A Randomized, Controlled Trial of In-Hospital Use of Virtual Reality to Reduce Preoperative Anxiety Prior to Cardiac Surgery.

Objective: To study the effectiveness of virtual reality (VR) in reducing anxiety levels in patients undergoing first-time sternotomy for cardiac surgery.

Patients And Methods: A total of 100 adult patients scheduled for cardiac surgery at Mayo Clinic in Rochester, Minnesota, USA, was recruited from April 19, 2022, to October 12, 2022. Before surgery, patients wore a physiological monitor to record vital signs. On the day of surgery, patients completed the State-Trait Anxiety Inventory (STAI) and were randomized into two groups: one receiving a tablet-based intervention (control) and the other an immersive VR experience in the preoperative holding area. After the interventions, patients repeated the state anxiety component of the STAI.

Results: The results showed that overall state anxiety scores decreased an average of 2.0 points with tablet treatment, but this change failed to reach statistical significance. However, 6 of 20 specific state anxiety features significantly improved with tablet treatment whereas 1 feature significantly worsened. With the VR experience, overall state anxiety scores were significantly reduced by an average of 2.9 points, with improvement in seven state anxiety features (three of which did not overlap with the tablet intervention). Despite a greater reduction in the STAI score with the VR experience, there were no significant differences in the anxiolytic responses between groups. Physiologically, both tablet and VR treatments slightly but significantly reduced pulse rate, with no difference between the groups.

Conclusion: Overall, the findings suggest that treatment of older adults with an immersive VR experience before cardiac surgery can significantly reduce overall anxiety. Further investigation determining how such interventions can be optimally implemented in surgical practices and whether such interventions reduce the need for anxiolytic medications and improve the overall patient experience is needed.