Related Experiment Video
Updated: Aug 5, 2026
Non-Intubated Video-Assisted Thoracoscopic Surgery
Published on: May 26, 2023
Perioperative immersive virtual reality intervention for acute and persistent postoperative pain after video-assisted
An-Kang Zhu1, Juan Zhang1, Yang-Ming Chen2
1Department of Thoracic Surgery, Shengli Clinical Medical College of Fujian Medical University, Fuzhou University Affiliated Provincial Hospital, No.134 Dongjie, Gulou District, Fuzhou, Fujian, 350000, China.
Background:
Postoperative pain remains a major barrier to recovery after video-assisted thoracoscopic surgery (VATS) and may progress to persistent postoperative pain. We evaluated whether perioperative immersive virtual reality (VR) could reduce acute and longer-term pain after VATS.
Methods:
A total of 120 patients undergoing elective VATS were randomized 1:1 to a VR group or a control group. The VR group received immersive VR from 1 day before surgery to postoperative days (POD) 1-3, followed by a 2-week home-based intervention. The primary outcome was pain scores during coughing over POD 1-3. Secondary outcomes included resting pain, pain on deep breathing, rescue analgesia within 72 h, subacute postoperative pain at 1 month, and persistent postoperative pain at 3 months.
Results:
Among 120 randomized patients, 100 were included in the evaluable acute pain cohort, of whom 96 completed the 3-month follow-up. Linear mixed-effects models showed significant group effects, time effects, and group × time interactions for resting pain, pain on deep breathing, and pain scores during coughing over POD 1-3. In Holm-adjusted time-point-specific comparisons, the VR group showed lower pain scores at selected postoperative time points across the three pain dimensions. A ≥30% reduction in pain during coughing was achieved in 48.1% of VR patients versus 16.7% of controls (P = 0.001). At follow-up, the VR group had lower rates of subacute postoperative pain at 1 month (24.0% vs. 56.5%, P = 0.002) and persistent postoperative pain at 3 months (10.0% vs. 32.6%, P = 0.011). Pain scores at both time points were also lower in the VR group.
Conclusion:
Perioperative immersive VR may improve acute postoperative pain recovery after VATS and may lower the risk of subacute and persistent postoperative pain. VR may serve as a useful non-pharmacological adjunct in thoracic perioperative pain management.