Brazilian Journal of Anesthesiology
Brazilian Journal of Anesthesiology
Original Investigation

Effect of virtual reality on preoperative anxiety in patients undergoing septorhinoplasty

Çağdaş Baytar, Keziban Bollucuoğlu

Downloads: 0
Views: 18


The aim of this study was to evaluate the effect of a virtual reality video on preoperative anxiety, hemodynamic parameters, and patient satisfaction in patients undergoing septorhinoplasty.

This was a prospective, observational cohort trial. Forty patients between the ages of 18–65 who were scheduled for elective septorhinoplasty, with an American Society of Anesthesiologists (ASA) physical status I–II were included in the study. Patients experienced a 15-minute virtual reality (VR) video via a phone using a VR device. A three-dimensional, 360° video depicted the beauty of nature and was accompanied by meditation music. Patients’ oxygen saturation values, heart rate, and blood pressure were monitored and recorded. Using the State-Trait Anxiety Inventory scale, anxiety scores and hemodynamic parameters were compared before and after VR application.

Median anxiety scores decreased significantly from 40.5 to 34 (p < 0.001). VR also had positive effects on hemodynamic parameters.

VR reduces preoperative anxiety and has positive effects on hemodynamic parameters in patients undergoing septorhinoplasty. We anticipate that VR will be increasingly used as a non-pharmacological preoperative approach in the future.


Virtual realityAnxietyPremedicationNasal surgery procedures


1 E. Erkilic, E. Kesimci, C. Soykut, et al. Factors associated with preoperative anxiety levels of Turkish surgical patients: From a single center in Ankara Patient Prefer Adherence., 11 (2017), pp. 291-296

2 N. Bahrami, M. Soleymani, Z. Arjinee, et al. Impact anxious patient care based upon the nursing process for elective surgery for women J Nurs Iran., 25 (2012), pp. 9-30

3 R.D. Miller Psychological preparation and preoperative medication in anesthesia. Miller’s Anesthesia (4th ed.), Churchill Livingstone, Philadelphia (1994), pp. 1015-1016

4 M. Namazi, S.A.A. Akbari, F. Mojab, et al. Aromatherapy with citrus aurantium oil and anxiety during the first stage of labor Iran Red Crescent Med J., 16 (2014), Article e18371

5 A. Ali, D. Altun, B.H. Oguz, et al. The effect of preoperative anxiety on postoperative analgesia and anesthesia recovery in patients undergoing laparascopic cholecystectomy J Anesth., 28 (2014), pp. 222-227

6 F. Dehghan, R. Jalali, H. Bashiri The effect of virtual reality technology on preoperative anxiety in children: a Solomon four-group randomized clinical trial Perioper Med., 8 (2019), pp. 1-7

7 E. Turksal, I. Alper, D. Sergin, et al. The effects of preoperative anxiety on anesthetic recovery and postoperative pain in patients undergoing donor nephrectomy Rev Bras Anestesiol., 70 (2020), pp. 271-277

8 L. Ganry, B. Hersant, M. Sidahmed-Mezi, et al. Using virtual reality to control preoperative anxiety in ambulatory surgery patients: A pilot study in maxillofacial and plastic surgery J Stomatol Oral Maxillofac Surg., 119 (2018), pp. 257-261

9 Alan Stevens Understanding addiction to benzos Mary Pomerantz Advertising, Palm Beaches (2013), pp. 4-16

10 J.J.I. Chan, C.T. Yeam, H.M. Kee, et al. The use of pre-operative virtual reality to reduce anxiety in women undergoing gynecological surgeries: a prospective cohort study BMC Anesthesiol., 20 (2020), pp. 1-8

11 G. Székely, R.M. Satava Virtual reality in medicine. Interview by Judy Jones BMJ., 319 (1999), p. 1305

12 A. Li, Z. Montano, V.J. Chen, J.I. Gold Virtual reality and pain management: Current trends and future directions Pain Manag., 1 (2011), pp. 147-157

13 J.H. Ryu, J.W. Park, F.S. Nahm, et al. The effect of gamification through a virtual reality on preoperative anxiety in pediatric patients undergoing general anesthesia: A prospective, randomized, and controlled trial J Clin Med., 7 (2018), p. 284

