PhD Scientific Days 2024

Budapest, 9-10 July 2024

Poster Session C - Mental Health Sciences 1.

Virtual reality as a tool for distraction in the perioperative period for anxiolysis in adolescents with pectus deformity: a randomized control trial


Sarolta Trinh1, János Pápai2, Judit Csillag3, Melinda Kis-Tamás3, Attila Kálmán2, Balázs Hauser3, Agnes Jermendy2
1: Semmelweis Egyetem ÁOK I. sz. Gyermekgyógyászati Klinika
2: Paediatric Centre
3: Department of Anaesthesiology and Intensive Therapy

Text of the abstract

Surgery for pectus deformity is minimally invasive, however, the postoperative discomfort can be significant due to the reconstruction of the thorax’ anatomy, and patients tend to be anxious in the perioperative period. Virtual reality (VR) is a non-invasive, non-pharmacological modality that may reduce anxiety in the pediatric population.
We aimed to assess if immersive VR as a distraction tool could lower anxiety associated with pectus repair surgery in adolescents.
In this single-center, randomized-controlled study, 34 patients aged 14-18 were enrolled to this ongoing study since 2022. Patients were scheduled for elective surgery with general anesthesia and were randomly allocated to VR (n=18) or control (n=16) group. Heart rate (HR), blood pressure (BP), oxygen saturation (SpO2), and respiratory rate (RR) were recorded and Strait-Trait Anxiety Inventory (STAI) test was filled out upon admission to the hospital, on arrival to the operating room and in the morning after the surgery. All patients received midazolam as premedication. Patients assigned to the VR group received a VR headset and underwent audiovisual distraction for a minimum of 1 hour before the surgery and optionally after the procedure. The main outcome was the STAI score in the operating room. Data are in median [IQR].
Mean patient age was 16 and 79% were male. Vital parameters measured on admission and in the operating room were similar in the control and VR group. We did not find a difference between the STAI-s scores measured in the control and VR group on admission (39 [34; 47] and 41 [34; 48]); in the operating room (43 [33; 50] and 42 [36 and 50]); and in the postoperative morning (35 [28; 42] and 39 [37; 45], respectively). Multiple linear regression analysis revealed that only STAI score measured on admission was a significant predictor of the STAI score in the operating room (p=0.014); the use of VR was not associated with the outcome (p=0.591), when controlling for sex, daily screen time and videogame use, and overall anxiety traits.
Although VR was proven useful in anxiolysis in previous studies in the pediatric setting, this study could not detect a change in anxiety with the use of VR in the perioperative period of pectus repair surgeries in adolescents. It is conceivable that the midazolam administered as premedication may neutralized the effect of VR.