| Effects of a virtual reality digital twin of the operating theatre on anxiety in pediatric surgery patients: a randomized controlled trial |
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Jiyoun Lee1, Jung-Hee Ryu1,2,3, Jin-Hee Kim1,2, Sung-Hee Han1,2,3, Jin-Woo Park1,2,3 |
1Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Bundang-gu, Seongnam, Republic of Korea
2Department of Anesthesiology and Pain Medicine, College of Medicine, Seoul National University, Seoul, Korea
3Department of Anesthesiology and Pain Medicine, Medical Virtual Reality Research Group, Seoul National University College of Medicine, Gwanak-gu, Seoul, Republic of Korea |
Corresponding author:
Sung-Hee Han,
Jin-Woo Park, Tel: 82-31-787-7499, Fax: 82-31-787-4063,
Email: jinul8282@gmail.com
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Received: 10 December 2024 • Revised: 1 April 2025 • Accepted: 1 April 2025
*Jiyoun Lee and Jung-Hee Ryu contributed equally to this study as co-first authors. |
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| Abstract |
Background
Sevoflurane-based volatile induction and maintenance of anesthesia (VIMA) is common in pediatric outpatient surgery but can elevate preoperative anxiety in unfamiliar settings. This study compared the effects of immersive 3D virtual reality (VR) digital twin that precisely simulated the operating theatre environment with those of two-dimensional (2D) video education on preoperative anxiety in pediatric patients undergoing VIMA.
Methods
In total, 102 pediatric patients undergoing elective ambulatory surgery were randomly assigned to either the VR or tablet group. Identical preoperative education was provided through a 3D VR digital twin or tablet video. Preoperative anxiety, induction compliance, and procedural behavior during anesthesia induction were assessed using the modified Yale Preoperative Anxiety Scale (mYPAS), induction compliance checklist (ICC), and procedural behavior rating scale (PBRS), respectively. The VIMA induction times, and parental satisfaction were recorded.
Results
Children in the VR group exhibited lower mYPAS (33.3 [23.3–49.2] versus 46.7 [33.3–55.8], P = 0.022), higher ICC (P = 0.007), and lower PBRS (0.0 [0.0–1.0] versus 1.0 [0.0–2.0], P = 0.009) scores than those in the tablet group. The VIMA induction time was also shorter in the VR group (305.0 [253.5–392.5] versus 382.0 [329.0–480.0] s, P = 0.002), although parental satisfaction was comparable between the two groups.
Conclusions
Compared with video education, preoperative education utilizing an immersive 3D VR digital twin enhanced the efficacy of VIMA process, resulting in reduced preoperative anxiety, increased compliance, lower distress during anesthetic induction, and shorter induction time. |
| Key Words:
Virtual reality; Virtual reality exposure therapy; Anesthesia, inhalation; Pediatric anesthesia; Preoperative care; Anxiety |
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