Feasibility of implementing a virtual reality program as an adjuvant tool for peri-operative pain control; Results of a randomized controlled trial in minimally invasive foregut surgery

• Published in: Complementary therapies in medicine 2020-03, Vol.49, p.102356-102356, Article 102356
• Main Authors: Haisley, Kelly R., Straw, Olivia J., Müller, Dolores T., Antiporda, Michael A., Zihni, Ahmed M., Reavis, Kevin M., Bradley, Daniel D., Dunst, Christy M.
• Format: Article
• Language: English
• Subjects: Adjuvants; Anxiety; Complications; Computer applications; Data collection; Esophagus; Feasibility; Foregut; Hernias; Hospitals; Meditation; Mindfulness; Multimodal pain control; Narcotic utilization; Narcotics; Nausea; Pain; Patient satisfaction; Peri-operative management; Randomization; Surgery; Utilization; Virtual reality
• ISSN: 0965-2299; 1873-6963
• DOI: 10.1016/j.ctim.2020.102356

•Virtual reality can be implemented as a multimodal peri-operative pain tool.•VR can be used with minimal interruption to workflow.•Patients largely enjoy the use of VR in the perioperative setting.•Patients would like to have pain specific VR devices available.•Narcotic utilization may decrease with VR usage. Post-operative pain control and narcotic over-utilization are challenging issues for surgeons in all fields. While virtual reality (VR) has been increasingly applied in various fields, its feasibility and efficacy in the peri-operative period has not been evaluated. The aim of this study was to examine the experience of an integrated VR protocol in the perioperative setting. Patients undergoing minimally invasive foregut surgery at a single institution were randomized to receive a series of VR meditation/mindfulness sessions (VR) or to standard care after surgery (non-VR). Post-operative pain levels, narcotic utilization and patient satisfaction were tracked. Fifty-two patients were enrolled with 26 in each arm. Post-operative pain scores, total narcotic utilization, and overall satisfaction scores were not significantly different between the two groups. For patients in the VR arm, sessions were able to be incorporated into the perioperative routine with little disruption. Most (73.9 %) were able complete all six VR sessions and reported low pain, anxiety, and nausea scores while using the device. A high proportion responded that they would use VR again (76.2 %) or would like a VR program designed for pain (62.0 %). There were no complications from device usage. VR is a safe and simple intervention that is associated with high patient satisfaction and is feasible to implement in the perioperative setting. While the current study is underpowered to detect difference in narcotic utilization, this device holds promise as an adjuvant tool in multimodal pain and anxiety control in the peri-operative period.