The effect of virtual reality glasses used during chest tube removal following open-heart surgery on pain and hemodynamic parameters: a randomized controlled trial

Abstract Background Chest tube removal (CTR) following open-heart surgery is a painful procedure that may adversely affect patients’ hemodynamic parameters. Purpose This study aimed to determine the effect of virtual reality glasses (VRG) used during chest tube removal after open-heart surgery on pain levels and hemodynamic parameters. Methods This prospective, two-arm (1:1), randomized controlled trial included 82 patients undergoing open-heart surgery. Patients in the VRG group ( n = 41) were exposed to relaxing forest-walk-themed virtual reality content starting five minutes before CTR and continuing for five minutes after the procedure. The control group ( n = 41) received routine care without any additional intervention. Pain levels were assessed using the Visual Analog Scale (VAS), and hemodynamic parameters—systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), respiratory rate (RR), and peripheral oxygen saturation (SpO₂)—were recorded before CTR, immediately after, and at 5, 15, and 30 min post-procedure. Results A significant group × time interaction was observed for pain ( p = 0.003). After adjustment for baseline pain and multiple comparisons, pain was significantly lower in the VRG group than in the control group immediately after CTR (adjusted mean difference [VRG − Control]: −1.26, 95% CI: −1.85 to − 0.68; adjusted p < 0.001), whereas no significant between-group differences were observed at 5, 15, or 30 min. A significant group × time interaction was also observed for SpO₂ ( p < 0.001), with significantly higher SpO₂ in the VRG group immediately after CTR (adjusted mean difference: 2.70, 95% CI: 1.88 to 3.53; adjusted p < 0.001). No significant group × time interactions were observed for SBP, DBP, HR, or RR. Conclusion VRG use during CTR was associated with lower pain immediately after the procedure and higher SpO₂ immediately after CTR. No significant effects were observed for SBP, DBP, HR, or RR. These findings suggest that VRG may be a useful non-pharmacological adjunct for short-term pain management during CTR following open-heart surgery. Further studies are needed to confirm its effects on oxygenation and other hemodynamic parameters. Trial registration ClinicalTrials.gov (NCT05585853) first submitted on October 12, 2022, and first posted on October 19, 2022.