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Virtual Reality and the Wide-Awake Hand Surgery Experience at a Rural Health Center
Kyler A Hardie1, Cole D Tessendorf2, Josefine Combs3
1Orthopedic Surgery Residency Program, University of North Dakota School of Medicine and Health Sciences.
Background:
Wide-awake, local anesthesia, no tourniquet (WALANT) surgery has been shown to be a safe technique with high patient satisfaction. However, patients may have anxiety about potential pain or the surgical environment. Virtual reality (VR) has been shown to be a safe and effective tool to improve medical procedures. This study aims to show that VR can be used for WALANT hand surgery in smaller hospital systems and describe its benefits.
Methods:
48 patients underwent WALANT using VR in a single facility's in-office procedure rooms from July 2023 to June 2024. Patients completed a preoperative questionnaire that included preoperative anxiety levels, GAD-7, and PHQ-9. Patients also reported intraoperative and postoperative anxiety levels, a "fun score" and whether the patient enjoyed using VR.
Results:
19% of patients (n=9) had GAD-7 scores >10 and 17% (n=8) had PHQ-9 scores >10. ANOVA analysis showed anxiety levels differed before, during, and after surgery (p<0.01), and t-tests showed anxiety significantly decreased from preoperative to intraoperative (p<0.01),and decreased again from intraoperative to postoperative (p<0.01). All patients enjoyed the experience with an average "fun score" of 8.54 out of 10.
Conclusions:
Using VR for wide awake (WA) hand surgery is safe, can lower patient anxiety, and results in high patient satisfaction. Because it can be used to both alleviate anxiety and increase a patient's overall experience, VR has great potential for utilization in hand surgery as well as other areas of medicine and surgery.
