Effect of virtual reality and music on anxiety and perioperative pain in impacted third molar extraction under local anesthesia.

INTERVNETION GROUP 1 (MUSIC GROUP) Once the bibliographic search has been carried out and based on the most effective, comfortable studies and with the best results for the patient, it has been proved that there is no clear evidence of which type of music is more beneficial decreasing anxiety, but music determined by patient is preferred. For their use, patients will be given an iPOD®-type electronic acoustic reproduction device with free and unlimited access to Spotify Premium® music application, with wireless headphones headband type (Trust Urban®) (property of the Service of Oral and Maxillofacial Surgery), with pads that improve acoustics and an adjustable headband, which allow individual and isolated listening to the music during the process. In the pre-operating room, when the patient is alone, the headband-type headset will be delivered 15 minutes before the molar extraction with the music selected by the patient. For the effectiveness of the musical effect, and to avoid the risk or possibility of acoustic damage to the patient, the recommended volume is about 60-70 decibels (db). After 15 minutes alone listening to music, the patient goes to the operating room where the standard surgical extraction of the lower third molar is performed while the patient uses the music player throughout the surgery. During the surgery, the basic vital signs will be taken again: TAD / TAS, Sat O2 and HR through the same tower with which they were taken in the consultation and in the ante-operating room. These constants will be taken at different times during the surgical procedure: during the infiltration of local anesthetic (articaine with epinephrine 40 / 0.005mg / ml (brand name Ultracain ®)); during mandibulotomy and dental section carried out with a handpiece at 40,000 revolutions with a 23 milling cutter; and after the closure of the flap and placement of local compressive gauze. This procedure may take around 15 minutes 15 minutes after the surgery, the STAI-Y1 questionnaire will be passed again and the basic vital signs will be taken again. And finally, a visual analog scale (VAS) will be used to indicate the perioperative pain experienced by the patient. INTERVENTION GROUP 2 (VIRTUAL REALITY GROUP) In this study, virtual reality glasses from Bnext ® (property of Oral and Maxillofacial Surgery service) will be used, these have adjustable straps to the contour of the head to give greater comfort to the patient and allow a prolonged use of them. It also has the ability to adjust the focus and distance that optimize the quality and focus of the image. It has a protection system for the patient's sight, to guarantee their visual safety. For its use, it is only necessary to insert a compatible smartphone in the front part of the glasses, thus allow to see images in a 360º world where the limit is the imagination. A 3D video with relaxing images of nature will then be played, along with the relaxing sounds that accompany the 3D images, that allow the patient to disconnect as there is a continuous fusion between listening and visualizing a relaxing situation. In the same way as in the music intervention group, in the pre-operating room and being unaccompanied, the patient will be provided virtual reality glasses 15 minutes before the intervention. After 15 minutes alone and viewing the 3D video, the patient goes to the operating room where the standard surgical extraction of the lower third molar is carried out while the patient uses the virtual reality device that will be used throughout the surgery. During the surgery, the basic vital signs will be taken again: TAD / TAS, Sat O2 and HR through the same tower with which they were taken in the consultation and in the ante-operating room. These constants will be taken at different times during the surgical procedure: during the infiltration of local anesthetic (articaine with epinephrine 40 / 0.005mg / ml (brand name Ultracain ®)); during mandibulotomy and odontosection carried out with a handpiece at 40,000 revolutions with a 23 bur; and after the closure of the flap and placement of local compressive gauze. 15 minutes after the surgery, the STAI-Y1 questionnaire will be passed again and the basic vital signs will be taken again. And finally, a visual analog scale (VAS) will be used to indicate and record the periopertory pain experienced by the patient.