Use of Perioperative Virtual Reality Experiences on Anxiety and Pain: A Randomized Comparative Trial

Objective To evaluate the effect of different virtual reality (VR) experiences on perioperative anxiety and pain among patients undergoing head and neck surgery. Methods Prospective, randomized, comparative trial among patients undergoing outpatient head and neck surgery from December 2021 to April 2022 at a single academic institution. Group 1 utilized a preoperative VR gaming experience and a postoperative VR mindfulness experience, while Group 2 utilized the same interventions in the reverse order. Anxiety and pain were measured using visual analog scales (VAS). Primary outcomes were changes in post‐intervention anxiety and pain. Secondary outcomes included vital sign changes and subjective patient experiences using a 5‐point Likert scale. Results There were 32 patients randomized for inclusion, with 16 patients per group. The majority of patients were female (65.6%) and mean (standard deviation) age was 47.3 (16.7) years. After outlier exclusion, there were no differences in post‐intervention preoperative anxiety reduction (Group 1 vs. Group 2, median [IQR]: −12.0 [15] vs. −10.5 [13], p = 0.62). There were minor differences in vital sign changes ( p < 0.05). Among the 10 patients in Group 1 and 12 patients in Group 2 who completed postoperative VR use, there were no differences in post‐intervention pain reduction (−8.5 [22.3] vs. −7.5 [19.3], p = 0.95) or vital sign changes ( p > 0.05). There were no differences in questionnaire responses, with high satisfaction in both groups ( p > 0.05). No adverse events encountered. Conclusions Use of different VR experiences among patients undergoing outpatient head and neck surgery appears associated with similar reductions in perioperative anxiety and pain. Level of Evidence 2 Laryngoscope , 134:1197–1202, 2024