The effect of a 360º educational video in a virtual reality on preoperative fear and postoperative pain in children undergoing tonsillectomy/adenoidectomy: a blind, randomized, controlled study

Abstract

Background : Preoperative anxiety and postoperative discomfort are critical issues in pediatric surgical management, especially in children undergoing tonsillectomy/ adenoidectomy. Virtual Reality (VR) is an immersive, non-pharmacological approach that may alleviate anxiety and improve procedural tolerance. Aim : The aim of this study was to assess the efficacy of a 360-degree educational virtual reality movie in alleviating preoperative anxiety and postoperative discomfort in children aged 6 to 12 years undergoing tonsillectomy/adenoidectomy. Methods : A single-blind, randomized controlled trial was performed with 92 pediatric patients allocated to either an experimental group (n = 46), who viewed a 360 degrees VR educational video, or a control group (n = 46) that got conventional preoperative care. The Children's Fear Scale and Wong-Baker Faces Pain Rating Scale were employed to evaluate preoperative anxiety and postoperative discomfort, respectively. The Wilcoxon Signed Rank test and the Mann-Whitney U test were employed for data analysis. Results : Participants in the VR group demonstrated markedly reduced fear scores following the intervention (Median (Q3-Q1) = 2 (3-1)) in contrast to pre-intervention levels (Median (Q3-Q1) = 3 (4-2), p < 0.001), as well as when compared to the control group (Median (Q3-Q1) = 3 (4-2), p < 0.001). Postoperative pain levels were considerably reduced in the VR group (Median (Q3-Q1) = 6 (7-5)) compared to the control group (median = 7 (8-6), p < 0.001). Conclusion : A 360 degrees educational movie in virtual reality was associated with significantly lower preoperative fear and postoperative pain compared with standard care in children undergoing tonsillectomy/adenoidectomy. The findings suggest that VR may serve as a valuable adjunct in pediatric preoperative preparation; nevertheless, further large-scale and multi-center studies are necessary to corroborate these results. Trial registration : Retrospectively registered. approved by TCTR Committee on 13 May 2024. The TCTR identification number is TCTR20240513003.