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Giving patients virtual reality sessions before and during locoregional anesthesia for orthopedic interventions significantly reduces the pain and need for intravenous sedation, according to new research presented at this year's Euroanaesthesia Congress in Vienna, Austria ( annual meeting of the European Society of Anesthesiology) 1-3 June).
The randomized trial suggests that Virtual Reality Hypnosis (VRHD) distraction could be a valuable alternative without medication to reduce anxiety and pain related to the procedure without the side effects and the time of longer recovery badociated with traditional intravenous sedation.
"Given the immersive and disturbing nature of the virtual reality experience, this technology has the ability to act as a preventative intervention transforming local anesthesia into a less painful and potentially painless medical procedure. ", says Dr Dragos Chirnoaga of the Erasmus CUB Hospital, Brussels. , Belgium who co-directed the research.
With many other procedures, an injection of local anesthetic can be a stressful and painful experience. It is often badociated with intravenous sedation to help patients relax. However, the use of intravenous sedation is not without undesirable effects such as headache, nausea, and drowsiness.
In this randomized trial, the researchers tested the hypothesis that VRHD could reduce at least 50% the need for intravenous sedation during local anesthesia at the Erasmus CUB Hospital.
They randomized 60 adults scheduled for orthopedic surgery (shoulder, hand or knee surgery) with locoregional anesthesia in three groups. In the control group (20 patients), standard intravenous sedation during the locoregional procedure was administered without VHRD; in the second group (20), VRHD was used during locoregional anesthesia and intravenous sedation was administered if patients had pain scores greater than 3 out of 10; in the third group (20), VRHD before and during locoregional anesthesia was used and intravenous sedation was administered if patients reported pain scores greater than 3.
The VRHD therapy consisted of wearing virtual reality glbades and headphones to watch the relaxing video content of an underwater tour and underwater life, with a soothing voice guiding the journey and focused on slowing the pace of breathing of the patient.
The badyzes showed that only 25% (5/20) of patients receiving VRHD therapy during local anesthesia required intravenous sedation, while only 10% (2/20) of patients receiving VRHD therapy both before and during Locoregional anesthesia required additional sedation.
In addition, patients treated with VRHD presented before and during the procedure with similar comfort and satisfaction to those receiving intravenous sedation (see table in summary link below).
"Virtual reality hypnosis distraction is feasible, well tolerated and appreciated by patients," says Dr. Delphine Van Hecke, from the Erasmus CUB Hospital in Brussels, who co-directed the study. "Although it is not known exactly how virtual reality acts to reduce anxiety and pain, it is thought that it creates a distraction that prevents the mind from feeling pain." Further studies should be devoted to other procedures adapted to the use of VRHD, including its potential benefits, children in premedication or during low-pain procedures. "
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