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In an effort to manage patient anxiety and control the costs of surgery, virtual reality (VR) is being used as an alternative to anesthesia and sedation in medical procedures with great success. One pioneering physician in Mexico began his research into this practice by beginning with the use of video games and moving to VR after experiencing success. The results have been published in an alternative to anesthesia and sedation in medical procedures with great success. One pioneering physician in Mexico began his research into this practice by beginning with the use of video games and moving to VR after experiencing success. The results have been published in an article by Jo Marchant with the BBC.

It has been said that necessity is the mother of invention. In 2004, Dr. Jose Luis Mosso Vazquez, a surgeon at Panamerican University in Mexico City, bought a Spider-Man game for his son. The game, an early form of VR, involved images projected onto a head-mounted display. Dr. Mosso was struck by how immersed his son became in the game and wondered if this was something that he could use to reduce the level of anxiety that patients experience during minor surgery. Dr. Mosso experimented using the Spider Man game with the head-mount while doing endoscopies. Patients were encouraged to play the game during the procedure instead of being sedated. He asked patients to score their pain level during the procedure and found that the immersive quality of the game reduced the need for sedation. In 2006, Dr. Mosso presented his results at the Medicine Meets Virtual Reality conference in California.

At the conference, Dr. Mosso met Albert “Skip” Rizzo, a psychologist (and now Director of Medical VR at the University of Southern California), who had been doing similar research with endoscopies. “He presented 10 cases,” says Mosso. “I presented 200.” Rizzo showed Mosso the expensive, state-of-the-art head-mounted displays he was using. “It was another world,” says Mosso. But then Rizzo revealed the equipment with which he had begun – it was the exact same Spider-Man game.

Rizzo was impressed with Mosso’s research and donated a headset to him. Rizzo also convinced a colleague, Brenda Wiederhold of the Virtual Reality Medical Center in San Diego, to let Mosso use some virtual worlds she had developed specifically for pain relief.

Mosso returned to Mexico and began using his new VR setup in a wide range of procedures, including childbirth and heart surgery. VR helped patients relax in all situations, but Mosso had the most success using VR in minor outpatient procedures where patients are awake but sedated. In these procedures, Mosso used a virtual scenario developed by Wiederhold called Enchanted Forest. This virtual world was meant to relax the patient and allowed them to explore rivers, lakes, trees, and forests. Virtual experiences involving guns and violence are not used because they tend to increase blood pressure, which could result in uncontrolled bleeding.

In using VR, Dr. Mosso found that patients required half as much sedation as they normally would require and, in some cases, required no sedation. In addition to relieving patient anxiety, there has been a significant cost savings for the clinics for sedative drugs such as fentanyl and midazolam, which are very expensive. Dr. Mosso estimates that the cost of surgery has been reduced by 25%. More important, less sedation reduces the risk of complications and recovery times. With these results, Dr. Mosso hopes to see VR more widely used not just for surgery, but to relieve pain in medical situations such as wound care and dentistry, as well as in chronic conditions such as phantom limb pain. And in areas where resources are limited, VR may be a welcome solution.

"Mosso doesn’t have the facilities here to sedate her, or offer her any painkillers more powerful than the local anesthetic, so he plugs in the laptop and switches the VR back on. Veronica keeps Oliveria talking as Mosso works. “What do you see?” she asks. “Fishes, water, stones,” Oliveria replies."

The University of Washington did a striking study with burn victims, showing them an experience they called SnowWorld during sessions of skin grafting. "Pain research using fMRI brain scans show significant reductions in pain-related brain activity..."

 

Photo credit: University of Washington

 

Using VR as a high-tech distraction technique allows surgeons to carry out operations that would normally require powerful painkillers and sedatives, with nothing more than local anesthetic. In addition to significant cost savings, VR has demonstrated that its immersive quality reduces patient anxiety and facilitates speedier recovery. Now that there is research to support these claims and the price of headsets has come down, consumers can hope that more doctors will take advantage of VR in improving patient experience and outcomes.

This attention distraction power is also a game changer for uncomfortable procedures such a dialysis and chemotherapy, waiting rooms, as well as what Mosso has done, for everything from fom childbirth to heart surgery. Distraction VR is sure to be a catalyst in VR wellness applications.

Please also read our white paper: "Using Virtual Reality for the Reduction of Anxiety: An Introduction to How Immersive VR Can Improve the Treatment of Anxiety"

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