The effectiveness of virtual reality (VR) on pain and anxiety during nail surgery under local anaesthesia

Abstract

Aim The aim of this study was to determine the effect of Virtual Reality (VR) on pain and anxiety during podiatric nail surgery under local anaesthesia by comparing levels of anxiety, pain, and heart rate between patients who use the VR system and patients who do not. Method Twenty participants (n=20) who were scheduled for a nail surgery procedure were recruited from the clinic at B’kara Health Centre. Demographic data, age, and gender were recorded. Participants were divided into two groups, mainly control (no VR) and experimental (with VR), based on the participant’s preference. The preoperative anxiety of both groups was assessed prior to the beginning of procedure using the Amsterdam Preoperative Anxiety and Information Scale (APAIS) questionnaire. After this, participants in the experimental group wore the VR headset while lying on the operating couch. The control group were asked to lie supine without the VR headset as per routine procedure. Anxiety and heart rate, before and after administration of local anaesthesia were assessed by the Subjective Units of Distress Scale (SUDS) and a pulse oximeter, respectively. Pain during administration of local anaesthesia was assessed using the Visual Analogue Scale (VAS) immediately after administration. After the procedure, satisfaction while wearing the VR headset was assessed using a 7-point Likert scale. Results Results indicate that the experimental group using VR showed significantly lower mean anxiety scores, before and after local anaesthesia administration, compared to the control group (0.020, 0.009, respectively, p=<0.05). Furthermore, the experimental group using VR demonstrated significantly lower mean pain scores during local anaesthesia administration compared to the control group (0.035, p=<0.05). Finally, the experimental group using VR showed significantly lower mean heart rate, before and after local anaesthesia administration, compared to the control group (0.001, 0.09, p=<0.05). Descriptive statistics showed that the majority of patients were feeling extremely satisfied while wearing the VR headset during the procedure (mean=6.50). Conclusion This study has shown that anxiety, pain perception, and heart rate during podiatric nail surgery were found to be significantly reduced with the use of VR. This VR technology has the potential to aid the podiatric surgeon to effectively manage preoperative anxiety, intraoperative pain and prevent complications from arising during the surgery, while also improving patient satisfaction, thus contributing to a better surgery outcome.