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

Area of Science:

• Anesthesiology
• Surgical Innovation
• Patient Experience

Background:

• Traditional sedation protocols for spinal anesthesia, often using midazolam, are linked to potential complications.
• Exploring alternative, non-pharmacological methods to enhance patient comfort and safety during procedures is crucial.

Purpose of the Study:

• To evaluate the efficacy of virtual reality (VR) distraction as a non-pharmacological alternative to midazolam sedation.
• To compare patient, surgeon, and anesthesiologist satisfaction levels between VR distraction and pharmacologic sedation.
• To assess the impact on respiratory side effects, specifically apnea, during endoscopic urologic surgery under spinal anesthesia.

Main Methods:

• A randomized controlled trial comparing VR distraction versus midazolam sedation in 37 patients undergoing urologic surgery under spinal anesthesia.
• Patient, surgeon, and anesthesiologist satisfaction were measured using a 5-point verbal rating scale.
• Incidence of apnea was recorded as a key safety outcome.

Main Results:

• Anesthesiologist satisfaction scores were significantly higher in the VR group (median 5) compared to the sedation group (median 4; p=0.005).
• The VR group demonstrated a significantly lower incidence of apnea (5.6%) versus the sedation group (36.8%; p=0.042).
• Both patients and anesthesiologists showed a higher likelihood of extreme satisfaction with VR distraction.

Conclusions:

• Virtual reality distraction provides superior satisfaction for patients and anesthesiologists compared to midazolam sedation during endoscopic urologic procedures.
• VR distraction effectively mitigates respiratory side effects, such as apnea, associated with midazolam use.
• VR distraction represents a promising, safer alternative to pharmacologic sedation in this surgical setting.