.”

Additional benefits

An additional benefit of VR applications during surgery is two-way communication with patients, Faruki added.

The researcher said:

“The VR screen allows you to send patients messages, so you could let them know how much longer the procedure will take or ask how they’re feeling.

“The VR group also had a much higher amount of redosing of local anaesthetic around the surgery site because they’re awake and can communicate whether they’re feeling any pain.

“Whenever your heavily sedate patients, you’re often masking what you’re managing, but with VR, the patients are fully awake.”

Faruki noted that he and his research colleagues weren’t studying pain reduction, but “whether you can maintain an adequate experience for patients with less intraoperative sedation.”

Researchers are now looking at the use of VR in joint repair surgery.

Faruki said:

“We’re looking to expanding the use of VR into more high-risk populations.

“Patients receiving surgery for a broken hip, for example, may be older or have more health conditions and giving them sedation is much higher risk.

“If we can give them an adequate spinal dose of medication, yet keep them awake and comfortable and hanging out in an immersive environment, it creates an opportunity to reduce the risks associated with anaesthesia.”

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