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虚拟现实对全髋关节置换术围手术期焦虑、应激及疼痛的影响:一项随机对照试验

Effect of virtual reality on perioperative anxiety, stress and pain in total hip arthroplasty: a randomized controlled trial.

作者信息

Moharam Saad Ahmed, ElSharkawy Mohammed Said, ELkashef Ahmed Mohamed, Romeih Mohamed Abdelhamed, El Rasool Ahmed Osama Abd Rab, Shaheen Mostafa Mohamed

机构信息

Faculty of Medicine, Anesthesiology, Surgical Intensive Care and Pain Medicine Department, Tanta University, Tanta, El Gharbia, 31511, Egypt.

Faculty of Medicine, Orthopedic Surgery Department, Faculty of Medicine, Tanta University, Tanta, Egypt.

出版信息

BMC Anesthesiol. 2025 Sep 9;25(1):446. doi: 10.1186/s12871-025-03316-3.

Abstract

BACKGROUND

Virtual reality (VR) has shown promise as a nonpharmacological alternative to pharmaceutical pain relievers and anxiety medications in clinical trials by decreasing pain and anxiety in orthopedic surgeries. The aim of the study was to evaluate the impact of VR on these outcomes in individuals undergoing total hip arthroplasty (THA).

METHODS

This randomized, controlled, open-label research included 50 participants planned for THA with spinal anesthesia (SA). Patients were allocated equally to group VR: patients were immersed in a peaceful natural environment with soft music preoperatively and intraoperatively, and group C did not receive VR.

RESULTS

The STAI-S for anxiety and PSS-10 scores for stress were significantly lower in group VR before SA and immediately postoperatively (P < 0.05). Hemodynamics at 5 min, 30 min, and 60 min, pain scores at 4 h and 6 h, 24 h pethidine consumption, haloperidol dose, and cortisol level at 6 h postoperative were decrease in group VR in comparision to group C (P < 0.05). Time to first analgesia request and satisfaction level were higher in group VR in comparision to group C (P < 0.05).

CONCLUSIONS

VR can reduce perioperative anxiety, stress, pain, and opioid requirements, and improve satisfaction in THA patients.

TRIAL REGISTRATION

The trial was registered https://clinicaltrials.gov/study/NCT06088069?id=NCT06088069&rank=1((ID:NCT06088069 , Principal investigator: (SAAD AHMED MOHARAM, Date of registration: 18-10-2023).

摘要

背景

在临床试验中,虚拟现实(VR)已显示出有望成为药物止痛剂和抗焦虑药物的非药物替代品,可减轻骨科手术中的疼痛和焦虑。本研究的目的是评估VR对接受全髋关节置换术(THA)患者这些结果的影响。

方法

这项随机、对照、开放标签研究纳入了50名计划接受脊髓麻醉(SA)下THA的参与者。患者被平均分配到VR组:术前和术中让患者沉浸在有轻柔音乐的宁静自然环境中,C组未接受VR。

结果

VR组在SA前和术后即刻的焦虑状态特质焦虑量表(STAI-S)和压力的10项感知压力量表(PSS-10)得分显著更低(P<0.05)。与C组相比,VR组在5分钟、30分钟和60分钟时的血流动力学、4小时和6小时时的疼痛评分、术后24小时哌替啶消耗量、氟哌啶醇剂量以及术后6小时的皮质醇水平均降低(P<0.05)。与C组相比,VR组首次要求镇痛的时间和满意度更高(P<0.05)。

结论

VR可降低THA患者围手术期的焦虑、压力、疼痛和阿片类药物需求,并提高满意度。

试验注册

该试验已在https://clinicaltrials.gov/study/NCT06088069?id=NCT06088069&rank=1((ID:NCT06088069,主要研究者:(萨阿德·艾哈迈德·穆罕默德),注册日期:2023年10月18日)注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/54e3/12418640/6470f85c4bf2/12871_2025_3316_Fig1_HTML.jpg

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