H Peuchot1, R Khakha2, V Riera1,3, M Ollivier1, J-N Argenson4. 1. Institute for Locomotion, Department of Orthopedic Surgery, Aix-Marseille University, Sainte-Marguerite Hospital, 270, boulevard Sainte-Marguerite, 13009, Marseille, France. 2. Guys and St Thomas' Hospitals, London, England. 3. Department of Anesthesiology, Aix-Marseille University, Marseille, France. 4. Institute for Locomotion, Department of Orthopedic Surgery, Aix-Marseille University, Sainte-Marguerite Hospital, 270, boulevard Sainte-Marguerite, 13009, Marseille, France. jean-noel.argenson@ap-hm.fr.
Abstract
INTRODUCTION: The effect of patient anxiety during the perioperative period has been shown to be of great importance in its influence on post-operative recovery. Over the last 10 years, virtual reality (VR) has been developed in anesthesia for patient's distraction by immersion. The aim of this study was to evaluate post-operative patient anxiety the day after TKA surgery under spinal anesthesia (SA) with or without VR distraction. MATERIALS AND METHODS: A single-center, prospective cohort study was performed looking at patients undergoing TKA surgery under SA with a VR headset (group 1) compared with those undergoing the same procedure with standard protocol (group 2). Data using a validated scoring system looking at patient anxiety (STAI Y-1) were collected. Secondary endpoints were need for sedation during surgery, intraoperative complications (hypotension and oxygen need), postoperative pain and comfort scores (VAS) and patient satisfaction. RESULTS: Ten patients (group 1) received the VR headset during surgery and 10 (group 2) received the standard protocol established in our center. Average age was 73 years old. No difference was found in post-operative patient anxiety regarding to STAI Y-1 score (95% CI - 7 to 10, p = 0.71. There was a decrease of sedation and intra-operative adverse event as hypotension and oxygen requirement in group 1 (p < 0.0001, p = 0.015, p = 0.0054), and a significant increase in comfort score (p = 0.002). No difference in patient satisfaction was found. CONCLUSION: Using VR for immersive distraction seemed to lead to no difference in patient anxiety in TKA under SA. Intra-operative adverse events were decreased, and post-operative comfort was increased. Patient satisfaction was not modified. This preliminary study is encouraging and gives us arguments to involve larger number of patients while exploring the various possibilities offered by VR.
INTRODUCTION: The effect of patientanxiety during the perioperative period has been shown to be of great importance in its influence on post-operative recovery. Over the last 10 years, virtual reality (VR) has been developed in anesthesia for patient's distraction by immersion. The aim of this study was to evaluate post-operative patientanxiety the day after TKA surgery under spinal anesthesia (SA) with or without VR distraction. MATERIALS AND METHODS: A single-center, prospective cohort study was performed looking at patients undergoing TKA surgery under SA with a VR headset (group 1) compared with those undergoing the same procedure with standard protocol (group 2). Data using a validated scoring system looking at patientanxiety (STAI Y-1) were collected. Secondary endpoints were need for sedation during surgery, intraoperative complications (hypotension and oxygen need), postoperative pain and comfort scores (VAS) and patient satisfaction. RESULTS: Ten patients (group 1) received the VR headset during surgery and 10 (group 2) received the standard protocol established in our center. Average age was 73 years old. No difference was found in post-operative patientanxiety regarding to STAI Y-1 score (95% CI - 7 to 10, p = 0.71. There was a decrease of sedation and intra-operative adverse event as hypotension and oxygen requirement in group 1 (p < 0.0001, p = 0.015, p = 0.0054), and a significant increase in comfort score (p = 0.002). No difference in patient satisfaction was found. CONCLUSION: Using VR for immersive distraction seemed to lead to no difference in patientanxiety in TKA under SA. Intra-operative adverse events were decreased, and post-operative comfort was increased. Patient satisfaction was not modified. This preliminary study is encouraging and gives us arguments to involve larger number of patients while exploring the various possibilities offered by VR.
Authors: Ediana Hoxhallari; Ian J Behr; Jonathan S Bradshaw; Michael S Morkos; Pam S Haan; Maureen C Schaefer; James H W Clarkson Journal: Plast Reconstr Surg Date: 2019-08 Impact factor: 4.730
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