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Immersion in virtual reality may reduce the dose of propofol used during hand surgery

September 23, 2022

2 minutes to read

Source / Disclosures

Disclosures:
O’Jara reports that he is a consultant for Sedana Medical.


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Published results show that the use of VR immersion during hand surgery may reduce the intraoperative propofol dose and length of post-anesthetic care unit duration without adversely affecting patient-reported outcomes.

“With the increasing amount of time people spend at the keyboard along with our aging population, there is an expected increased need for common elective hand surgeries,” Brian P. O’Gara, MD, MPH, Senior author and anesthesiologist in the Department of Anesthesia, Intensive Care and Pain Medicine at Beth Israel Deaconess Medical Center, said in a press release. “Improving care for these patients will undoubtedly involve modifying anesthesia practices. The purported benefit of virtual reality is to manage patients who are experiencing pain or anxiety by providing an immersive experience capable of distracting the mind from addressing the unpleasantness of having surgery.”

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O’Gara and colleagues randomly assigned 40 patients undergoing hand surgery to receive either intraoperative virtual reality (VR) in addition to monitored anesthesia care or usual monitored anesthesia care. The researchers noted that patients in the VR group viewed the programming of their choice during surgery through a head-mounted monitor, and patients in both groups received regional anesthesia prior to surgery at the provider’s discretion. The investigators considered propofol dose during surgery per hour as the primary outcome, and patient-reported pain and anxiety, and overall satisfaction, functional outcomes, and length of stay after anesthesia (PACU) as secondary outcomes.

Among the 34 patients who completed the perioperative portion of the trial, the results showed that patients in the VR group received significantly less propofol per hour versus the control group. The researchers found no significant differences in overall patient-reported satisfaction between the two groups. Both groups also had no significant differences regarding PACU pain scores, perioperative opioid analgesic dose, or postoperative functional outcomes, according to the findings. The researchers noted that patients in the virtual reality group had significantly reduced length of stay in the pediatric intensive care unit.

“Our trial is novel in that it is the first to report a significant reduction in sedative doses with VR immersion during hand surgery on adults,” O’Gara, who is also an assistant professor of anesthesiology at Harvard Medical School, said in the statement. . “Using VR immersion technology, the potential harms of unnecessary anesthesia can be avoided without compromising patient comfort during hand surgery. Moreover, we saw that patients of the VR group were discharged from the pediatric intensive care unit 22 minutes earlier than patients of the control group. Reducing stay in the PACU helps improve perioperative efficiency if virtual reality technology is used more widely.”

References:

Faruki AA et al. PLUS ONE. 2022; doi: 10.1371/journal.pone.0272030.

Virtual reality in the operating room: Virtual reality has reduced the need for anesthesia during hand surgery. https://www.eurekalert.org/news-releases/965190? Published September 21, 2022. Accessed September 21, 2022.


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