Effect of virtual reality hypnosis on intraoperative sedation needs and functional recovery in knee arthroplasty : a prospective randomized clinical trial
© American Society of Regional Anesthesia & Pain Medicine 2024. No commercial re-use. See rights and permissions. Published by BMJ..
BACKGROUND AND OBJECTIVES: Perioperative psychological stress and pharmacological anxiolysis can negatively affect the quality of recovery after total knee arthroplasty. We aimed to assess whether hypnosis combined with virtual reality could reduce intraoperative pharmacological sedation and improve quality of recovery after total knee arthroplasty surgery.
METHODS: In this prospective randomized clinical trial, 60 patients scheduled for total knee arthroplasty with spinal anesthesia were randomly divided into 2 groups of 30 patients each. Intraoperatively, intermittent boluses of midazolam 1 mg were administered at 5 min intervals at the patient's request, with a maximum driven by the clinical assessment of sedation depth. During surgery, patients received standard care (group control) or virtual reality hypnosis (group VRH). An unblinded observer recorded the total dose of midazolam administered during surgery, and changes in the Quality-of-Recovery 15-item score, comfort, fatigue, pain and anxiety before and 1, 3 and 7 days after surgery.
RESULTS: Patients in the VRH group required a lower dose of midazolam (mg; median (range)) intraoperatively (group VRH: 0 (0-4) and group control: 2 (0-9), p<0.001). Quality-of-Recovery 15-item, anxiety, and pain were similar between groups.
CONCLUSIONS: In total knee arthroplasty with spinal anesthesia, VRH reduces the requirement for intraoperative pharmacological sedation, without a change in the quality of recovery.
TRIAL REGISTRATION NUMBER: NCT05707234.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2024 |
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| Enthalten in: |
Regional anesthesia and pain medicine - (2024) vom: 27. Feb. |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Carella, Michele [VerfasserIn] |
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| Links: |
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| Themen: |
Acute Pain |
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| Anmerkungen: |
Date Revised 27.02.2024 published: Print-Electronic ClinicalTrials.gov: NCT05707234 Citation Status Publisher |
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| doi: |
10.1136/rapm-2023-105261 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM369031105 |
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| 500 | |a published: Print-Electronic | ||
| 500 | |a ClinicalTrials.gov: NCT05707234 | ||
| 500 | |a Citation Status Publisher | ||
| 520 | |a © American Society of Regional Anesthesia & Pain Medicine 2024. No commercial re-use. See rights and permissions. Published by BMJ. | ||
| 520 | |a BACKGROUND AND OBJECTIVES: Perioperative psychological stress and pharmacological anxiolysis can negatively affect the quality of recovery after total knee arthroplasty. We aimed to assess whether hypnosis combined with virtual reality could reduce intraoperative pharmacological sedation and improve quality of recovery after total knee arthroplasty surgery | ||
| 520 | |a METHODS: In this prospective randomized clinical trial, 60 patients scheduled for total knee arthroplasty with spinal anesthesia were randomly divided into 2 groups of 30 patients each. Intraoperatively, intermittent boluses of midazolam 1 mg were administered at 5 min intervals at the patient's request, with a maximum driven by the clinical assessment of sedation depth. During surgery, patients received standard care (group control) or virtual reality hypnosis (group VRH). An unblinded observer recorded the total dose of midazolam administered during surgery, and changes in the Quality-of-Recovery 15-item score, comfort, fatigue, pain and anxiety before and 1, 3 and 7 days after surgery | ||
| 520 | |a RESULTS: Patients in the VRH group required a lower dose of midazolam (mg; median (range)) intraoperatively (group VRH: 0 (0-4) and group control: 2 (0-9), p<0.001). Quality-of-Recovery 15-item, anxiety, and pain were similar between groups | ||
| 520 | |a CONCLUSIONS: In total knee arthroplasty with spinal anesthesia, VRH reduces the requirement for intraoperative pharmacological sedation, without a change in the quality of recovery | ||
| 520 | |a TRIAL REGISTRATION NUMBER: NCT05707234 | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Acute Pain | |
| 650 | 4 | |a Drug-Related Side Effects and Adverse Reactions | |
| 650 | 4 | |a Lower Extremity | |
| 650 | 4 | |a Outcome Assessment, Health Care | |
| 650 | 4 | |a Pain Management | |
| 700 | 1 | |a Beck, Florian |e verfasserin |4 aut | |
| 700 | 1 | |a Quoilin, Caroline |e verfasserin |4 aut | |
| 700 | 1 | |a Azongmo, Murielle M |e verfasserin |4 aut | |
| 700 | 1 | |a Loheac, Adrien |e verfasserin |4 aut | |
| 700 | 1 | |a Bonhomme, Vincent L |e verfasserin |4 aut | |
| 700 | 1 | |a Vanhaudenhuyse, Audrey |e verfasserin |4 aut | |
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