Use of Biofeedback-Based Virtual Reality in Pediatric Perioperative and Postoperative Settings: Observational Study

Area of Science:

• Pediatric surgery
• Virtual Reality Biofeedback (VR-BF)
• Pain Management

Background:

• VR-BF is a novel, non-pharmacologic method using gamified virtual reality to teach breathing control, enhancing heart rate variability (HRV) and potentially reducing pain.
• This study is the first to integrate VR-BF in the pediatric perioperative setting to assess feasibility and acceptability.
• The ultimate goal is to evaluate VR-BF's efficacy in reducing pain, anxiety, and opioid consumption in children undergoing surgery.

Purpose of the Study:

• To develop a clinical trial protocol for VR-BF in the pediatric perioperative setting, including preoperative and postoperative applications.
• To evaluate patient and parent experiences with VR-BF.

Main Methods:

• 23 patients (12-18 years) undergoing surgery were recruited.
• Participants completed daily 10-minute VR-BF sessions for 7 days pre-surgery and during hospitalization, with potential use up to 2 weeks post-discharge.
• VR-BF usage, HRV achievement, and patient/parent experiences via questionnaires and interviews were assessed.

Main Results:

• Achieving target HRV parameters was most likely after 4 sessions (OR 5.1).
• Session durations of 9-10 minutes showed the greatest odds of achieving target HRV parameters.
• 85% of patients reported satisfaction with VR-BF for managing perioperative stress, while 40% found it beneficial for pain.

Conclusions:

• Children and adolescents successfully learned behavioral strategies using VR-BF with 10-minute daily sessions for 5 days.
• For future clinical trials, patients will be instructed to complete three 10-minute VR-BF sessions daily for 7 days post-surgery.
• VR-BF shows promise as a therapeutic intervention for pediatric perioperative care.