Originally published by our sister publication Anesthesiology News

Patients who use a virtual reality headset during hand surgery may need less anesthesia care, according to data from a new study.

Researchers enrolled 40 adults undergoing hand surgery and randomly assigned them to receive intraoperative VR in addition to monitored anesthesia care (MAC) or standard MAC alone (PLoS One 2022;17[9]:e0272030). In both groups, patients received preoperative regional anesthesia at the discretion of the provider.

The researchers’ primary outcome was intraoperative propofol dose per hour (mg, hr-1). Patient-reported pain and anxiety, overall satisfaction, functional outcome, and PACU length of stay were included as secondary outcomes.

During the operation, the VR group viewed programming on a headset which was “designed to promote relaxation and calmness,” according to the researchers. Patients were also provided with noise-canceling headphones with which they could listen to guided meditations. Choice of which VR environment to use was left to individual participants. A total of 34 patients (VR group, n=17; control, n=17) completed the trial and contributed to the data for analysis.

Compared with the control group, patients in the VR group received substantially less propofol per hour (mean, 125.3 vs. 750.6 mg, hr-1; P<0.001).

Findings also showed that PACU length of stay was significantly shorter for VR users (53.0 minutes [median IQR, 43.0-72.0 minutes] vs. 75.0 minutes [median IQR, 57.5-89.0 minutes]; P=0.018). In both groups, breathing was characterized as normal throughout the surgery in 13 of the 17 patients. A single patient in the control group was given a nasal trumpet for upper airway obstruction and one participant in the VR group required an oral airway.

Furthermore, there was no significant difference in post-PACU pain scores, perioperative opioid analgesic dose or postoperative functional outcome between study groups.

“The results from our study do support the hypothesis that the immersive nature of VR can reduce anxiety during surgeries where propofol was regularly used for this purpose,” said lead author Adeel A. Faruki, MD, an assistant professor of anesthesiology and the program director of Advanced Perioperative Ultrasound and Clinical Training at the University of Colorado, in Aurora.

By Myles Starr

Faruki reported no relevant financial disclosures.