Effects of Immersive Virtual Reality on Patient Anxiety During Surgery Under Regional Anesthesia: A Randomized Clinical Trial.

Background: Surgery and anesthesia are associated with increased patient anxiety. Perioperative anxiety is a common problem in regional anesthesia procedures and has an extensive impact. Immersive virtual reality (IVR) is a potential non-pharmacological distraction method to reduce anxiety. Immersive virtual reality creates a virtual environment that allows patients to interact and immerse in the virtual world, reducing patient anxiety. Objectives: This study aimed to examine the effect of IVR on the anxiety of patients undergoing regional anesthetic surgery. Methods: A total of 30 participants referred to Dr. Kariadi General Hospital (Indonesia) from October 2021 to December 2021 were enrolled in this randomized, single-blind clinical trial. The patients were divided into virtual reality (VR) and control groups (n = 15 in each group). The control group received midazolam (0.02 mg/kg) as premedication. The VR group received an IVR intervention without premedication. The data of anxiety scores were assessed using the Spielberger State-Trait Anxiety Inventory 6 (STAI-6). This study also collected vital signs, side effects, and patient and surgeon satisfaction level data. Results: The average anxiety level during surgery in the operating room decreased in both groups (P < 0.05); the VR group had a lower score (P = 0.04). A significant reduction in perioperative anxiety levels was observed in the VR group compared to the control group. The patient satisfaction level was also significantly higher in the VR group than in the control group (P = 0.024). Both groups had no significant difference in monitored vital signs, side effects, and surgeon satisfaction. Conclusions: The IVR intervention could reduce anxiety in patients undergoing surgery under regional anesthesia and improve patient satisfaction.