The Effect of Virtual Reality on Peri-Operative Anxiety during WALANT Hand Surgery: A Prospective Randomized Trial

Objectives Wide-awake local anesthesia no-tourniquet (WALANT) hand surgery is increasing in utilization due to increased perioperative efficiency and decreased costs and complications associated with systemic anesthetics. However, patient anxiety during WALANT hand surgery could be a concern. This study evaluated how virtual reality (VR) augmentation impacts the patient experience and anxiety during WALANT hand surgery. Methods A prospective randomized controlled trial of 59 patients undergoing WALANT hand surgery with patients randomized to VR and no VR augmentation. Pre-, intra-, and postoperative vitals, anxiety scores, and pain scores were collected. A satisfaction survey was completed after surgery. Results Preoperatively, there were no differences in mean anxiety scores. However, mean anxiety scores were significantly lower in the VR group intraoperatively and postoperatively. Within the control group, there were no differences in mean anxiety scores pre-, intra- or postoperatively. However, within the VR group, mean anxiety scores were significantly decreased intraoperative and postoperatively relative to preoperatively. Conclusions VR augmentation significantly lowers patient anxiety during the WALANT hand surgery experience. Patients expressed high satisfaction rates with the use of VR.