14 T.M. Hendricks, C.N. Gutierrez, J.M. Stulak, J.A. Dearani, J.D. Miller The use of virtual reality to reduce preoperative anxiety in first-time sternotomy patients: a randomized controlled pilot trial Mayo Clin Proc., 95 (2020), pp. 1148-1157

15 H.G. Hoffman, I.N. Doctor, D.R. Patterson, et al. Virtual reality as an adjunctive pain control during burn wound care in adolescent patients Pain., 85 (2000), pp. 305-309

16 H.G. Hoffman, A. Garcia-Palacios, D.R. Patterson, et al. The effectiveness of virtual reality for dental pain control: a case study Cyberpsychol Behav., 4 (2001), pp. 527-535

17 K. Kim, C.H. Kim, S.Y. Kim, et al. Virtual reality for obsessive-compulsive disorder: past and the future Psychiatry Investig., 6 (2009), pp. 115-121

18 H.G. Hoffman Virtual-reality therapy Sci Am., 291 (2004), pp. 58-65

19 L. Gregg, N. Tarrier Virtual reality in mental health: a review Soc Psychiatry Psychiatr Epidemiol., 42 (2007), pp. 343-354

20 L.J. Julian Measures of anxiety: State-Trait Anxiety Inventory (STAI), Beck Anxiety Inventory (BAI), and Hospital Anxiety and Depression Scale-Anxiety (HADS-A) Arthritis Care Res (Hoboken)., 63 (2011), pp. 467-472

21 N. Öner, A. Le Compte Handbook of State-Trait Anxiety Inventory Boğaziçi University Press, Istanbul (1983)

22 A. Le Compte, N. Öner Durumluk-Sürekli Kaygı Envanterinin Türkçe’ye adaptasyon ve standardizasyonu ile ilgili bir çalışma [A study on the adaptation and standardization of the State-Trait Anxiety Inventory]. IX. Milli Psikiyatri ve Nörolojik Bilimler Kongresi Çalışmaları (1975), pp. 457-462

23 C.H. Koo, J.W. Park, J.H. Ryu, et al. The effect of virtual reality on preoperative anxiety: a meta-analysis of randomized controlled trials J Clin Med., 9 (2020), p. 3151

24 J.B. Palmer, D. Lane, D. Mayo, et al. Effects of music therapy on anesthesia requirements and anxiety in women undergoing ambulatory breast surgery for cancer diagnosis and treatment: a randomized controlled trial J Clin Oncol., 33 (2015), pp. 3162-3168

25 G.A. Uğraş, G. Yıldırım, S. Yüksel, et al. The effect of different types of music on patients’ preoperative anxiety: A randomized controlled trial Complement Ther Clin Pract., 31 (2018), pp. 158-163

26 J.Y. Moon, J. Shin, J. Chung, et al. Virtual reality distraction during endoscopic urologic surgery under spinal anesthesia: a randomized controlled trial J Clin Med., 8 (2018), p. 2

27 P.G. Pandya, T.E. Kim, S.K. Howard, et al. Virtual reality distraction decreases routine intravenous sedation and procedure-related pain during preoperative adductor canal catheter insertion: a retrospective study Korean J Anesthesiol., 70 (2017), pp. 439-445, 10.4097/kjae.2017.70.4.439

28 M. Maze, W. Tranquilli Alpha-2 adrenoceptor agonists: Defining the role in clinicalanesthesia Anesthesiology., 74 (1991), pp. 581-605

29 M. Aho, M. Scheinin, A.M. Lehtinen, et al. Intramuscularly administered dexmedetomidine attenuates hemodynamic and stress hormone responses to gynecologic laparoscopy Anesth Analg., 75 (1992), pp. 932-939

30 G. Eren, Z. Cukurova, G. Demir, et al. Comparison of dexmedetomidine and three different doses of midazolam in preoperative sedation J Anaesthesiol Clin Pharmacol., 27 (2011), pp. 367-372

6154a93ca95395573b645052 rba Articles
Links & Downloads

Braz J Anesthesiol

Share this page
Page Sections