Ask the Doctors 12/3

Ask the Doctors 12/3

By Eve Glazier, MD, and Elizabeth Ko, MD

Andrews McMeel Syndication

Dear Doctors: I am having surgery next year. to help with carpal tunnel, and I’m not thrilled to have anesthesia. I’ve read about surgeons whose patients use VR headsets to reduce the need for anesthesia. Does it really work?

Dear reader: The use of anesthesia in surgical procedures dates back to ancient times. Historical records show that the Incas used plant extracts like datura and coca to reduce pain and induce unconsciousness, and early Chinese doctors offered patients opium-based potions. Centuries later, efforts to refine and improve the process continue. And a little wonder.

Anesthesia is a complex practice with multiple and sometimes contradictory objectives. Treatment should sedate the patient and suppress their response to pain, but not interfere with critical physiological functions of the bodyincluding heart rate, breathing, and maintaining stable blood pressure. While modern anesthesia is safer than ever before, it always involves an element of risk. This is why research in new drugs and new techniques keep on going.

In recent years, this research has included investigations into the use of virtual reality, or VR, as a complementary therapy. This approach is being explored in conjunction with what is called regional anesthesia. Unlike general anesthesia, where the patient is completely unconscious, a person undergoing regional anesthesia is sedative but rest aware. Nerve blocks are used to inhibit sensation in a specific, limited part of the body. The technique is often used in surgery on an extremity, such as an arm, hand, leg, or foot.

Because the patient stays awake during regional anesthesia, managing stress and anxiety is crucial. Many patients are given sedation to be able to relax or even doze off during the procedure. With the advent of computer-generated virtual reality, which uses special headsets to immerse the user in an immersive 3D world, researchers began to wonder if this might reduce a surgical patient’s need for sedation.

The most recent study on this idea has yielded some intriguing results. For eight months, researchers at a Boston medical center assessed the anesthesia needs of 34 patients undergoing hand surgery. The patients were divided into two groups. All received drugs to completely block the pain response and all received intravenous sedation. But one group also received VR headsets with a selection of programs specifically designed to promote relaxation and a sense of calm. These included nature scenes, like a secluded meadow or mountain peak, guided meditations, or immersive visuals, like a starry night sky.

At the end of the study, the data showed that patients who used VR headsets during their surgery needed significantly less sedation than the control group without VR. Additionally, the post-surgical recovery period for the VR groupduring which patients wait for the effects of sedation to wear off, was significantly shorter.

Although the research is promising, it is important to note that both surgical teams and patients understood that virtual reality could reduce the need for sedation, which could have influenced the results. In your own case, it is crucial that you discuss your anesthesia concerns with your surgeon. Understanding the process, risks, and benefits can help ease your concerns.

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