Effect of virtual reality hypnosis on intraoperative sedation needs and functional recovery in knee arthroplasty: a prospective randomized clinical trial.
Acute Pain; Drug-Related Side Effects and Adverse Reactions; Lower Extremity; Outcome Assessment, Health Care; Pain Management; Anesthesiology and Pain Medicine; General Medicine
Abstract :
[en] [en] BACKGROUND AND OBJECTIVES: Perioperative psychological stress and pharmacological anxiolysis can negatively affect the quality of recovery after total knee arthroplasty. We aimed to assess whether hypnosis combined with virtual reality could reduce intraoperative pharmacological sedation and improve quality of recovery after total knee arthroplasty surgery.
METHODS: In this prospective randomized clinical trial, 60 patients scheduled for total knee arthroplasty with spinal anesthesia were randomly divided into 2 groups of 30 patients each. Intraoperatively, intermittent boluses of midazolam 1 mg were administered at 5 min intervals at the patient's request, with a maximum driven by the clinical assessment of sedation depth. During surgery, patients received standard care (group control) or virtual reality hypnosis (group VRH). An unblinded observer recorded the total dose of midazolam administered during surgery, and changes in the Quality-of-Recovery 15-item score, comfort, fatigue, pain and anxiety before and 1, 3 and 7 days after surgery.
RESULTS: Patients in the VRH group required a lower dose of midazolam (mg; median (range)) intraoperatively (group VRH: 0 (0-4) and group control: 2 (0-9), p<0.001). Quality-of-Recovery 15-item, anxiety, and pain were similar between groups.
CONCLUSIONS: In total knee arthroplasty with spinal anesthesia, VRH reduces the requirement for intraoperative pharmacological sedation, without a change in the quality of recovery.
TRIAL REGISTRATION NUMBER: NCT05707234.
Disciplines :
Anesthesia & intensive care
Author, co-author :
Carella, Michele ; Centre Hospitalier Universitaire de Liège - CHU > > Service d'anesthésie - réanimation
Beck, Florian ; Centre Hospitalier Universitaire de Liège - CHU > > Service d'anesthésie - réanimation
Quoilin, Caroline; Oncomfort SA, Wavre, Belgium
Azongmo, Murielle M; Department of Anesthesia and Intensive Care Medicine, Centre Hospitalier Universitaire de Liège, Liège, Belgium
Lohéac, Adrien ; Centre Hospitalier Universitaire de Liège - CHU > > Service d'anesthésie - réanimation
Bonhomme, Vincent ✱; Université de Liège - ULiège > GIGA > GIGA Consciousness - Anesthesia and Intensive Care Laboratory
✱ These authors have contributed equally to this work.
Language :
English
Title :
Effect of virtual reality hypnosis on intraoperative sedation needs and functional recovery in knee arthroplasty: a prospective randomized clinical trial.
AstraZeneca Belgian Foundation Against Cancer ULiège - University of Liège Fonds Léon Fredericq CHU Liège - Central University Hospital of Liege
Funding text :
University and University Hospital of Liege and its Department of Anesthesia and Intensive Care Medicine and Algology Interdisciplinary Centre; European Foundation of Biomedical Research
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