The Promise of Virtual Reality in Surgery
Two recent pilot studies are extending the possible use cases of VR into surgery, both intraoperatively and in post-operative recovery.
November 3, 2022
The use of virtual reality to combat anxiety, chronic pain, and cognitive decline is well established. Now, two recent pilot studies are extending the possible use cases of VR into the surgical theater, both intraoperatively and in post-operative recovery.
The studies found the use of VR reduced the amount of medication administered to patients who used VR compared to control groups; one found no difference in post-op pain scores while the other found noticeable reduction in pain scores. Both studies also made it a point to note that published work exploring the efficacy of VR in treating pain both during and after surgery was still rare.
“I had seen how VR was used by hospitalists dealing with pain in the hospital,” Vivek Pandrangi, M.D., a fourth-year resident physician at the Oregon Health & Science University, first author of the study published in June in JAMA Otolaryngology, said. “From my standpoint, what was being done in the surgical field was so minimal. Nothing was done in the field of ENT, especially among our hospitalized patients after surgery, so it made sense to see what it might bring to a patient in that context.”
What Pandrangi and his colleagues found, and what the authors of the other study, conducted at Beth Israel Deaconess Hospital in Boston and published in PLOS One, showed promise for VR in surgical pain relief.
In a trial of 30 patients hospitalized after head and neck surgery, Pandrangi and his colleagues found that the use of a 3-dimensional immersive VR experience reduced post-intervention pain scores more than a 2-D control intervention of the same technology. Use of VR was also associated with what they called “meaningful” 4- and 8-hour reductions in post-intervention opioid use compared with preintervention opioid use.
The Beth Israel Deaconess researchers found patients who received perioperative VR treatment received significantly less propofol per hour than the control group, while there were no significant differences between groups in patient reported overall satisfaction, post-anesthesia care unit pain scores, perioperative opioid analgesic dose, or in postoperative functional outcome. PACU length of stay was significantly decreased in the VR group.
Both studies were small (34 in the Beth Israel Deaconess study and 29 in the Oregon study), and among the limitations both noted was a difficulty in blinding participants. But both teams are moving forward in designing larger studies given the pilots’ results.