Impact of preoperative audiovisual distraction on emergence agitation in patients undergoing orthognathic surgery: a...

Emergence agitation is an adverse complication following general anesthesia in patients undergoing orthognathic surgery and associated with anxiety and pain. Audiovisual distraction may reduce perioperative anxiety and pain. In this study, we aimed to investigate the feasibility of preoperative audiovisual distraction with video goggles in patients undergoing orthognathic surgery and estimate its potential for preventing emergence agitation.

A prospective, randomized, single-blinded pilot study was conducted in 40 patients undergoing orthognathic surgery under general anesthesia. Participants were randomly assigned to receive either preoperative audiovisual distraction with video goggles (intervention group) or standard care alone (control). A blinded outcome assessment was also performed. The predictor variable was the use of video goggles. The primary endpoint was postoperative agitation according to Aono's four-point scale. Secondary endpoints included agitation by the Richmond Agitation-Sedation Scale, postoperative pain, nausea, and vomiting measured using an 11-point numeric rating scale, length of stay in the recovery room, and the Quality of Recovery score. Descriptive statistics were calculated.

Of the 43 screened patients, 42 consented to participate (consent rate: 97.7 %). Audiovisual distraction was successfully implemented in all patients in the intervention group. No adverse effects or harm were observed. Severe agitation was less frequent in patients who used video goggles (21%) than in the control group (40%). No clinically significant differences were observed in postoperative pain, nausea and vomiting, recovery room stay, or patient satisfaction.

For adults undergoing orthognathic surgery, audiovisual distraction prior to induction of general anesthesia is safe, feasible, and well-accepted. This may also influence the incidence of emergence agitation. Funding: The authors received no funding and declare no conflict of interest.Trial registration: Registered in the German Clinical Trials Register (DRKS00030349) on 05/10/2022.