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Intraoperative virtual reality distraction in TKA under spinal anesthesia: a preliminary study.

H Peuchot¹, R Khakha², V Riera^1,3

¹Institute for Locomotion, Department of Orthopedic Surgery, Aix-Marseille University, Sainte-Marguerite Hospital, 270, boulevard Sainte-Marguerite, 13009, Marseille, France.

Archives of Orthopaedic and Trauma Surgery

|July 22, 2021

Summary

Virtual reality (VR) distraction did not significantly reduce patient anxiety after knee replacement surgery. However, VR use decreased intraoperative adverse events and improved patient comfort.

Keywords:

Anxiety Satisfaction Sedation TKA Virtual reality

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Area of Science:

Anesthesiology
Medical Technology
Orthopedic Surgery

Background:

Patient anxiety significantly impacts perioperative recovery.
Virtual reality (VR) has emerged as a distraction technique in anesthesia.
The role of VR in managing anxiety during total knee arthroplasty (TKA) under spinal anesthesia (SA) requires further investigation.

Purpose of the Study:

To evaluate the impact of VR distraction on patient anxiety the day after TKA surgery.
To compare post-operative anxiety levels in patients undergoing TKA under SA with and without VR.
To assess secondary outcomes including sedation, intraoperative complications, pain, comfort, and satisfaction.

Main Methods:

A prospective cohort study compared TKA patients under SA with VR (group 1) to those without VR (group 2).
Patient anxiety was measured using the STAI Y-1 score.
Secondary endpoints included sedation, intraoperative complications (hypotension, oxygen need), VAS pain/comfort scores, and patient satisfaction.

Main Results:

No significant difference in post-operative anxiety (STAI Y-1) was observed between the VR and standard protocol groups.
The VR group showed a significant decrease in sedation and intraoperative adverse events (hypotension, oxygen requirement).
Postoperative comfort scores (VAS) were significantly higher in the VR group, while patient satisfaction remained unchanged.

Conclusions:

VR immersive distraction did not alter patient anxiety levels following TKA under SA.
VR use was associated with reduced intraoperative complications and enhanced postoperative comfort.
This preliminary study suggests VR is a promising tool for improving patient experience in orthopedic surgery, warranting larger trials.