Dear Doctors: I’m having hand surgery next year to help with carpal tunnel. I’m not thrilled about anesthesia. I’ve been reading about surgeons whose patients use virtual reality headsets to need less anesthesia. Does that really work?
A: Anesthesia is a complex practice with multiple, sometimes conflicting objectives. The treatment must sedate the patient and suppress their pain response but not interfere with the body’s critical physiological functions, including heartbeat, breathing and maintaining steady blood pressure.
While modern anesthesia is safer than ever, it still carries a risk. That’s why research into novel drugs and new techniques continues.
For years, that research has included inquiries into the use of virtual reality, VR, as an add-on therapy.
This is being explored in conjunction with what’s known as regional anesthesia. Unlike general anesthesia, in which a patient is completely unconscious, someone undergoing regional anesthesia is sedated but remains conscious. Nerve blocks are used to inhibit sensation from a specific and limited part of the body.
The is often used in surgery on an extremity, such as an arm, hand, leg or foot.
Because the patient remains awake, managing their anxiety is crucial. Many patients receive sedation so they can relax or even doze off during the procedure.
With the advent of computer-generated virtual reality, which uses special headsets to plunge the user into an immersive, 3D world, researchers began to wonder whether it might lessen a surgical patient’s need for sedation.
The latest study into this yielded intriguing results. Over eight months, researchers at a medical center in Boston evaluated the anesthesia needs of 34 patients undergoing hand surgery.
They were divided into two groups. All received drugs to completely block pain response, and all received intravenous sedation. But one group also was given VR headsets with a selection of programs designed to promote relaxation.
The study found that patients who used VR headsets needed markedly less sedation than the control group.
And the post-surgical recovery period for the VR group, during which patients wait for the effects of sedation to wear off, was significantly shorter.
While the research is promising, the surgical teams and patients understood that VR might lessen the need for sedation, and this could have influenced the outcomes.
It’s crucial that you discuss your concerns about anesthesia with your surgeon. Understanding the process can help allay your concerns.
Dr. Eve Glazier and Dr. Elizabeth Ko are internists at UCLA Health.
