Virtual Reality for Perioperative Care in Cardiac Surgery: A Systematic Review and Meta-Analysis.

Area of Science:

• Cardiology
• Medical Technology
• Psychological Medicine

Background:

• Cardiac surgery causes significant stress, leading to preoperative anxiety and postoperative pain.
• Existing perioperative care advances haven't fully resolved these issues.
• Nonpharmacological interventions are needed to complement current treatments.

Purpose of the Study:

• To systematically review and meta-analyze randomized controlled trials (RCTs) on virtual reality (VR) use in adult cardiac surgery.
• To assess VR's impact on anxiety, pain, and patient satisfaction.
• To evaluate VR's effect on physiological responses and safety.

Main Methods:

• Systematic review and meta-analysis following PRISMA 2020 guidelines.
• Searched PubMed, Embase, and Cochrane Library up to October 2025.
• Included 9 RCTs (888 participants), assessed risk of bias (RoB 2) and evidence certainty (GRADE).

Main Results:

• A nonsignificant trend towards reduced preoperative anxiety with VR (SMD = -0.23).
• Nonsignificant trend favoring VR for patient satisfaction (SMD = 0.36).
• VR showed potential to lower heart rate and blood pressure, but findings were heterogeneous; no consistent analgesic benefit found.

Conclusions:

• Virtual reality is a feasible and safe adjunctive therapy in cardiac surgery.
• VR demonstrates favorable, though nonsignificant, trends in reducing anxiety and enhancing patient satisfaction.
• Further large-scale RCTs are required to confirm VR's clinical utility and physiological effects.