The effect of preoperative virtual reality distraction to reduce anxiety in pediatric patients undergoing general anesthesia

Background: Children are very susceptible to preoperative anxiety due to limited cognitive abilities and greater dependence on others. Children's limited insight and understanding of the benefits of the medical procedures they will undergo, especially separation from their parents, medical procedures, thus worsening the anxiety they experience and potentially causing long-term effects. This is the reason for the development of therapies to reduce children's anxiety both pharmacological and non-pharmacological. This study focuses on non-pharmacological therapy using Virtual Reality (VR) to divert children's attention in terms of audio and visuals by playing their favorite cartoon films. Methods: This study is an Unblinded Randomized Controlled Trial. Forty pediatric patients aged 5-12 years who met the eligibility criteria undergoing general anesthesia at Prof. Dr. IGNG Ngoerah General Hospital, Denpasar during the study period (September - October 2024), were recruited into the study. Subjects were then randomly allocated into 2 groups, where group P1 was given Virtual Reality (VR) and group P2 was not given VR. Then anxiety scoring was assessed with the Modified Yale Preoperative Anxiety Scale (mYPAS) in the reception room when the patient arrived and before entering the operating room. Results: There were no significant differences in demographic characteristics and initial mYPAS scores between the two groups. Statistical tests showed a lower mean mYPAS score in the VR distraction treatment group compared to the standard treatment group (37.5 vs 59.4, p < 0.001). Conclusion: The use of VR in the perioperative period can reduce anxiety in pediatric patients undergoing general anesthesia compared to patients who are not given VR.