Virtual Reality Improves Patient Experience and Anxiety During In-office Carpal Tunnel Release

Area of Science:

• Orthopedic Surgery
• Patient Experience Research
• Anesthesia Techniques

Background:

• Wide-awake local anesthesia no tourniquet (WALANT) surgery is an alternative to traditional operating room (OR) procedures.
• Patient experience is a critical factor in surgical outcomes and satisfaction.
• The role of virtual reality in augmenting patient comfort during awake procedures is emerging.

Purpose of the Study:

• To compare patient experience between WALANT surgery performed in an office setting versus a standard OR.
• To evaluate the impact of wide awake virtual reality (WAVR) on patient experience when used with office-based WALANT.

Main Methods:

• A patient-reported outcome study involving carpal tunnel release patients between August 2017 and March 2021.
• Patients were categorized by surgical location (OR vs. in-office WALANT) and WAVR use.
• Patient experience, enjoyability, and anxiety were assessed using a 7-point Likert scale.

Main Results:

• Office-based WALANT patients reported significantly better experiences, higher enjoyment, and lower anxiety than OR patients.
• The addition of WAVR to office-based WALANT further increased patient enjoyment.
• Patients with a history of anxiety disorder were more likely to opt for WAVR and reported greater anxiolysis and enjoyment when using it.

Conclusions:

• Office-based WALANT surgery significantly improves patient experience compared to traditional OR procedures.
• Wide awake virtual reality (WAVR) serves as an effective adjunct to enhance patient enjoyment and reduce anxiety during awake surgery.
• Preexisting anxiety disorder is a predictor for WAVR utilization, with positive outcomes observed.