Ask the doctors 12/3 | The Spokesman-Review

Eve Glazier, MD, and Elizabeth Ko, MD

Andrews McMeel syndication

Dear doctors: I have hand surgery next year help with carpal tunnel, and I’m not excited about anesthesia. I’ve read about surgeons whose patients use virtual reality headsets so they need less anesthesia. It really works?

Dear readers: The use of anesthesia in surgical procedures dates back to ancient times. The historical record shows that the Incas used extracts from plants such as dahlia and coca to relieve pain and induce unconsciousness, and early Chinese physicians offered opium potions to patients. Centuries later, efforts to refine and improve this process continue. And a small miracle.

Anesthesia is a complex practice with multiple and sometimes conflicting goals. Treatment must calm the patient and suppress his response to pain, but must not interfere with critical physiological functions of the bodyincluding heart rate, breathing and maintaining a constant blood pressure. While modern anesthesia is safer than ever before, still carries an element of risk. Hence the research to new drugs and new techniques continues.

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In the past few years, this research has included inquiries into the use of virtual reality, or VR, as an adjunctive therapy. This approach is being investigated in conjunction with what is known as regional anesthesia. Unlike general anesthesia where the patient is completely unconscious, someone undergoing regional anesthesia is soothes but remains conscious. Nerve blocks are used to suppress sensations from a specific and limited part of the body. This 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 their stress and anxiety is essential. Many patients are given sedation to relax or even take a nap 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 could reduce the need for sedation of the surgical patient.

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The most recent study of this idea produced interesting results. Over the course of eight months, researchers at Boston Medical Center evaluated the anesthesia needs of 34 patients undergoing hand surgery. Patients were divided into two groups. All received medication to completely block the pain response and all received intravenous sedation. However, one group was also given a VR headset with a selection of programs specifically designed to promote relaxation and a sense of calm. These included natural scenes such as a secluded meadow or mountaintop, guided meditations or immersive visuals such as a starry night sky.

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At the end of the study, data showed that patients who used VR headsets during surgery needed significantly less sedation than the non-VR control group. In addition, the recovery period after surgery for the VR groupduring which patients wait for the effects of sedation to wear off, was significantly shorter.

While the research is promising, it’s important to note that surgical teams and patients understand that VR can reduce the need for sedation, and this may have influenced outcomes. In your own case, it is essential that you discuss your concerns about anesthesia with your surgeon. Understanding the process, risks, and benefits can help alleviate your concerns.

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