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BALTIMORE -- Providing patients scheduled for colorectal cancer surgery with a virtual reality experience beforehand, to acquaint them with what to expect during surgery and recovery, showed promise for lowering pre-procedure anxiety, results from a small randomized trial indicated.

For participants in the virtual reality group (VR), the mean post-VR Hospital Anxiety and Depression Scale for Depression (HAD-D) score was 2.40, compared to a mean basal HAD-D score of 3.20 (P=0.061). Mean post-VR Hospital Anxiety and Depression Scale for Anxiety (HAD-A) score was 6.45 and mean basal HAD-A score was 7.10 (P=0.25), according to Romina Pena, MD, of Hospital Clínic de Barcelona in Spain.

The average post-VR State-Trait Anxiety Inventory (STAI-A/T) score was 18.35, and the average basal STAI-A/T score was 21.40 (P=0.036). The average post-VR State-Trait Anxiety Inventory (STAI-A/S) score was 17.50, and average basal STAI-A/S score was 19.85 (P= 0.26), reported Pena here at the .

There were no differences between participants based on age or gender, Pena added. Although most of the pre- vs post-operative comparisons in the 65-patient study did not reach statistical significance, virtual reality "seems to be a promising tool," Pena told attendees. She added that larger studies are needed to confirm a genuine benefit.

Preoperative anxiety affects as many as 76% of patients undergoing a scheduled operation, Pena explained. Prior research has "shown that high anxiety levels are associated with higher rates of postoperative complications and lower patient satisfaction and quality of life scores."

Session co-chair Ankit Patel, MD, of Emory University in Atlanta, pointed out that the Veterans Affair hospital in Atlanta is piloting something similar. The pilot is not just limited to surgeries, but to the whole process of navigating the VA, which is a very complicated system to deal with due to their care of patients with higher rates of post-traumatic stress disorder (PTSD). "One issue that they noted early on is higher rates of nausea with this VR system," Patel emphasized.

However, that's "not really" the case here, Pena noted. "We don't really have cases of nausea even in early patients," she said, but "we can address that better" as more data accumulate.

Pena's group randomized 27 patients to the virtual reality group and 38 to the standard procedure group. Patients' mean age was 67.8 and 33.8% were women. Patients viewed the VR software for about 16.5 minutes.

The virtual reality experience depicted a hospital setting, including the surgical ward, operating rooms, and postoperative recovery room, all of which were similar to the Hospital Clinic of Barcelona. The recordings were reviewed by surgeons, secretaries, nurses, and experts in audiovisual technology.

The experience went over key steps of the surgical process as explained by the treatment team. Anxiety was assessed using STAI and HAD questionnaires. Patients were excluded if they had visual or neurological impairment, prior abdominal operation in adulthood, and permanent stoma indication.

Looking ahead, the investigators hope to extend the use of this technology to different types of medical and surgical scenarios, Pena indicated.

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