Virtual reality immersion compared to monitored anesthesia care for hand surgery: A randomized controlled trial

Area of Science:

• Anesthesiology
• Surgical Innovation
• Medical Technology

Background:

• Standard anesthesia for hand surgery involves regional anesthesia and monitored anesthesia care (MAC).
• Intraoperative sedatives, while common, can lead to oversedation and complications.
• Virtual reality (VR) offers a potential non-pharmacological method to mitigate these risks.

Purpose of the Study:

• To test the hypothesis that intraoperative VR use reduces sedative dosing during elective hand surgery.
• To evaluate if VR impacts patient satisfaction compared to standard care.
• To assess the effect of VR on other perioperative outcomes.

Main Methods:

• Forty adult patients undergoing hand surgery were randomized into two groups: intraoperative VR with MAC or usual MAC.
• All patients received preoperative regional anesthesia.
• The primary outcome was intraoperative propofol dose; secondary outcomes included satisfaction, pain, and PACU length of stay (LOS).

Main Results:

• Patients using VR received significantly less propofol (125.3 mg·hr⁻¹) compared to the control group (750.6 mg·hr⁻¹).
• No significant differences were found in overall patient satisfaction between the VR and control groups.
• The VR group experienced a significantly shorter PACU LOS (53.0 min) than the control group (75.0 min).

Conclusions:

• Intraoperative VR immersion during hand surgery effectively reduces the need for intraoperative sedatives like propofol.
• VR use did not negatively affect patient satisfaction, pain, or functional outcomes.
• VR is a promising tool for reducing sedative requirements and improving efficiency in hand surgery anesthesia.