The Effect of Virtual Reality on the Patient Experience During Wide-Awake Hand Surgery: A Randomised Controlled Trial
试验速览
- 阶段
- 不适用
- 状态
- 撤回
- 主要终点
- Patient-reported Discomfort Score
研究概览
简要总结
The vast majority of hand surgery performed at the Royal London Hospital is carried out with patients wide-awake. This is either using local or regional (brachial block) anaesthesia. A high proportion of patients find the process stressful and intimidating, which can lead to intraoperative anxiety and increased requirements for anaesthetic dosages. Most of the hand surgery lists are primarily performed by trainees under consultant supervision: conscious, aware, and anxious patients can hinder the degree of training that can take place intra-operatively. Trainees requesting for assistance can further contribute to patient anxiety levels. Virtual Reality (VR) is a relatively new technology that allows total immersion in audio-visual entertainment. Early research work has demonstrated a positive effect of VR at reducing patient anxiety and analgesia requirements during invasive procedures. The investigators hope to conduct a research study whereby adult patients undergoing wide-awake hand surgery under the care of the Department of Plastic Surgery at the Royal London Hospital are given a VR headset (the Oculus Quest 2) and headphones to wear during their operation. The investigators aim to compare their levels of perceived pain, discomfort, anxiety, relaxation and satisfaction with the intraoperative experience to patients who undergo the same operation without VR, i.e. under the conditions of standard care. The investigators will also look at the patients' additional anaesthetic requirements during the operation and physiological markers of anxiety, like heart rate and blood pressure. The operating surgeon will be given the opportunity to answer questions regarding their levels of comfort performing the operation, communicating with their assistant surgeon and calling for help if required. The investigators believe the use of VR will have a positive effect on the patient experience and will improve training opportunities for junior surgeons.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Supportive Care
- 盲法
- Single (Outcomes Assessor)
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Written, informed consent provided prior to the occurrence of any study procedures;
- •Aged 18 years or above;
- •Undergoing a planned day-case operation involving the upper limb for any indication, under either local or regional anaesthesia.
排除标准
- •Suffer from claustrophobia, seizures or vertigo;
- •Have an active infection or open wound on the face;
- •Require droplet or airborne infection precautions;
- •Have eyesight or hearing problems that would impair the audio-visual experience of using VR (e.g. if the patient plans to wear hearing aids or eyeglasses during the operation);
- •Have a pacemaker or any other implanted medical device;
- •Are allergic to any materials on the VR headset or headphones (e.g. the VR headset facial interface foam).
研究组 & 干预措施
WITH Virtual Reality headset + headphones
Participants in the VR arm will undergo wide-awake hand surgery while using an Oculus Quest 2 Virtual Reality headset and Beats Ep Wired On-Ear headphones for the duration of the operation, as an adjunct to standard local or regional anaesthesia.
干预措施: Virtual Reality headset + headphones (Device)
WITHOUT Virtual Reality headset + headphones
Participants in the non-VR arm will undergo wide-awake hand surgery under the conditions of routine intraoperative care, that is under local or regional anaesthesia without any adjuncts, such as the Virtual Reality headset, headphones, or any other form of distraction or relaxation strategy.
结局指标
主要结局
Patient-reported Discomfort Score
时间窗: Intraoperative score measured in the immediate postoperative period (<1 day)
This will be measured by asking participants to rate their level of intraoperative discomfort along a 100-mm long visual analogue scale.
Patient-reported Anxiety Score
时间窗: Intraoperative score measured in the immediate postoperative period (<1 day)
This will be measured by asking participants to rate their level of intraoperative anxiety along a 100-mm long visual analogue scale.
Patient-reported Relaxation Score
时间窗: Intraoperative score measured in the immediate postoperative period (<1 day)
This will be measured by asking participants to rate their level of intraoperative relaxation along a 100-mm long visual analogue scale.
Patient-reported Pain Score
时间窗: Intraoperative score measured in the immediate postoperative period (<1 day)
This will be measured by asking participants to rate their level of intraoperative pain along a 100-mm long visual analogue scale (0 - 100).
Patient-reported Satisfaction Score
时间窗: Intraoperative score measured in the immediate postoperative period (<1 day)
This will be measured by asking participants to rate their level of overall satisfaction with their intraoperative experience along a 100-mm long visual analogue scale.
次要结局
- Intraoperative Heart Rate(Intraoperative (<1 day))
- Intraoperative Blood Pressure(Intraoperative (<1 day))
- Additional Intraoperative Anaesthetic Doses(Intraoperative (<1 day))
- Surgeon-reported Level of Comfort Performing the Operation(Intraoperative score measured in the immediate postoperative period (<1 day))
- Additional Intraoperative Sedative Doses(Intraoperative (<1 day))
- Surgeon-reported Level of Comfort Communicating with Assistant Surgeon(Intraoperative score measured in the immediate postoperative period (<1 day))
- Surgeon-reported Level of Comfort Calling for Help(Intraoperative score measured in the immediate postoperative period (<1 day))