A study has found that the amount of anesthesia a surgical patient needs can be reduced if they wear virtual reality (VR) glasses during the procedure.
Immersion in a virtual reality experience while in the operating room (OR) has been found to reduce pain and anxiety to the point that milder chemical sedation is required.
Scientists at Beth Israel Deaconess Medical Center in Massachusetts, USA studied the reactions of patients who wore a headset while undergoing hand surgery.
While they were able to request a sedative at any time during the procedure, the group ended up receiving lower doses than the control group who did not use VR.
They also spent less time in the post-anesthesia care unit, and reported the same level of satisfaction as the control group.
It is hoped that these findings will reduce the incidence of over-anesthesia and its adverse side effects in the future.
A study has found that the amount of anesthesia a surgical patient needs can be reduced if they wear virtual reality (VR) glasses during the procedure. A: Picture of the study patient using a virtual reality device. B: Screenshot of a typical immersive environment with an example of text communication from the study staff
While they were able to request a sedative at any time during the procedure, the group ended up receiving lower doses than the control group who did not use VR. They also spent less time in the post-anesthesia care unit, and reported the same level of satisfaction as the control group. A: The average total dose of propofol by group. B: Mean length of stay in a post-anesthetic care unit by group
Virtual reality explained
Virtual reality is a computer-generated simulation of an environment or situation.
- It immerses the user by making them feel like they are in simulated reality through images and sounds
- For example, in virtual reality, you might feel like you’re climbing a mountain while sitting at home
Virtual reality is the term used to describe a computer-generated 3D environment that anyone can explore and interact with.
This person becomes part of this virtual world or immersed in this environment and while in it, he is able to manipulate objects or perform a series of actions.
How is virtual reality achieved?
Virtual reality is usually implemented using computer technology. There are a range of systems used for this purpose, such as headphones, multi-directional treadmills, and special gloves.
These are used to stimulate our senses together to create the illusion of reality.
Senior author and anesthesiologist Dr Brian P. O’Gara said: “With the increasing amount of time people spend on the keyboard along with our aging population, there is an anticipated increased need for common elective hand surgeries.
Improving care for these patients will undoubtedly include modification of anesthesia practices.
“The purported benefit of virtual reality in managing patients with pain or anxiety is by providing an immersive experience capable of distracting the mind from addressing the unpleasantness of having surgery.”
According to the British Society for Surgery of the Hand, the demand for elective hand surgery is expected to increase by 39 per cent over the next decade.
This is due to an aging population and the prevalence of diabetes – both of which contribute to common hand conditions.
These include carpal tunnel syndrome, osteoporosis and Dupuytren’s contracture.
Patients who undergo hand surgery usually receive a local anesthetic to prevent pain in the area during the procedure, in addition to Monitored Anesthesia Care (MAC).
This usually includes a sedative given intravenously – such as propofol – to keep patients asleep and calm, but awake enough to follow instructions as needed.
However, too much anesthesia can lead to low blood pressure, upper airway obstruction, or more serious complications such as stroke, heart attack, or respiratory failure.
In this study, published today in PLoS ONE, clinicians aim to discover whether immersion in virtual reality reduces the dose of sedatives required during hand surgery, without negatively affecting patient satisfaction.
The team recruited 17 adults who were going to have hand surgery with local anesthesia and MAC to experience virtual reality during their procedure.
They wore a noise-isolating headset and headphones, and chose one of a handful of immersive 360-degree environments.
Each is designed to promote relaxation and tranquility, and options include a meadow, a forest, or a mountaintop.
Another group of 17 subjects who received local anesthesia and MAC was enrolled as a control group and did not wear a headset.
For both groups, supplementary sedation and pain relievers may be administered either at the request of the patient or on the advice of the clinical anesthesiologist.
Significantly more patients in the VR group received additional local anesthesia from the surgeon than the control group. This indicates that receiving VR-assisted preoperative anesthesia is important to the success of the technique (stored image)
The results revealed that patients in the VR group received significantly less propofol than those in the control group—an average of 260 mg less per condition.
In fact, only four patients in this group received anything at all, while every patient in the control group received the sedative.
However, the surgeon received significantly more additional local anesthesia in the VR group than in the control group.
This indicates that receiving VR-assisted preoperative anesthesia is important for the success of the technique.
Patients were also given post-operative questionnaires asking them to self-report any pain, stress or functional difficulty.
No differences in overall satisfaction were found between the virtual reality groups and the control group, and both said their pain was well controlled and they felt comfortable during surgery.
There were also no significant differences between postoperative pain scores and functional outcomes of the groups, or preoperative opioid doses.
However, the VR group was discharged from the hospital on average 22 minutes earlier than their counterparts in the control group.
“Reducing the stay in the post-anesthetic care unit could help improve perioperative efficiency if virtual reality technology is used more widely,” said Dr. Ogara.
Our experience is novel in that it is the first to report a significant reduction in sedative doses with VR immersion during adult hand surgery.
“Using virtual reality immersion technology, the potential harms of unnecessary anesthesia can be avoided without compromising patient comfort during hand surgery”
NHS medical students are now training in HOLOGRAMS to practice treating anaphylaxis and pneumonia
Patient holograms are used to train British medical students globally.
Doctors at Addenbrooke’s Hospital in Cambridge will wear virtual reality headsets and treat life-like 3D patients as part of their training.
Leading technology will be used to teach a range of modules, ranging from respiratory medicine and emergency medicine.
When wearing headphones or using smartphones or tablets, students can see each other but also interact with a multi-layered 3D patient.
The trainees will give patients medications, connect them to ventilation and read their vital signs.
Read more here
Wearing mixed reality headsets or using their smartphones or tablets, students can see each other but also interact with a multi-layered, medically accurate holographic patient