Patients in VR during surgery need fewer sedatives, trial finds

Patients in VR during surgery need fewer sedatives, trial finds

A fascinating clinical trial has reported that virtual reality immersion can reduce the amount of anesthesia needed during certain types of hand surgery. The trial found that patients using virtual reality could undergo full surgery with only local anesthesia.

Researchers are exploring a number of new medical uses for VR technology, ranging from using VR as a tool for managing chronic back pain to incorporating it into cutting-edge psychedelic therapies. But can virtual reality be used to replace anesthesia in surgical procedures?

As a replacement for sedation during minor procedures such as endoscopy or complex dressing changes, VR has been shown to be somewhat effective. However, in more serious procedures, such as orthopedic surgery, the technology has not been as successful.

In this study, the researchers focused on hand surgeries, increasingly common procedures that frequently require complete unconscious sedation with a drug called propofol. Brian P. O’Gara, lead author of the new study, said changing the amount of sedation used in these procedures will make them safer for patients and faster to perform.

“With the increase in the amount of time people spend at the keyboard combined with our aging population, there is a projected increased need for routine elective hand surgeries,” O’Gara said. “Optimizing care for these patients will undoubtedly involve modifying anesthetic practices.”

The research recruited 34 patients scheduled for hand surgery and randomized them to a VR or control group. The VR group wore a headset for the procedure and engaged in a calming experience of their choosing, such as a 360-degree environment on top of a mountain.

The procedure began using only localized anesthesia blocking the nerves. At all stages of surgery, patients could request either additional local anesthesia or propofol to put them to sleep.

Only four of the 17 patients in the VR group ultimately received propofol during the procedure, while every patient in the control group required more extensive anesthesia. Interestingly, VR patients ultimately used more local anesthetic in their procedures, but were discharged from post-surgical care an average of 22 minutes earlier than patients in the control group.

This suggests that virtual reality could offer a number of benefits to patients and hospitals in certain settings. Propofol sedation is not without minor risks, and in some frail patients it can lead to persistent complications.

Lighter sedation also means shorter wait times for patients after surgeries, providing hospitals with more efficient protocols to cope with higher volumes of procedures.

“Our trial is novel in that it is the first to report a significant reduction in virtual reality immersion sedative dosage during hand surgery in adults,” O’Gara added. “Through virtual reality immersion, potential harm from unnecessary sedation can be avoided without compromising patient comfort during hand surgery.”

The new research has been published in PLOS A.

Source: Beth Israel Deaconess Medical Center

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