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Virtual reality ‘reduces need for intravenous sedation by 50%’

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Giving patients virtual reality sessions before and during anaesthesia for orthopaedic procedures substantially reduces pain and the need for intravenous sedation, according to Belgian researchers.

They found virtual reality hypnosis distraction (VRHD) improved tolerance of anaesthesia procedures and reduced the need for intravenous sedation by at least 50%.

“This technology has the ability to act as a preventive intervention transforming local anaesthesia”

Dragos Chirnoaga

They said VRHD could be a drug-free alternative for reducing anxiety and procedure-related pain without the side effects and longer recovery time associated with traditional intravenous sedation.

Along with many procedures, having a local anaesthetic injection could be a stressful and painful experience, and it was often combined with intravenous sedation to help patients relax, they noted.

However, the study authors also highlighted that the use of intravenous sedation was not without adverse effects, such as headache, nausea and drowsiness.

Their randomised trial tested the hypothesis that VRHD could reduce the requirement for intravenous sedation by at least 50% during local anaesthesia at the CUB Erasmus Hospital in Brussels.

They randomised 60 adults scheduled for orthopaedic surgery – shoulder, hand or knee surgeries – with locoregional anaesthesia into three groups.

In the control group, standard intravenous sedation during locoregional procedure was administered without VHRD.

In a second group of patients, VRHD was used during locoregional anaesthesia, and intravenous sedation was given if participants reported pain scores of greater than three out of 10.

Meanwhile, in the third group, VRHD before and during locoregional anaesthesia was used, and intravenous sedation given if patients reported pain scores greater than three.

“Virtual reality hypnosis distraction is feasible, well tolerated, and liked by patients”

Delphine Van Hecke

VRHD therapy consisted of wearing virtual reality goggles and headphones to watch relaxing video content of a submarine ride and life under the sea, with a calming voice guiding the journey and focused on slowing the patient’s breathing rhythm.

Just 25% of patients receiving VRHD during local anaesthesia required intravenous sedation, while only 10% given VRHD both before and during locoregional anaesthesia needed further sedation.

Additionally, patients receiving VRHD showed similar comfort and satisfaction before and during the procedure as those given intravenous sedation, according to the researchers.

Dr Dragos Chirnoaga, who co-led the research, said: “Given the immersive and distracting nature of the virtual reality experience, this technology has the ability to act as a preventive intervention transforming local anaesthesia into a less distressing and potentially pain-free medical procedure.

Fellow co-author Dr Delphine Van Hecke said: “Virtual reality hypnosis distraction is feasible, well tolerated, and liked by patients.

“While it is not clear exactly how virtual reality works to reduce anxiety and pain, it’s thought that it creates a distraction that stops the mind feeling pain,” she said.

“Further studies should focus on other procedures suited for the use of VRHD, particularly its potential benefit in children as premedication or during low pain procedures,” she added.

The research was presented earlier this month in Vienna at this year’s Euroanaesthesia Congress – the annual meeting of the European Society of Anaesthesiology.


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