Satisfaction and tolerability using virtual reality (VR) as adjunctive treatment during flexible bronchoscopy: a randomized control trial

The Effects of Virtual Reality Application on Pain Intensity, Anxiety Level and Patient Satisfaction in Patients Who Undergo Bronchoscopy: A Randomized Controlled Trial

BACKGROUND

Bronchoscopy is a medical procedure that allows imaging of the airways and lungs. With the help of a light and camera at its tip, the bronchoscope device can enter the airway and provide real-time visualization. Since most patients are conscious during the bronchoscopy procedure, they may experience pain and anxiety regarding possible complications and an uncertain outcome.

AIM

This study was conducted to determine the effects of virtual reality (VR) application on pain intensity, anxiety level, physiological symptoms of anxiety (vital signs) and patients' satisfaction level with the use of virtual reality while undergoing a bronchoscopy.

DESIGN

A parallel randomized controlled trial.

SETTING

Bronchoscopy unit of the chest diseases service of a 1053 bed university hospital in eastern Turkey.

SAMPLE AND METHODS

The study was conducted with a total of 70 patients, 35 in the intervention group and 35 in the control group. The researcher interviewed patients and approved those who met the research criteria and agreed to participate in the study. The researcher applied relaxation exercises to the patients in the intervention group using virtual reality glasses for 5 minutes before the procedure and 4-5 minutes during the procedure. No interventions were made for the patients in the control group. Data were collected using the Descriptive Information Form, Visual Analog Scale (VAS), Anxiety Assessment Scale (AAS), Physiological Symptoms of Anxiety Follow-up Form, and Virtual Reality Glasses Application Satisfaction Form.

RESULTS

When compared with the control group, the mean scores of VAS, AAS, heart rate, diastolic and systolic blood pressure, and respiratory rate of the intervention group were found to decrease significantly, while the O2 saturation value increased significantly (p < .05). It was found that 82.5% of the patients in the intervention group want to use virtual reality glasses if they have another intervention, and 70% recommend relaxation exercises with virtual reality glasses to patients who will undergo bronchoscopy.

CONCLUSION

Study results for this sample revealed that the use of VR decreased pain intensity scores, state anxiety levels, anxiety severity, diastolic blood pressure, systolic blood pressure, heart rate and respiratory rate, and increased O2 saturation in patients who underwent bronchoscopy. In line with these results, VR should be considered during bronchoscopy procedures.

The effect of virtual rainforest and a white noise mobile application on satisfaction, tolerance, comfort, and vital signs during arthroscopy

BACKGROUND AND PURPOSE

This study was conducted to investigate the effect of Virtual Rainforest (VRF) and a White Noise (WN) mobile applications on patient satisfaction, tolerance, comfort, and vital signs during arthroscopic knee surgery.

METHODS

This is a randomized, controlled, interventional study. The study was completed with a total of 93 participants, 31 in the VRF group, 31 in the WN group, and 31 in the control group. Data were collected using a Patient Information Form and a Visual Analog Scale for satisfaction, tolerance, and comfort.

RESULTS

The results of study showed that there were significant increases in tolerance, satisfaction, comfort, respiratory rate, and oxygen saturation levels and significant decreases in heart rate, systolic and diastolic blood pressures in both VRF and WN groups (p < .05). In the control group, no significant difference was found between the means of the variables before and after the procedure (p > .05).

CONCLUSION

According to the results of the study, VRF and WN applied during the arthroscopy procedure increased satisfaction, tolerance, and comfort in patients and had a positive effect on vital signs.

TRIAL AND PROTOCOL REGISTRATION

ClinicalTrials.gov, NCT05992714.

Innovations to Improve Lung Isolation Training for Thoracic Anesthesia: A Narrative Review

A double-lumen tube or bronchial blocker positioning using flexible bronchoscopy for lung isolation and one-lung ventilation requires specific technical competencies. Training to acquire and retain such skills remains a challenge in thoracic anesthesia. Recent technological and innovative developments in the field of simulation have opened up exciting new horizons and possibilities. In this narrative review, we examine the latest development of existing training modalities while investigating, in particular, the use of emergent techniques such as virtual reality bronchoscopy simulation, virtual airway endoscopy, or the preoperative 3D printing of airways. The goal of this article is, therefore, to summarize the role of existing and future applications of training models/simulators and virtual reality simulators for training flexible bronchoscopy and lung isolation for thoracic anesthesia.

[The effects of hypnosis by virtual reality on tolerance to flexible bronchoscopy]

INTRODUCTION

Patients often perceive flexible bronchoscopy as an unpleasant procedure. The aim of this study was to investigate the effect of virtual reality (VR) hypnosis on tolerance to flexible bronchoscopy.

MATERIALS AND METHODS

We conducted a prospective, randomized, controlled, monocentric study comparing flexible bronchoscopy with VR-induced hypnosis to the usual procedure. Patient tolerance was evaluated using a visual analogue scale (VAS), the state-trait anxiety inventory (STAI) before and after the procedure and, finally, willingness to repeat the examination under the same conditions (WTR).

RESULTS

Among the 70 patients included, 34 were randomized to the VR hypnosis group and 36 to the control group. There was no difference between the 2 groups in terms of modification of the pre-/post-bronchoscopy VAS for anxiety, pain, cough, choking, nausea and overall discomfort, or modification of the STAI score and WTR. Subgroup analysis among patients who were more anxious before the procedure revealed a trend toward reduced anxiety in the VR hypnosis group.

CONCLUSION

This study did not observe any effect of VR hypnosis on the tolerance of patients during routine flexible bronchoscopy. However, VR hypnosis may be beneficial in patients with higher anxiety score before bronchoscopy, a hypothesis that needs to be confirmed by further studies with a larger number of subjects.

Effect of Virtual Reality Distraction on Satisfaction and Tolerability in Patients Undergoing In-Office KTP Laser Procedure

OBJECTIVES

To study the effect of virtual reality (VR) on satisfaction, discomfort, stress, and cooperation in patients undergoing in-office potassium titanyl phosphate (KTP) laser procedure.

STUDY DESIGN

Prospective study.

METHODS

Thirty-seven patients were enrolled in this prospective study. The State Anxiety Scale of Spielberg's State-Trait Anxiety Inventory was used to measure the level of state anxiety. Satisfaction, discomfort, pain, stress, acceptance of VR, relaxation with VR, and willingness to wear VR were evaluated using a 100-mm visual analog scale (VAS). A 5-point Likert-like scale was used to rate the patient cooperation.

RESULTS

All procedures were completed successfully with cooperation of patients. Satisfaction score in VR group was 88.3 ± 9.0, and in control group was 81.6 ± 9.7 (P = 0.040). There were significant differences in both nasal cavity and laryngopharynx discomfort between two groups (P = 0.030 and P = 0.016, respectively). The pain score of control group was higher than that of VR group but it was not statistically significant (P = 0.140). The stress of control group during procedure was more obvious than that of VR group (30.5 ± 24.0 versus 17.0 ± 9.2, P = 0.021). The mean VAS scores of acceptance of VR were all more than 75. The results of regression analysis showed that VR had significant effects on satisfaction with the procedure (P = 0.004), discomfort of nasal cavity (P = 0.030) and laryngopharynx (P = 0.016), and feeling of stress (P = 0.021) during the procedure.

CONCLUSION

Distraction of VR can enhance satisfaction in both procedure and stress management for patients undergoing in-office KTP laser procedure. Acceptance of VR in VR group was relatively good.