Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Dec 8, 2023
Date Accepted: Mar 31, 2025
Effects of virtual reality-based intervention on preoperative anxiety in patients for elective surgery under anesthesia: a systematic review and meta-analysis
ABSTRACT
Background:
Preoperative anxiety is a common yet often neglected problem for patients undergoing surgery. The virtual reality (VR)-based intervention is a promising alternative that benefits managing preoperative anxiety. However, the components of VR-based intervention and its effectiveness on preoperative anxiety in patients for elective surgery under anesthesia remain unclear.
Objective:
This study aimed to identify the major components (i.e. device, medium, format, and duration) of VR-based intervention and summarize evidence regarding its effectiveness in reducing preoperative anxiety in patients for elective surgery under anesthesia.
Methods:
Allied and Complementary Medicine, Chinese University of Hong Kong Full Text Journals, Cumulative Index to Nursing and Allied Health Literature (CINAHL) via EBSCOhost, Cochrane Library, Joanna Briggs Institute EBP Database, EMBASE, Medline via OvidSP, Pubmed, PsychINFO, Scopus, China Journal Net and WanFang Data Chinese Dissertations Database were searched from inception to April 2020. Randomized controlled trials (RCTs) of VR-based interventions in patients for elective surgery undergoing anesthesia were included. The Cochrane Collaboration’s tool was used for risk of bias assessment. A random effect model was used for pooling the results.
Results:
A total of 10 RCTs with 1036 patients (female: 53%) were included in this systematic review and meta-analysis. Compared with usual care, VR-based interventions showed substantial benefits in decreasing preoperative anxiety in patients for elective surgery (standardized mean difference [SMD] 1.68, 95% CI 0.83 to 2.54, P < .001). Regarding the subgroup analysis, VR-based intervention showed significantly large effects on preoperative anxiety in the adult population (SMD 4.45, 95% CI 2.35 to 6.55, P < .001) than in the pediatric population (SMD 0.61, 95% CI 0.25 to 0.96 P .0007). The exposure approach showed more significant effects (SMD 2.17, 95% CI 1.09 to 3.24, P < .001) on preoperative anxiety than the distraction approach (SMD 0.71, 95% CI 0.35 to 1.07, P < .001).
Conclusions:
Patients for elective surgery under anesthesia may benefit from VR as a novel alternative to reduce preoperative anxiety, especially for the adult population via the exposure approach. However, more rigorous research is needed to confirm the effectiveness.
Citation
Per the author's request the PDF is not available.
Copyright
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