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Regional anesthesia allows surgery without affecting the patient's level of consciousness.However, this may cause anxiety in some patients.In previous research, scientists have tried to prevent anxiety with non-pharmacological interventions such as music and cognitive therapies.Virtual reality is thought to offer an immersive experience that can alter the mind's perception of pain. Scientists have found in previous preliminary studies that virtual reality is safe and effective as an adjunct to standard sedative/analgesic protocols for reducing patients' pain and anxiety during endoscopy, colonoscopy, dental treatments, burn dressings, and labor. In this study, it is expected that anxiety scores, postoperative analgesic need and intraoperative sedation need will decrease, recovery quality will improve and patient satisfaction will increase in patients who will undergo upper extremity surgery under regional anesthesia and watch videos through VR glasses.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Standart Anesthesia management | Other | In the non-VR group, the standard anesthesia procedure will be followed. Brachial plexus nerve block will be performed with a 50mm peripheral block needle (Vygon echoplex+ 22Gx50mm) with a mixture of 2% lidocaine and 0.5% bupivacaine (10 mL each) prepared as 20ml. After waiting for a sufficient time, the nerve block effectiveness of the patients will be measured by Modified Broomage scale and pinprick. Additional sedative agents may be applied to both groups at the discretion of the anesthesiologist and will be recorded. Anesthesia management will be applied to both groups in accordance with the standard working order of the Anesthesia clinic. |
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| VR group | Experimental | Oculus Quest 2 VR virtual reality glasses and wired over-ear headphones will be used for patients to hear the sounds of the immersive environment and to block the sounds coming from the operating room environment. Brachial plexus nerve block will be performed with a 50mm peripheral block needle (Vygon echoplex+ 22Gx50mm) with a mixture of 2% lidocaine and 0.5% bupivacaine (10 mL each) prepared as 20ml. After waiting for a sufficient time, the nerve block effectiveness of the patients will be measured by Modified Broomage scale and pinprick.Additional sedative agents may be applied to both groups at the discretion of the anesthesiologist and will be recorded. Anesthesia management will be applied to both groups in accordance with the standard working order of the Anesthesia clinic. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Oculus Quest 2 VR virtual reality glasses and wired over-ear headphones | Device | After the VR group comes to the preoperative area and is evaluated, they will be asked to wear VR glasses and headphones. VR glasses and headphones were worn on the patient during peripheral nerve block applications and the operation. At the end of the operation, the VR glasses and headphones were removed and they were taken to the postoperative recovery room. |
| Measure | Description | Time Frame |
|---|---|---|
| State-Trait Anxiety Scale | preoperative and postoperative STAI I and II score questions will be asked. | Preoperative, Postoperative 4.hour |
| Measure | Description | Time Frame |
|---|---|---|
| systolic blood pressure | non invasive systolic blood pressure measurement | Preoperative, İntraoperative 0 min, İntraoperative 60min, End of Operation, Postoperative 4.hour |
| diastolic blood pressure |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Ankara City Hospital | Ankara | Cankaya | Turkey (Türkiye) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 30577461 | Background | Moon JY, Shin J, Chung J, Ji SH, Ro S, Kim WH. Virtual Reality Distraction during Endoscopic Urologic Surgery under Spinal Anesthesia: A Randomized Controlled Trial. J Clin Med. 2018 Dec 20;8(1):2. doi: 10.3390/jcm8010002. | |
| 36312886 | Background | Barry KS, Nimma SR, Spaulding AC, Wilke BK, Torp KD, Ledford CK. Perioperative Outcomes of Immersive Virtual Reality as Adjunct Anesthesia in Primary Total Hip and Knee Arthroplasty. Arthroplast Today. 2022 Oct 22;18:84-88. doi: 10.1016/j.artd.2022.09.015. eCollection 2022 Dec. |
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| ID | Term |
|---|---|
| D001008 | Anxiety Disorders |
| D010149 | Pain, Postoperative |
| ID | Term |
|---|---|
| D001523 | Mental Disorders |
| D011183 | Postoperative Complications |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| ID | Term |
|---|---|
| D035061 | Control Groups |
| ID | Term |
|---|---|
| D015340 | Epidemiologic Research Design |
| D004812 | Epidemiologic Methods |
| D008919 | Investigative Techniques |
| D012107 | Research Design |
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| No VR | Other | After evaluation of the patients taken to the preoperative area, routine peripheral nerve block application was performed without the use of VR glasses. VR glasses were not worn during the operation, as is the routine protocol. At the end of the surgery, they were taken to the postoperative recovery room. |
|
|
non invasive diastolic blood pressure measurement
| Preoperative, İntraoperative 0 min, İntraoperative 60min, End of Operation, Postoperative 4.hour |
| mean arterial pressure | mean blood pressure measurement | Preoperative, İntraoperative 0 min, İntraoperative 60min, End of Operation, Postoperative 4.hour |
| heart rate | intraoperatif and perioperatif ecg monitarization | Preoperative, İntraoperative 0 min, İntraoperative 60min, End of Operation, Postoperative 4.hour |
| oxygen saturation | intraoperatif and perioperative pulse oxymeter measurement | Preoperative, İntraoperative 0 min, İntraoperative 60min, End of Operation, Postoperative 4.hour |
| aditional analgesic requirement | postoperative additional analgesic requirement | postoperative up to 24 hour |
| VAS score | A blinded evaluator will evaluate the visual analog scale score. | Postoperative 1.hour, 4.hour., 12.hour., 24hour. |
| Patient satisfaction scale | A blinded evaluator will evaluate the Patient satisfaction scale | Postoperative 4.hour |
| Surgeon satisfaction scale | A blinded evaluator will evaluate the surgeon satisfaction scale | Postoperativ 1.hour |
| The quality of recovery-15 (QoR-15) | A blinded evaluator will evaluate the QoR-15 scale. | Preoperative, Postoperative 24.hour |
| 31941129 | Background | Alaterre C, Duceau B, Sung Tsai E, Zriouel S, Bonnet F, Lescot T, Verdonk F. Virtual Reality for PEripheral Regional Anesthesia (VR-PERLA Study). J Clin Med. 2020 Jan 13;9(1):215. doi: 10.3390/jcm9010215. |
| 41455966 | Derived | Kose M, Nalbant B, Kavak Akelma F. Anxiolytic effect of virtual reality headset in upper extremity surgery: a prospective randomized trial. BMC Surg. 2025 Dec 27;26(1):87. doi: 10.1186/s12893-025-03448-w. |
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D008722 | Methods |