Feasibility of implementing a virtual reality program as an adjuvant tool for peri-operative pain control; Results of a randomized controlled trial in minimally invasive foregut surgery

Haisley, Kelly R.; Straw, Olivia J.; Müller, Dolores T.; Antiporda, Michael; Zihni, Ahmed M.; Reavis, Kevin M.; Bradley, Daniel Davila; Dunst, Christy M.

doi:10.1016/j.ctim.2020.102356

Cited by 53 publications

(57 citation statements)

References 17 publications

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“…In the remaining 18 articles, the full texts were examined and among them, eight articles were excluded from the analysis due to the following reasons: no full-length articles ( n = 4), patients experienced VR during surgery ( n = 1), healthy subjects ( n = 1), non-randomized trial ( n = 1), and patients in both groups experienced VR ( n = 1). Finally, a total of 10 RCTs were included in this meta-analysis ( Figure 1 ) [ 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 ]. Among them, seven studies included two groups (VR group and control group) [ 21 , 22 , 23 , 27 , 28 , 29 , 30 ], while three studies included multiple groups [ 24 , 25 , 26 ].…”

Section: Resultsmentioning

confidence: 99%

“…Among them, seven studies included two groups (VR group and control group) [ 21 , 22 , 23 , 27 , 28 , 29 , 30 ], while three studies included multiple groups [ 24 , 25 , 26 ]. Of these three studies with multiple groups, two included four groups (two intervention groups and two control groups) [ 24 , 25 ]. According to the Cochrane guidelines [ 18 ], we combined two intervention groups into a single VR group and two control groups into a single control group.…”

Section: Resultsmentioning

confidence: 99%

“…The preoperative anxiety score was measured and reported in 10 RCTs, including 813 patients [ 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 ]. It was measured with various tools, including modified Yale Preoperative Anxiety Scale [ 23 , 27 , 28 , 29 ], Yale Preoperative Anxiety Scale [ 22 ], Amsterdam Preoperative Anxiety and Information score [ 21 , 30 ], Hospital Anxiety and Depression Scale [ 26 ], Visual Analogue Scale [ 25 ], or Numeric Rating Scale [ 24 ]. A high score corresponded to a high level of anxiety in 9 RCTs [ 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 ], whereas it was associated with a low level of anxiety in 1 RCT [ 21 ].…”

Section: Resultsmentioning

confidence: 99%

“…It was measured with various tools, including modified Yale Preoperative Anxiety Scale [ 23 , 27 , 28 , 29 ], Yale Preoperative Anxiety Scale [ 22 ], Amsterdam Preoperative Anxiety and Information score [ 21 , 30 ], Hospital Anxiety and Depression Scale [ 26 ], Visual Analogue Scale [ 25 ], or Numeric Rating Scale [ 24 ]. A high score corresponded to a high level of anxiety in 9 RCTs [ 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 ], whereas it was associated with a low level of anxiety in 1 RCT [ 21 ]. Therefore, we multiplied the mean values from a given study by “−1” to ensure that all the scales were moving in the same direction, according to the Cochrane guidelines [ 18 ].…”

Section: Resultsmentioning

confidence: 99%

“…Therefore, we multiplied the mean values from a given study by “−1” to ensure that all the scales were moving in the same direction, according to the Cochrane guidelines [ 18 ]. The preoperative anxiety scores were presented as the means with SD in two RCTs [ 24 , 25 ], median with interquartile range in four RCTs [ 23 , 27 , 28 , 30 ], and mean difference with 95% CI between two groups in two RCTs [ 21 , 29 ]. Robertson et al [ 26 ] presented the change in scores, from baseline to post-intervention, without baseline values.…”

Section: Resultsmentioning

confidence: 99%

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The Effect of Virtual Reality on Preoperative Anxiety: A Meta-Analysis of Randomized Controlled Trials

Koo

Park

Ryu

et al. 2020

JCM

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Virtual reality (VR), a technology that provides a stimulated sensory experience, has recently been implemented in various fields of medicine. Several studies have investigated the efficacy of VR on preoperative anxiety. The purpose of this meta-analysis was to validate whether VR could relieve preoperative anxiety in patients undergoing surgery. Electronic databases were searched to identify all randomized controlled trials (RCTs) investigating the effect of VR on preoperative anxiety. The primary outcome was defined as the preoperative anxiety scores. We estimated the effect size using the standard mean difference (SMD) with a 95% confidence interval (CI) using a random effect model. Ultimately, 10 RCTs, with a total of 813 patients, were included in the final analysis. Preoperative anxiety was significantly lower in the VR group than in the control group (SMD −0.64, 95% CI −1.08 to −0.20, p = 0.004). In a subgroup analysis, the preoperative anxiety scores were lower in the VR group than in the control group in pediatric patients (SMD −0.71, 95% CI −1.14 to −0.27, p = 0.002), whereas a significant difference was not observed between the two groups in adult patients (p = 0.226). The results of this meta-analysis indicated that VR could decrease preoperative anxiety, especially in pediatric patients.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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The Effect of Virtual Reality on Preoperative Anxiety: A Meta-Analysis of Randomized Controlled Trials

