Using VR during waking surgeries helps reduce anxiety

Photo credit: Michigan State University

Imagine the breathtaking aerial view of Zambia’s Victoria Falls – watch as water plummeting more than 300 feet into a seemingly endless abyss comes into focus and listen to the soothing strains of soft music playing in the background. Relax as steam rises from the waterfall, which locals call Mosi-oa-Tunya, “the smoke that thunders.”

Patient James Klunzinger, 79, sits in an East Lansing procedure room wearing virtual reality goggles. He finally stops fidgeting as he immerses himself in the experience. His left arm is stretched out while his doctor, James Clarkson, cleans his hand and prepares for surgery to release the carpal tunnel.

Less than 20 minutes later, Klunzinger leaves the room, his left hand wrapped in bandages, with a smile on his face.

“It was much better than having to watch the operation,” he says. “It was distracting, which is good. I would give it a thumbs up.”

Like Klunzinger, patients immersed in VR, or virtual reality, while undergoing wide-awake surgery experience more pleasure and less anxiety than those who underwent the surgery in a traditional operating room, according to an MSU study published in the Magazine Plastic and Reconstructive Surgery was published – Global Open.

“We definitely saw an increase in happiness in patients who were immersed in the VR experience,” said James Clarkson, the study’s senior author and assistant professor of surgery at Michigan State University College of Human Medicine. “And in patients with an anxiety disorder, we saw decreased anxiety and significantly increased happiness,” said Clarkson, hand surgeon at MSU Health Care.

The researchers wanted to compare patients who had undergone traditional carpal tunnel removal surgery in a hospital, requiring monitored anesthesia or general anesthesia, with patients who underwent the surgery while awake using local anesthesia without a tourniquet in the office setting and with the option of having it performed had an immersion in virtual reality.

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In a retrospective study, researchers looked at 404 patients who underwent surgery at three Michigan sites between August 2017 and March 2021.

The survey showed that patients who underwent conventional surgery in an operating room were twice as likely to report a neutral or negative experience as patients who underwent surgery while they were awake (23% vs. 11%). Patients undergoing conventional surgery also reported significantly lower pleasure scores (44% vs. 20%) and more anxiety (42% vs. 26%).

Patients who underwent surgery while awake in an office setting and chose to use VR experienced greater pleasure than those who did not use VR (85% vs. 73%). Patients who reported an anxiety disorder were more likely to opt into the VR experience, and when they did, they experienced less anxiety (79% vs. 47%) and more joy (90% vs. 59%).

Innovations to satisfy patients and reduce costs

Clarkson said a few years ago, doctors in Canada developed a method for carpal tunnel release surgery that avoided the use of a tourniquet and the need for a hospital operating room, costly procedures, fasting and anesthesia requirements for patients, and a driver after the procedure bypassed for the patient. But time and time again, Clarkson’s patients rejected the idea of ​​being awake during surgery, preferring to be euthanized instead.

“The patients were like, ‘Just let me out, Doc; I don’t want to know about it.’ We still put them through these incredibly expensive, time-consuming, sterile procedures in large hospitals.”

In 2016, Clarkson was watching his kids play with a VR system at home when he saw a potential solution right before his eyes.

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“I felt immediately, ‘This is exactly what my patients need,'” said Clarkson, who had been looking for ways to keep his patients awake and distracted during surgery. “I could tell them, ‘I’m not going to throw you out, but I can put you somewhere else.'”

After that initial “Aha!” At that moment, Clarkson examined the effect of patients using VR and published a study. He was later approached by others interested in developing this technology and together they formed the Wide Awake VR company to adapt its use to surgical needs.

“VR has changed the patient experience,” he said. “They no longer had to starve after midnight and could drive the same day – have surgery and go home, just like at the dentist.”

The carpal tunnel is a narrow passage of bones and ligaments at the base of the palm, including the medial nerve that runs from the forearm into the palm. When this median nerve is squeezed at the wrist, it causes a tingling, pain, and tingling feeling.

Left untreated, carpal tunnel syndrome can lead to nerve atrophy. Often the condition is managed with rest and immobilisation of the hand, pain medication, and by treating underlying conditions, but in the most extreme cases, surgery is required.

Back in East Lansing, and as Clarkson and a nurse prepared for the procedure, Klunzinger donned the VR goggles and began viewing a tour of the International Space Station. However, Klunzinger still seemed uncomfortable, turning his head to follow the movements in the space station and stretching his left hand to ease the pain.

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“Would you like me to take you to East Africa instead? You don’t strike me as a NASA guy,” says Clarkson, motioning the nurse to change the VR experience on a nearby iPad. “That is better?” Clarkson asks as the iPad lights up, showing the vivid colors of a rainbow now shining over the waterfall.

With the VR glasses, Klunzinger sees the same video and smiles, finally calming down.

“It’s not the Masters, but it will do,” he says as Clarkson makes an incision about an inch long near the base of the palm to begin the procedure.

A few stitches later, Klunzinger is ready to leave. He’ll be back for a check-up in two weeks and if things don’t go as hoped he will next need surgery on his right hand.

If that’s the case, he says he’ll go back to the VR experience.

“It was really something different,” he adds, as he packs up his personal belongings and gets ready to drive himself home.

For more information: McKenzie B. Miller et al., Virtual Reality Improves Patient Experience and Anxiety While In-office Carpal Tunnel Release, Plastic and Reconstructive Surgery – Global Open (2022). DOI: 10.1097/GOX.0000000000004426

Provided by Michigan State University

Citation: Using VR During Wide Wake Surgery Helps Alleviate Anxiety (2023 March 6) Retrieved March 6, 2023 from -awake-surgery-ease-anxiety. html

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