Alaterre Camille, Duceau Baptiste, Sung Tsai Eileen, Zriouel Siham, Bonnet Francis, Lescot Thomas, Verdonk Franck
Department of Anaesthesiology and Intensive Care, Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, 75012 Paris, France.
Department of Anaesthesiology and Intensive Care, Hôpital européen Georges-Pompidou, Assistance Publique-Hôpitaux de Paris, 75015 Paris, France.
J Clin Med. 2020 Jan 13;9(1):215. doi: 10.3390/jcm9010215.
When used as an add-on to regional anesthesia, virtual reality (VR) has been reported to provide anxiety-reducing benefits and sedation-sparing effects. However, its impact on patient satisfaction is still a matter of controversy. We investigated the feasibility and benefits of implementing intraoperative VR distraction in a French University Hospital (Hôpital Saint-Antoine, AP-HP). This monocentric observational before-after study included 100 patients who underwent ambulatory upper limb surgery under peripheral nerve block in January 2019, 50 before and 50 after implementation of an intraoperative VR distraction protocol. Primary outcome was patient self-rated satisfaction score evaluated right after surgery. Secondary outcomes included 2-month patient-reported satisfaction score, perioperative self-rated anxiety and intraoperative hemodynamic changes. Compared to former standard care, VR distraction was associated with significantly higher postoperative satisfaction scores (10 [IQR 9; 10] vs. 9 [8; 10], < 0.001) still reported two months after surgery (10 [10;10] vs. 10 [8.5;10], = 0.06). Patient median intraoperative anxiety score was lower in the VR group, compared to Standard Care group (0 [0; 2] vs. 3 [0.25; 7], < 0.001), and occurrence of intraoperative hemodynamic changes was also lessened in the VR group (2% vs. 16%, 0R = 0.11[95% CI 0.002-0.87], = 0.031). The present findings suggest that VR distraction program in the operating room could effectively improve patient satisfaction with anxiety-reduction and hemodynamic benefits.
当作为区域麻醉的辅助手段使用时，据报道虚拟现实（VR）具有减轻焦虑的益处和节省镇静剂的效果。然而，其对患者满意度的影响仍存在争议。我们在法国圣安托万医院（AP-HP）研究了术中实施VR分散注意力的可行性和益处。这项单中心前后观察性研究纳入了100例于2019年1月在周围神经阻滞下接受门诊上肢手术的患者，其中50例在实施术中VR分散注意力方案之前，50例在之后。主要结局是术后立即评估的患者自评满意度得分。次要结局包括术后2个月患者报告的满意度得分、围手术期自评焦虑和术中血流动力学变化。与之前的标准护理相比，VR分散注意力与术后显著更高的满意度得分相关（10[四分位间距9；10]对9[8；10]，<0.001），术后两个月仍有报道（10[10；10]对10[8.5；10]，=0.06）。与标准护理组相比，VR组患者术中焦虑得分中位数更低（0[0；2]对3[0.25；7]，<0.001），并且VR组术中血流动力学变化的发生率也降低了（2%对16%，OR=0.11[95%CI0.002 - 0.87]，=0.031）。目前的研究结果表明，手术室中的VR分散注意力方案可以有效提高患者满意度，并具有减轻焦虑和改善血流动力学的益处。
