Virtual reality reduces the need for anesthesia

A study published in the specialized magazine “Games for Health Journal” shows some opportunities that VR technology offers in modern medicine.

The highlighted results show that virtual reality simulations can improve pain management (by reducing the patient’s perception of pain and anxiety), enhance clinical rehabilitation programs and physical rehabilitation protocols (through immersive audio-visual environments) and can improve clinical assessment of cognitive function.

The process has been tested on cancer patients, both in terms of pain management and long chemotherapy sessions.

It has also shown its effectiveness in the treatment of severe burns and in various types of interventions (such as gastrointestinal endoscopy or orthopedic surgery) as an adjunct to sedation.

Disadvantages of Propofol

Precisely in the field of anesthesia and sedatives, a study was recently published in “PlosOne” magazine regarding the use of virtual reality during hand operations. In this type of intervention, the usual anesthetic practice consists of a combination of local anesthesia before surgery and supervised intraoperative anesthetic care (MAC), that is, throughout the intervention, when propofol, a short-acting anesthetic, is given.

Despite the appropriate use of local anesthesia, patients may receive intraoperative doses of sedation, which can lead to excessive sedation and potentially preventable complications. In the United States, one claim for respiratory depression is seen from five procedures due to overdose of sedatives.

Added to this is the fact that propofol is a widely used drug in pediatric procedures. The Spanish Pediatric Association states that when propofol is administered for the induction and maintenance of anesthesia, slight changes in heart rate and a decrease in mean arterial pressure are observed. It should also be noted that propofol reduces cerebral blood flow, intracranial pressure, and cerebral metabolism. It should be added that some drugs can cause a drop in body temperature, induce involuntary movements, etc.

Considering all this, a tool capable of reducing the dose of intraoperative sedation may be useful in preventing adverse effects. Of course, the option of not sedating or reducing the dose and crossing one’s fingers that the patient endures the pain is not a popular option. Even less in interventions that require a high degree of precision, such as during surgery on the hand or any organ where the area to be operated on must be stationary to guarantee success.

The danger of oversedation

And this is where the use of virtual reality comes in. According to the study’s authors, led by Adeel A. Faruki of the University of Colorado, virtual reality can be a valuable tool for patients and health care personnel by distracting the mind from processing noxious stimuli, reducing the minimization of sedative use. and minimize the risk of oversedation. All this without affecting the patient’s satisfaction at the end of the process.

To conduct the study, Farooqui’s team recruited 40 volunteers who would undergo hand surgery and could view VR footage during the procedure. These images consisted of relaxing landscapes, with immersive sound (patients wore headphones) or videos projected in an outdoor theater under a starry sky. Patients could switch videos as often as they wanted. For the study, one of the authors could record what the patients felt.

In this way, possible changes in constants can be detected and modifications can be made quickly. The results showed that the patients’ required dose of propofol was significantly lower in those who used virtual reality than in those who had conventional surgery. The mean was about 125,000 grams per hour for RV patients versus 750 mg/h for the control group.

Farooq’s team also found that not only was the dose of sedatives reduced, but patients also had less postoperative pain, less anxiety at all stages, and their stay in the post-anesthesia care unit was also improved.

If we consider that supervised anesthetic care is performed in interventions, such as endoscopy, bronchoscopy or cardiovascular surgery, in almost 30% of cases virtual reality can become a very interesting ally. Maybe not so much in pediatrics because of the risk of movement caused by realistic scenes, but in adults.

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