Distraction, Elderly (people Aged 65 or More), Virtual Reality
Conditions
Keywords
virtual reality, distraction
Brief summary
We want to investigate whether Virtual Reality (VR) could be a good alternative to the relaxing or pain-relieving medications that are often used to alleviate anxiety when patients undergo surgery under local anesthesia.
Detailed description
This study is a randomized controlled trial based on both quantitative and qualitative methods. Inclusion criteria are elderly patients aged ≥65 years with an estimated surgery time of a maximum of 90 minutes, who undergo surgery/treatment under local anesthesia and sedation. Randomization is to either standard sedation or sedation/VR. Randomization is carried out using mixed, sealed envelopes. The studies will be conducted at the following locations: Hallands Hospital, Kungsbacka: Open inguinal hernia surgery with implant, anesthesia type is infiltration anesthesia. Sahlgrenska Hospital: Intervention, cannulation of the groin and vascular surgery performed via catheters/guides on blood vessels, liver, pancreas, and abdominal organs, with anesthesia type infiltration. Alingsås Hospital: Surgery on the hand, arm, lower extremity, urology, with anesthesia type block and infiltration. Data collection will include baseline preoperative stress levels measured with The State-Trait Anxiety Inventory (STAI-S) and pain assessment using a numerical rating scale (NRS) from 0-11. We also plan to use an objective marker for measuring anxiety-induced stress perioperatively, such as heart rate variability or skin conductance measurement. Postoperative data will include STAI-S, NRS, intraoperative sedative medication (type and dosage in mg/kg), time to urination, time to oral nutrition, discharge time, and time spent in the postoperative ward. The patient will assess their well-being with the QoR 15 and NRS during the first five days postoperatively. The patient will be contacted to schedule a follow-up individual interview with semi-structured questions via Zoom two weeks after the surgery. The primary outcome effect of VR glasses on mg/kg of propofol used intraoperatively or another sedative drug and/or the amount of local anesthetic used in mg. The secondary outcome effect of VR glasses on anxiety-induced stress perioperatively, where data collection will be conducted using EEG spectral edge frequency and The State-Trait Anxiety Inventory (STAI-S).
Interventions
DEVICEVirtual reality
Participant will try virtual reality glasses with tailormade software films to see if it's possible to use them as distraction during awake surgery. We will measure doses of propofol given, level of anxiety, experience of the patient and surgeons satisfaction.
Sponsors
Sahlgrenska University Hospital
Pether Jildenstal
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
RCT
Eligibility
Sex/Gender
ALL
Age
65 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* over 65 years, planed surgery in local anesthesia/regional anesthesia
Exclusion criteria
* dementia, unable to cooperate, cognitive impairment
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| propofol mg/kg | during the surgery (90 minutes max) | dose of propofol given during surgery to the participant |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Surgeons satisfaction | Directly after surgery is finished | surgeons satisfaction, measured with NASA task load index (tlx). Higher score, worse outcome. |
| Stress/anxiety | during the surgery (90 minutes max) | Stress or anxiety felt during surgery by participant, measured with State-Trait Anxiety Inventory (STAI) . Higher score worse outcome. |
| Nurse anesthetists experience, (questionnaire). | Directly after surgery is finished | Nurse anesthetists experience will be measured with a questionnaire egarding how well the monitoring of the patient could be carried out and the degree to which the patient was perceived as calm. The higher score, the better. |
| Level of pain | Directly after surgery is finished | Patients level of pain after surgery, measured with Numeric rating scale (NRS). The higher scores mean worse outcome. |
Countries
Sweden
Contacts
Primary ContactPether Jildenstål, Docent
Outcome results
None listed