The use of Pre-operative Virtual Reality to Reduce Anxiety in Women Undergoing Gynecological Surgeries

A Prospective Cohort Study

Jason Ju In Chan; Cheng Teng Yeam; Hwei Min Kee; Chin Wen Tan; Rehena Sultana; Alex Tiong Heng Sia; Ban Leong Sng


BMC Anesthesiol. 2020;20(261) 

In This Article


A total of 110 patients aged 24–59 years old were recruited but only 108 patients' data were analyzed as two patients withdrew prior to the intervention. Table 1 shows the demographic data for the patients. Majority of the patients were of Chinese ethnicity (70.37%), ASA 1 status (72.22%) and underwent dilatation, curettage and hysteroscopy (82.41%) (Table 1). No adverse events were reported during and post VR intervention, and we observed no motion sickness nor dizziness in the recruited patients. Pre-operative HADS scores compared between types of surgery showed no significant difference (p = 0.4879). Eighty-eight patients (81.5%) were discharged on the same day of their surgery, whereas the rest (n = 20 or 18.5%) were hospitalized overnight.

Pre- and post-VR psychological outcomes are displayed in Table 2. Importantly, for our primary outcome, there were statistically significant reduction in anxiety and depression using HADS (p < 0.0001). Furthermore, for our secondary outcome, anxiety/depression (p < 0.0001), self-reported perception of pain and discomfort (p = 0.0073) and perceived health states (p < 0.0001) in EQ-5D-3L also showed statistically significant improvements post-VR intervention pre-operatively. There was no significant association between STAI and change in HADS anxiety scores (p = 0.6352).

Table 3 displays values of EQ-5D-3L for all five dimensions and three levels in detail, with the number of patients reporting each level within each dimension pre-VR and post-VR intervention. There was a statistically significant difference on EQ-5D-3L VAS health state (mean ± SD) of pre- and post-VR intervention (71.57 ± 17.75 vs 76.05 ± 15.07; p < 0.001). Table 4 shows the pain and satisfaction scores collected. Notably, pain scores collected pre- and post-VR intervention did not reveal any significantly changes (p = 0.2178). Intra- and post-operative pharmacological information, including type, dosage and route of analgesia, are displayed in Table 4. Significantly, for the secondary outcome of patient satisfaction of the VR intervention, 82.41% of the participants rated the experience as 'Good' or 'Excellent' (Table 4).

In terms of immersive VR scenario selection, majority of the participants (n = 24, 22.22%) selected Wine Glass Bay Beach, Australia, followed by Northern Lights, USA (n = 20, 18.51%), Tropical beach, Philippines (n = 19, 17.59%), Daisy Garden, Germany (n = 15, 13.89%), the Twelve Apostles, Australia (n = 9, 8.33%), Fern Bern, New Zealand (n = 6, 5.56%) and Forest Creek, Germany (n = 6, 5.56%).