VIRTUAL REALITY INTERVENTIONS FOR PAIN, ANXIETY, AND PRE OPERATIVE EDUCATION IN SURGICAL PATIENTS: A SYSTEMATIC REVIEW

ABSTRACT Perioperative anxiety, pain, and insufficient patient education continue to pose significant challenges in surgical care, often negatively affecting clinical outcomes and patient satisfaction. Virtual reality (VR) has recently gained attention as an innovative, non-pharmacological intervention capable of improving psychological and experiential outcomes in surgical settings. This systematic review evaluated the effectiveness of VR-based interventions in reducing perioperative anxiety and pain, enhancing patient education, and improving overall perioperative experiences across diverse surgical populations. A comprehensive search of major electronic databases, including PubMed, Europe PMC, Google Scholar, CORE, and TRIP databases , was conducted to identify studies published between 2023 and 2026. Eligible studies comprised randomized controlled trials, pilot studies, and feasibility studies assessing VR interventions in perioperative contexts. Ten studies met the inclusion criteria, involving both pediatric and adult populations. Most studies reported significant reductions in perioperative anxiety, with several also demonstrating improvements in pain perception, patient cooperation, and satisfaction. Interventions that combined immersive VR with educational or mindfulness-based components produced the most consistent outcomes, with particularly strong effects observed among pediatric patients and individuals undergoing surgery for the first time. However, variations in intervention design, outcome measures, and study populations limited direct comparison across studies. Overall, VR appears to be a promising adjunct in perioperative care, offering meaningful benefits in psychological preparation and patient experience. Nevertheless, further large-scale, multicenter trials with standardized methodologies are necessary to confirm long-term effectiveness, cost-efficiency, and broader clinical applicability.