VR and Video Equally Reduce Anxiety in Pediatric Surgery

TOPLINE:

Passive distraction through three-dimensional (3D) virtual reality (VR) and two-dimensional (2D) video is equally effective in reducing anxiety in children during the induction of anesthesia before surgery.

METHODOLOGY:

• Researchers conducted a randomized controlled trial including 188 children (aged 4-13 years) undergoing elective or emergency surgery under general anesthesia at Perth Children’s Hospital in Nedlands, Australia.
• Participants were randomly assigned to use either 3D VR goggles or a 2D video tablet during the induction of anesthesia, with 98 children in the VR group (mean age, 8.83 years) and 90 in the video group (mean age, 8.80 years).
• The primary outcome was anxiety measured using the modified Yale Preoperative Anxiety Scale-Short Form (mYPAS-SF) at two timepoints: In the preoperative holding area and during the induction of anesthesia.
• Secondary outcomes included compliance during induction of anesthesia; incidence of emergence delirium; usefulness of the devices as perceived by anesthesiologists, anesthetic technicians, and parents; and patient satisfaction.

TAKEAWAY:

• The researchers observed no significant difference in the increase in anxiety scores (mYPAS-SF) for children in the 3D VR and 2D video groups (P = .948).
• Children in the 3D VR group were less likely to be rated as having undergone a perfect induction by technicians (odds ratio, 0.45; P = .039).
• Both devices were rated highly for usefulness and patient satisfaction, with children preferring VR and anesthesiologists and parents preferring the 2D device.
• The incidence of emergence delirium did not differ between the two groups.

IN PRACTICE:

“The results of this randomized controlled trial demonstrated that passive video distraction through 3D VR was comparable with 2D video to limit the increase in anxiety in children at induction,” the authors wrote.

SOURCE:

The study was led by Sarah Samnakay of the Telethon Kids Institute in Perth, Australia. It was published online on August 23, 2024, in Anesthesia & Analgesia.

LIMITATIONS:

One limitation of the study was the lack of a control group that did not receive device distraction, which limits direct claims about the impact of 3D VR or 2D video on reducing anxiety compared with nonscreen-based distraction. The study did not consider prior acclimatization to the intervention, which could contribute to anxiety for some participants. The study population may have had a lower risk for high anxiety. The video used as a distraction provided a passive experience.

DISCLOSURES:

The VR devices were donated by the Be Giving charity through Perth Children’s Hospital Foundation. One author declared receiving partial funding from the Stan Perron Charitable Foundation and through a National Health and Medical Research Council Investigator Grant. The authors declared no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.