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Virtual Reality as a Hypnotic Tool in the Management of Anxiety During the Performance of the Axillary Block

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Abstract

Regional anaesthesia is a gold standard in upper limb orthopaedic surgery. Carried out on an awake patient, it can be a source of anxiety. In recent years, hypnotic techniques have been proposed in the management of perioperative anxiety. Among them, virtual reality is increasingly used as a distraction tool during anxious or painful actions despite the scarcity of proof of its benefit in the literature. Before implementing the systematic use of virtual reality when performing regional anaesthesia in our institution, we designed a study hypothesizing that the use of a virtual reality headset when performing an axillary block would reduce patient’s anxiety. The study is an investigator-initiated, prospective monocentric and observational trial comparing anxiety scores of patients who underwent upper limb surgery under an axillary block with or without virtual reality headset. The perioperative anxiety was assessed by a numerical range scale before and after the peripheral nerve block performance. Between June 2021 and June 2022, 99 patients were included: 53 wearing the virtual reality headset and 46 not. The difference in numerical range scale for anxiety before and after the axillary block performance did not differ in the virtual reality group compared to the group without headset (mean = -1.9 ± 2.5 vs -1.5 ± 2.0, (p = 0.2520)). Technical difficulties reported by the operators were similar in both groups. Despite the large number of patients included, the virtual reality headset did not reduce patient’s anxiety during a peripheral nerve block. Perioperative anxiety was low in all patients.

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Data availability

Data are available upon request at the following adress: helene.beloeil@chu-rennes.fr.

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. CHU Rennes, Anesthesia and Intensive Care Department, Univ Rennes, Rennes, F-35000, France

    Kelly Lopes & Thierry Dessieux

  2. Univ Rennes, CHU Rennes, Inserm, CIC-1414, Biostatistics, Rennes, F-35000, France

    Chloe Rousseau

  3. Anesthesia and Intensive Care Department, Univ Rennes, CHU Rennes, Inserm, CIC-1414, COSS-1242, Rennes, F-35000, France

    Helene Beloeil

Authors
  1. Kelly Lopes
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Contributions

HB had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. HB, TD, KL contributed to the conception and design of the study. KL, TD and HB contributed to the acquisition, analysis and interpretation of the data. KL wrote the first draft of the manuscript. HB,TD, CR critically revised the manuscript. CR was responsible for the statistical analysis. All authors approved the final version of the manuscript.

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Correspondence to Helene Beloeil.

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Ethical approval

The study has been approved by the ethics committee of the French Society of Anesthesiologists (IRB 00010254—2021—08; 03/05/2021). Written informed consent was waived by the ethics committee as the study was fully observational.

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The authors declare that they have no competing interest.

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Lopes, K., Dessieux, T., Rousseau, C. et al. Virtual Reality as a Hypnotic Tool in the Management of Anxiety During the Performance of the Axillary Block. J Med Syst 47, 31 (2023). https://doi.org/10.1007/s10916-023-01923-6

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