Virtual reality in preoperative preparation of children undergoing general anesthesia: a randomized controlled study

Preoperative anxiety can cause hyperalgesia, postoperative delirium and other adverse events, and even long-term psychological disorders. The aim of this trial was to determine whether preoperative virtual reality (VR) preparation reduces anxiety prior to induction of anesthesia. Data were analyzed for 99 children undergoing elective surgery. Participants were randomly assigned to a VR exposure intervention group or a control group. In the VR group, children watched a VR video showing a realistic interactive immersive virtual version of the perioperative process. The control group received conventional preoperative preparation. Preoperative anxiety using the modified Yale Preoperative Anxiety Scale-Short Form (mYPAS-SF) during anesthesia induction was the main outcome. Secondary outcomes included induction compliance, emergence delirium, pain, and parental satisfaction. The VR group had lower mYPAS-SF scores when leaving the waiting area (27.1, interquartile range, IQR 22.9–33.3 vs. 33.3, IQR 27.1–39.6; P = 0.006), and during anesthesia induction (29.2, IQR 22.9–33.3 vs. 39.6, IQR 33.3–55.2; P = 9×10−6). The Induction Compliance Checklist (ICC) scores during anesthesia induction were lower in the VR group (0.0, IQR 0.0–0.0 vs. 1.0, IQR 0.0–1.0; P = 0.003) than the control group, while parental satisfaction in the VR group was higher. Virtual reality exposure as a preparation tool has a beneficial effect on anxiety, induction compliance and parental satisfaction in children undergoing elective surgery. ChiCTR2000035417