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The Use of Virtual Reality to Reduce Preoperative Anxiety in First-Time Sternotomy Patients: A Randomized Controlled Pilot Trial

      Abstract

      Objective

      To report the first randomized controlled trial to investigate if immersive virtual reality (VR) treatment can reduce patient perceptions of anxiety compared with a tablet-based control treatment in adults undergoing a first-time sternotomy.

      Methods

      Twenty first-time sternotomy patients were prospectively randomized (blinded to investigator) to a control or VR intervention. The VR intervention was a game module “Bear Blast” (AppliedVR) displayed using a Samsung Gear Oculus VR headset. The control intervention was a tablet-based game with comparable audio, visual, and tactile components. The State-Trait Anxiety Inventory was administered before and after the assigned intervention. Self-reported anxiety measures between the control and VR groups were evaluated using an unpaired t test. Changes in self-reported anxiety measures pre- and post-intervention were evaluated with a paired t test for both the control and VR groups. The study took place from May 1, 2017, through January 1, 2019 (Institutional Review Board 16-009784).

      Results

      Both control and VR groups were 90.0% male, with a mean ± SD age of 63.4 ± 9.11 and 69.5 ± 6.9 years, respectively. VR users experienced significant reductions in feeling tense and strained, and significant improvements in feeling calm when compared with tablet controls (P<0.05). They also experienced significant reductions in feeling strained, upset, and tense when compared with their own self-reported anxiety measure pre- and post-intervention (P<0.05). Critically, control patients had no change in these categories.

      Conclusion

      Immersive VR is an effective, nonpharmacologic approach to reducing preoperative anxiety in adults undergoing cardiac surgery and shows the validity and utility of this technology in adult patients.

      Abbreviations and Acronyms:

      STAI (state-trait anxiety inventory), VR (virtual reality)
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      Linked Article

      • Improving Reality Virtually: Advent of the Virtual “Digi-ceutical”?
        Mayo Clinic ProceedingsVol. 95Issue 6
        • Preview
          Management of the psychological state through pharmacological and nonpharmacological treatments has been a focus of health care for millennia. Ancient therapies, such as ingesting devil peppers in ancient India or bowssening (immersing in water) in medieval Europe, relied on distraction rather than alteration of neurobiochemistry to alleviate anxiety. In modern times, pharmacological therapies such as benzodiazepines have replaced such ancient techniques. However, given the concerns of pharmacological interactions, risk of postoperative delirium, and physiological dependence, there has been interest in identifying alternative nonpharmacological solutions that alleviate anxiety, depression, and other psychological disturbances.
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