Koo

Park

Ryu

et al. 2020

JCM

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Virtual Reality–Based Intervention to Reduce Preoperative Anxiety in Adults Undergoing Elective Surgery

Chiu,

Li,

Yap

et al. 2023

JAMA Netw Open

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IMPORTANCEPreoperative anxiety is common among adult patients undergoing elective surgery and is associated with negative outcomes. Virtual reality (VR)–based interventions have been considered simpler, safer, and more effective for reducing anxiety in patients undergoing surgery than conventional care.OBJECTIVETo examine the effectiveness of a VR-based intervention with preoperative education in reducing preoperative anxiety among adult patients undergoing elective surgery.DESIGN, SETTING, AND PARTICIPANTSAn assessor-blinded prospective randomized clinical trial was conducted to recruit adult patients aged 18 years or older who were scheduled for their first elective surgery procedure under general anesthesia within the next 2 to 4 weeks at a preanesthesia assessment clinic in Hong Kong from July to December 2022.INTERVENTIONSParticipants were randomly assigned to either an intervention group (an 8-minute immersive 360° VR video tour in the operating theater via a head-mounted display console) or a control group (standard care).MAIN OUTCOMES AND MEASURESThe primary outcome of preoperative anxiety was measured using the Amsterdam Preoperative Anxiety and Information Scale (range, 6-30; higher scores indicate greater anxiety), and the secondary outcomes (ie, stress, preparedness, and pain) were assessed by Visual Analog Scale at 3 time points: baseline at beginning of clinical session (T0), at the end of the clinical session immediately after the intervention (T1), and before the surgery (T2). Pain, satisfaction levels, and postoperative length of stay were evaluated after the surgery (T3). Simulation sickness was assessed after the intervention by use of the Simulation Sickness Questionnaire. A generalized estimating equations model was applied to compare changes in outcomes over time.RESULTSA total of 74 participants (mean [SD] age, 46.34 [14.52] years; 38 men [51.4%] and 36 women [48.6%]) were recruited and randomized to the control group (37 participants) and intervention group (37 participants). Compared with the control group, the VR-based intervention group showed significantly decreased preoperative anxiety at T1 (β, −5.46; 95% CI, −7.60 to −3.32; P &lt; .001) and T2 (β, −5.57; 95% CI, −7.73 to −3.41; P &lt; .001), lower stress at T1 (β, −10.68; 95% CI, −16.00 to −5.36; P &lt; .001) and T2 (β, −5.16; 95% CI, −9.87 to −0.45; P = .03), and higher preparedness at T1 (β, 6.60; 95% CI, 0.97 to 12.19; P = .02). Satisfaction levels were significantly increased in the intervention group vs the control group (mean [SD] score, 81.35 [9.24] vs 65.28 [8.16]; difference, 16.07; 95% CI, 12.00 to 20.15; P &lt; .001). No significant differences in pain and postoperative length of stay were found.CONCLUSIONS AND RELEVANCEThe findings of this study suggest that a VR-based intervention is a feasible and effective way to reduce preoperative anxiety in adult patients undergoing elective surgery. Given the promising results of this study, further study in the form of large-scale, multicenter, randomized clinical trials with broader implementation is warranted.TRIAL REGISTRATIONChinese Clinical Trial Registry Identifier: ChiCTR2100051690

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Using a Virtual Reality and Communication Intervention to Reduce Pain and Anxiety in Patients Undergoing Lipoma Excision With Local Anesthesia: A Randomized Controlled Trial

Yeşilot¹,

Çiftçi²,

Yener³

2022

AORN Journal

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In this randomized controlled trial, we assessed the effects of using a virtual reality (VR) and communication intervention on pain and anxiety in patients undergoing lipoma excision under local anesthesia. We conducted the study at a large hospital in Turkey between March 15 and September 15, 2019, with 100 participants. We used a pretest and posttest design to collect data with a personal information form, the Numeric Pain Rating Scale, and the State‐Trait Anxiety Inventory. The intervention group participants watched a video using a VR headset during the procedure and communicated with an investigator; the control group participants only received routine surgical treatment. The intervention had a significant effect on pain during the procedure (P < .001) and a moderate effect on anxiety 60 minutes after the procedure (P = .01). Use of VR and active communication may help reduce pain and anxiety for patients undergoing procedures performed with local anesthesia.

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Feasibility of implementing a virtual reality program as an adjuvant tool for peri-operative pain control; Results of a randomized controlled trial in minimally invasive foregut surgery

Cited by 53 publications

References 17 publications

The Effect of Virtual Reality on Preoperative Anxiety: A Meta-Analysis of Randomized Controlled Trials

The Effect of Virtual Reality on Preoperative Anxiety: A Meta-Analysis of Randomized Controlled Trials

Virtual Reality–Based Intervention to Reduce Preoperative Anxiety in Adults Undergoing Elective Surgery

Using a Virtual Reality and Communication Intervention to Reduce Pain and Anxiety in Patients Undergoing Lipoma Excision With Local Anesthesia: A Randomized Controlled Trial

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