Effect of Virtual Reality on Intraoperative Anxiety and Stress among Palestinian Patients undergoing Regional Anesthesia

patients assigned to the VR group will receive an immersive VR intervention that includes meditative 3D videos for the natural environment by a head-mounted device and earphones to listen to soothing nature sounds for 30 minutes. For natural environment that will be presented by VR glasses, universes were proposed: tropical beach, diving, forests, snowy landscape, with relaxing music with nature sound and the patient can choose one of them. It will be selected based on Guided Meditation VR application, developed by CUBICLE NINJAS AGENCY. https://guidedmeditationvr.com/. If, before 30 minutes, there was a patient who felt uncomfortable and wanted to stop using VR, it will be excluded from study and recorded in study report. The control group will receive traditional care during operation.

Procedure description
On the day prior to surgery, patients will be informed about the purpose of the study and the principles of the VR headset; and written consent form will be obtained from them. Patients will complete a Socio-demographic data, STAI and PSS-10 in the pre-operation room on the day of the operation. They will also be randomly assigned to the experimental group (VR group) and control group.

An anesthesiologist, who will be blind to the patients’ groups during the regional anesthesia procedure, will perform spinal anesthesia using heavy Marcaine (15-20 mg) and fentanyl (12.5-25 meg) administered to the subarachnoid space (L3-L4 or L4-L5). Regional (spinal) anesthesia will be performed, and nerve blocking need to pass about 3-5 minutes. The average time for surgery is 30–60 min (DiLorenzo & Schell, 2014).

After spinal anesthesia is completed, VR will start. According to the literature, the patients assigned to the VR group will receive an immersive VR intervention that includes meditative 3D videos for the natural environment by a head-mounted device and earphones to listen to soothing nature sounds for 30 minutes. For natural environment that will be presented by VR glasses, universes were proposed: tropical beach, diving, forests, snowy landscape, with relaxing music with nature sound and the patient can choose one of them. It will be selected based on Guided Meditation VR application, developed by CUBICLE NINJAS AGENCY. https://guidedmeditationvr.com/. If, before 30 minutes, there was a patient who felt uncomfortable and wanted to stop using VR, it will be excluded from study and recorded in study report. The control group will receive traditional care during operation.

Once the spinal anesthetic induction is completed, hemodynamic parameter monitoring will be performed on all patients during surgery in both groups (control group and VR group), including non-invasive blood pressure (NIBP), heart rate (HR), and respiratory rate (RR) monitoring every 15 minutes, and oxygen saturation (SpO2) will be monitored continuously until the operation is completed. Post-operation and in the recovery room, PSS-10 and STAI will be redistributed among patients in both groups. Also, VAS will be used to evaluate patients' satisfaction levels post-operation will be filled by all patients.

2024-04-20

2024-09-20

investigate the effect of virtual reality on intraoperative anxiety and stress among Palestinian patients undergoing regional anesthesia.

An experimental design known as randomized control trials (RCT) will be used in this study. Such a design fits the nature of the problem under investigation; an RCT will be used to investigate the effect of a new intervention without bias. This is because the act of randomization balances participant characteristics (both observed and unobserved) between the groups, allowing the attribution of any differences in outcome to the study intervention.

An experimental design known as randomized control trials (RCT) will be used in this study. Such a design fits the nature of the problem under investigation; an RCT will be used to investigate the effect of a new intervention without bias. This is because the act of randomization balances participant characteristics (both observed and unobserved) between the groups, allowing the attribution of any differences in outcome to the study intervention

Randomized block design

Patients who meet the inclusion criteria will be randomly assigned to two groups: immersive VR group and control-group. Randomized block design will be used to select and divide participants into different groups to avoid selection bias. It ensures that participants are assigned to groups with an equal probability, and the same number of participants for each group. Also, will be prepared opaque, sealed envelopes numbered sequentially to conceal the allocation sequences (Chiu et al., 2023). For blinding, because of the nature of the intervention, the participants and researcher could not be blinded, only the anesthesiologist will be blind to the patients’ groups during the regional anesthesia procedure.

No

The total sample was 128 participants. To overcome the attrition rate and who refused to participate, the final sample was 150 participants 75 participants per group (75 in VR group and 75 in control group).

The total sample was 128 participants. To overcome the attrition rate and who refused to participate, the final sample was 150 participants 75 participants per group (75 in VR group and 75 in control group).

The total sample was 128 participants. To overcome the attrition rate and who refused to participate, the final sample was 150 participants 75 participants per group (75 in VR group and 75 in control group).