Randomized clinical trial of immersive virtual reality tour of the operating theatre in children before anaesthesia

Ryu, Jin Suk; Park, Seong‐Jik; Park, Jang Won; Kim, J.-W.; Yoo, Hee Jeong; Kim, T.-W.; Hong, Jeongpyo; Han, Sung Hee

doi:10.1002/bjs.10684

Cited by 123 publications

(198 citation statements)

References 18 publications

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“…There was no difference in the baseline preoperative anxiety between the two groups, and a VR tour of the operating theater reduced preoperative anxiety by about 20% compared with the conventional method. This result was in line with a previous investigation, which evaluated the effect of VR tour of the OR on preoperative anxiety as well as the compliance during induction of anesthesia …”

Section: Discussionsupporting

confidence: 92%

“…The VR tour was provided as described by Ryu et al . The 4‐minute video of the VR tour, a 360° movie, introduced and explained the perioperative preparation process.…”

Section: Methodsmentioning

confidence: 99%

“…Currently available strategies for managing preoperative anxiety include premedication, parental presence during induction of anesthesia, various behavioral preparation programs for distraction and preprocedural tour, or informative education . Among preprocedural educations, virtual reality (VR) tour of the operating theater with smartphone and head‐mounted display provided a vivid experience about the operating theater to children and parents without organizational and financial limits . The main characteristics offered by VR technology are the high immersion and real‐time interaction, which is realized with a sense of presence in the VR .…”

Section: Introductionmentioning

confidence: 99%

“…The main characteristics offered by VR technology are the high immersion and real‐time interaction, which is realized with a sense of presence in the VR . In a previous investigation, immersive VR tour of the operating theater prior to induction of anesthesia significantly reduced preoperative anxiety in children undergoing elective surgery and general anesthesia . However, the effect of immersive VR tour of the operating theater on ED and postoperative behavioral disturbance has not been investigated during the perioperative setting.…”

Section: Introductionmentioning

confidence: 99%

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The effect of an immersive virtual reality tour of the operating theater on emergence delirium in children undergoing general anesthesia: A randomized controlled trial

Ryu

Yoo

et al. 2018

Pediatric Anesthesia

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Summary Background and Aims An immersive virtual reality tour of the operating theater could reduce preoperative anxiety. This study was designed to determine whether a preoperative immersive virtual reality tour demonstrates a reduction in emergence delirium through reducing the preoperative anxiety in children undergoing general anesthesia. Methods Eighty‐six children were randomly allocated into either the control or virtual reality group. The control group received conventional education regarding the perioperative process. The virtual reality group watched a 4‐minute virtual reality video showing the operating theater and explaining the perioperative process. Incidence and severity of emergence delirium were the main outcomes. Secondary outcomes included preoperative anxiety using modified Yale Preoperative Anxiety Scale and postoperative behavioral disturbance. Results Eighty children completed the final analysis (control group = 39, virtual reality group = 41). The incidence (risk ratio [95% CI]: 1.1 [0.5‐2.8], P = 0.773) and severity of emergence delirium (mean difference [95% CI]: −0.2 [−2.7 to 2.2], P = 0.791) were similar in the two groups. After the intervention, children in the virtual reality group had a significantly lower modified Yale Preoperative Anxiety score than those in the control group (mean difference [95% CI]: 9.2 [0.3‐18.2], P = 0.022). No difference was observed regarding postoperative behavioral disturbance between the two groups at postoperative 1 day (mean difference [95% CI]: −0.1 [−0.3 to 0.1], P = 0.671) and 14 day (mean difference [95% CI]: −0.0 [−0.1 to 0.0], P = 0.329). Conclusion Preoperative immersive virtual reality tour of the operating theater did not reduce the incidence and severity of emergence delirium, although it was effective in alleviating preoperative anxiety in children.

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Section: Discussionsupporting

confidence: 92%

“…The VR tour was provided as described by Ryu et al . The 4‐minute video of the VR tour, a 360° movie, introduced and explained the perioperative preparation process.…”

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The effect of an immersive virtual reality tour of the operating theater on emergence delirium in children undergoing general anesthesia: A randomized controlled trial

Ryu

Yoo

et al. 2018

Pediatric Anesthesia

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“…Consequently, the preanesthetic consultation should focus on reassuring patients and explain what to expect intraoperatively and during the postoperative period. The development of specific booklets or online videos explaining the course of events during the perioperative period has been previously found to decrease anxiety at induction of anesthesia . Given the limited time available at the preanesthetic consultation, any booklets and videos should be provided beforehand, leaving time to concentrate on anesthetic safety issues, to reassure parents and patients and to respond to any questions that arise.…”

Section: Discussionmentioning

confidence: 99%

Description of typical personality factors and events that lead to anxiety at induction of anesthesia in French children

Delivet

Beauvais

Mialot

et al. 2018

Pediatric Anesthesia

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Summary Background Preventive strategies are available to reduce preoperative anxiety in children, the ideal time for implementing such strategies remains poorly determined. Aims The aim of this study was to determine psychological factors and events involved in the development of preoperative anxiety in children. Methods This study consisted of prospective evaluations of anxiety trait and state during the preoperative period. Attendance at a preanesthetic consultation is obligatory for all patients undergoing surgery in France. Anxiety trait and state assessments were quantified in mothers and children before and after the preanesthetic consultation using visual analog and faces numerical scales. Preoperative anxiety in children was assessed immediately before induction of anesthesia using an analog scale. Other data recorded included demographic and medical data and type of hospital stay. Univariate and multivariate logistic regression analyses were used. Results Overall 111 consecutive patients were included. The following factors emerged leading to anxiety state at induction of anesthesia: maternal anxiety state before the preanesthetic consultation, a feeling of not being reassured by the anesthesiologist, maternal anxiety state after the consultation, and anxiety trait in the child. Logistic regression found this combination of factors (OR = 4 [1.4 ‐12]) and inpatient stay (OR = 3 [1.4‐7]), predicting anxiety with an accuracy of 69%. Conclusion The present study identified a combination of psychological factors and events associated with the development of anxiety at induction of anesthesia in children. Parental anxiety impacts upon children and occurs before the preanesthetic consultation. This result may assist clinicians to prescribe personalized preventive strategies against anxiety.

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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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Randomized clinical trial of immersive virtual reality tour of the operating theatre in children before anaesthesia

Abstract: This preoperative VR tour of the operating theatre was effective in alleviating preoperative anxiety and increasing compliance during induction of anaesthesia in children undergoing elective surgery. Registration number: UMIN000025232 (http://www.umin.ac.jp/ctr).

Cited by 123 publications

References 18 publications

The effect of an immersive virtual reality tour of the operating theater on emergence delirium in children undergoing general anesthesia: A randomized controlled trial

The effect of an immersive virtual reality tour of the operating theater on emergence delirium in children undergoing general anesthesia: A randomized controlled trial

Description of typical personality factors and events that lead to anxiety at induction of anesthesia in French children

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

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