Virtual reality distraction decreases routine intravenous sedation and procedure-related pain during preoperative adductor canal catheter insertion: a retrospective study

Abstract

BackgroundVirtual reality (VR) distraction is a nonpharmacological method to prevent acute pain that has not yet been thoroughly explored for anesthesiology. We present our experience using VR distraction to decrease routine intravenous sedation for patients undergoing preoperative perineural catheter insertion.MethodsThis 1-month quality improvement project involved all elective unilateral primary total knee arthroplasty patients who received a preoperative adductor canal catheter. Clinical data were analyzed retrospectively. For the first half of the month, all patients received usual care; intravenous sedation was administered at the discretion of the regional anesthesiologist. For the second half of the month, patients were offered VR distraction with intravenous sedation upon request. The primary outcome was fentanyl dosage; other outcomes included midazolam dosage, procedure-related pain, procedural time, and blood pressure changes.ResultsSeven patients received usual care and seven used VR. In the VR group, 1/7 received intravenous sedation versus 6/7 who received usual care (P = 0.029). The fentanyl dose was lower (median [10th–90th percentiles]) in the VR group (0 [0–20] µg) versus the non-VR group (50 [30–100] µg; P = 0.008). Midazolam use was lower in the VR group (0 [0–0] mg) than in the non-VR group (1 [0–1] mg; P = 0.024). Procedure-related pain was lower in the VR group (1 [1–4] NRS) versus the non-VR group (3 [2–6] NRS; P = 0.032). There was no difference in other outcomes.ConclusionsVR distraction may provide an effective nonpharmacological alternative to intravenous sedation for the ultrasound-guided placement of certain perineural catheters.

Virtual reality as a distraction technique for pain and anxiety among patients with breast cancer: A randomized control trial

“…The mean of pain score in the intervention group was lower than the comparison group after the intervention. This findings support the work of other researchers who used VR distraction interventions during painful procedures (Chan & Scharf, 2017;Gromala et al, 2015;Pandya et al, 2017).…”

Virtual Reality Distraction during Endoscopic Urologic Surgery under Spinal Anesthesia: A Randomized Controlled Trial

“…VR has been studied for its potential use in simulated medical training [17,18], pain control for medical procedures and physical trauma [19,20,21], and rehabilitation of patients with stroke or Parkinson’s disease [22,23]. Recently, VR distraction has been studied in regional anesthesia to assess its sedation and analgesic-sparing effects [12,24]. However, the studies included only a small number of patients as a pilot and feasibility study or were retrospective in nature.…”

Effects of immersive virtual reality therapy on intravenous patient-controlled sedation during orthopaedic surgery under regional anesthesia: A randomized controlled trial

“…There have been several other studies that demonstrate a sedation or analgesic sparing effect of IVR [7][8][9][10][11]. Further efforts have also been made to commercialize IVR, with little high-quality evidence of effectiveness [12].…”