The impact of virtual reality on patient experience during wide-awake surgery: a randomized controlled trial

J Hand Surg Eur Vol. 2025 Jan 24:17531934241313207. doi: 10.1177/17531934241313207. Online ahead of print.

Abstract

This study aimed to establish whether virtual reality can reduce patient anxiety and improve surgical satisfaction during wide-awake local anaesthetic no tourniquet hand procedures. Previously validated questionnaires were used to assess subjective anxiety and patient satisfaction. Objective anxiety was determined using patient blood pressure and heart rate measured four times during the procedure. The median difference in intra-operative minus pre-operative diastolic blood pressure was significantly lower in the virtual reality group compared with the control group (p = 0.003). There was a significant decrease in heart rate from pre-operative to post-operative within the virtual reality group (p < 0.001). No differences were observed in subjective anxiety or surgical satisfaction between the groups. Virtual reality can benefit wide-awake patients during hand procedures, particularly where patient preference exists.Level of evidence: Level I, Randomized Controlled Trial.

Keywords: Anxiety; WALANT; patient satisfaction; virtual reality.