JMIR Publications

ABSTRACT

Background:

The perioperative environment is complex and may be challenging for patients and guardians to navigate. The emotional burden and stressors inherent to the perioperative process commonly result in preoperative anxiety. Many studies have demonstrated the usefulness of virtual reality (VR) in various patient populations.

Objective:

Our aim was to determine the effect of a VR-based exposure tool on the preoperative anxiety of children and their guardians.

Methods:

We performed a single-center prospective randomized controlled trial including children 6-12 years of age, presenting for ambulatory tonsillectomy and/or adenoidectomy, with or without bilateral ear tube insertion. The patients were randomized to receive VR instruction of the perioperative workflow or standard preoperative experience (non-VR). The primary outcome was patient and guardian preoperative anxiety, as measured by the 6-item State-Trait Anxiety Inventory.

Results:

The study cohort included 107 parent/guardian dyads; 51 in the intervention (VR) group and 56 in the control (non-VR) group. Baseline characteristics between the study and control groups were comparable; however, patients in the control group were more likely to report feeling upset compared to the VR group. Following VR intervention, both patients and guardians experienced reduced preoperative anxiety compared to the control group. Patients exposed to VR were five times more likely to feel calm [odds ratio (OR) 4.95; 95% Confidence Interval (CI) 2.32-10.61; p<0.001]. Both patients and guardians exposed to VR were significantly less likely to have moderate or high levels of preoperative anxiety than the control group (OR patient 0.15; 95%CI 0.05-0.41; p<0.001) (OR guardian 0.14; 95%CI 0.06-0.38; p<0.001).

Conclusions:

Virtual reality exposure can be effective in reducing pediatric and guardian anxiety. VR may be a suitable alternative to pharmacologic anxiolysis and future studies should compare the effect to premedication techniques. Clinical Trial: Registered the study on ClinicalTrials.Gov (NCT05008107)