Complications associated with the use of virtual reality therapy during the treatment of postoperative pain

Abstract

Relevance. The therapy based on virtual reality is used as a method of non-pharmacological treatment of postoperative pain. Possible complications are poorly understood, making it difficult to use in everyday clinical practice.The objective was the evaluation of the development of complications when using therapy based on virtual reality in the treatment of postoperative pain syndrome.Materials and methods. A prospective clinical study was performed. 90 patients who had to perform surgical interventions were included. After randomization, three groups were formed: group I (n = 30) – therapy with a 15-minute session as an addition to standard therapy for postoperative pain, group II (n = 30) – therapy with a 25-minute session, and group III (n = 30) receiving only drug treatment of postoperative pain syndrome. Virtual reality-based therapy (VR-therapy) was performed 3, 7, 12 hours after surgery using the Oculus Quest 2 device. Postoperative nausea, vomiting and dizziness were considered complications of VR-therapy. The development of complications was assessed using the FMS (Fast Motion Sickness Scale) self-assessment of motion sickness and the Postoperative Nausea and Vomiting Scale (PONV). The quality of the patient’s recovery after anesthesia was assessed using the QoR-15 scale.Results. There were no differences in the incidence of visually induced motion sickness between groups with different session durations. The incidence of postoperative nausea and vomiting and the need for antiemetic drugs did not differ between the main and control groups. A positive correlation was found between the occurrence of visually induced motion sickness (VIMS) and the use of opioid drugs in the postoperative period. In patients with a VR-therapy session duration of 25 minutes, the indicators of the quality of recovery after anesthesia were higher than in other groups.Conclusions. The use of VR-therapy with a session of 15 and 25 minutes does not lead to an increase in the incidence of postoperative nausea and vomiting. The duration of therapy did not affect the development of VIMS. The indicators of the quality of recovery after anesthesia in the group with a duration of VR-therapy of 25 minutes were higher than in other groups.

Keywords

• postoperative pain
• vr-therapy
• virtual reality
• postoperative nausea and vomiting
• visually induced motion sickness