This study aims to evaluate the effectiveness of virtual reality (VR) in managing preoperative anxiety and postoperative pain in patients undergoing total knee replacement. Investigators will assess the impact of preoperative VR training on anxiety levels, explore the effectiveness of relaxing and distracting VR videos for pain management after surgery, and determine the optimal timing for VR application by comparing different VR intervention times. Our goal is to identify how VR can improve both the emotional and physical recovery process for patients undergoing knee replacement surgery.
Patients with an ASA score of 1, 2, or 3
Elective unilateral total knee replacement surgery was planned,
Patients who are able to read and write in Turkish
Using >30 mg of oral oxycodone or equivalent daily
Long-term opioid use (>12 weeks)
Substance use disorder
Scheduled for emergency surgery
Parallel
Virtual Reality Intervention for Preoperative Anxiety and Postoperative Pain Management (2 hours)
DeviceThe Virtual Reality intervention involves participants wearing a VR headset at least one hour prior to their surgery to watch immersive, pre-recorded educational videos showing the operating room with a nurse explaining the process aimed at reducing pre-operative anxiety and nature videos with distraction effect after surgery for pain management. The intervention for pain management will be delivered 2 hours after surgery. The videos to be shown to patients will be limited to a maximum of 30 minutes. In addition, all participants will be reminded that they can remove the glasses or leave the study at any time.
Device: Virtual Reality Intervention for Preoperative Anxiety and Postoperative Pain Management (4 hours)
DeviceThe Virtual Reality intervention involves participants wearing a VR headset at least one hour prior to their surgery to watch immersive, pre-recorded educational videos showing the operating room with a nurse explaining the process aimed at reducing pre-operative anxiety and nature videos with distraction effect after surgery for pain management. The intervention for pain management will be delivered 4 hours after surgery. The videos to be shown to patients will be limited to a maximum of 30 minutes. In addition, all participants will be reminded that they can remove the glasses or leave the study at any time.
Virtual Reality Intervention for Preoperative Anxiety and Postoperative Pain Management (6 hours)
DeviceThe Virtual Reality intervention involves participants wearing a VR headset at least one hour prior to their surgery to watch immersive, pre-recorded educational videos showing the operating room with a nurse explaining the process aimed at reducing pre-operative anxiety and nature videos with distraction effect after surgery for pain management. The intervention for pain management will be delivered 6 hours after surgery. The videos to be shown to patients will be limited to a maximum of 30 minutes. In addition, all participants will be reminded that they can remove the glasses or leave the study at any time.
Change from Baseline in Postoperative Pain Intensity as Measured by Visual Analogue Scale (VAS) at 2, 4, and 6 Hours After Surgery in Patients Receiving Virtual Reality Interventions.
0 = No pain 10 = Worst pain possible
Preoperative Anxiety Measured Using the State-Trait Anxiety Inventory-State (STAI-S) Scale
Preoperative anxiety will be measured using the State-Trait Anxiety Inventory-State (STAI-S) scale, which is a validated tool for assessing temporary feelings of anxiety. Patients will complete the scale before undergoing any intervention or VR exposure. This measurement will provide an understanding of the patient's baseline anxiety level before the application of VR. This measurement will be taken twice: once before the patients view the educational videos and once after viewing them. Total scores range from 20 to 80. Higher scores = Higher levels of anxiety.
Change from Baseline in Virtual Reality Sickness as Measured by the Virtual Reality Sickness Questionnaire (VRSQ)
The Virtual Reality Sickness Questionnaire (VRSQ) assesses the level of discomfort or sickness experienced by participants during or immediately after wearing the Virtual Reality headset. Total scores range from 0 to 15, with higher scores indicating higher levels of discomfort or sickness.
Patient Satisfaction as Measured by a 0-10 Numeric Rating Scale Post-Intervention
Patient satisfaction will be measured using a 0-10 Numeric Rating Scale (NRS), where 0 represents no satisfaction and 10 represents the highest level of satisfaction.
Change in Body Temperature (Celsius) from Baseline
Postoperative Infection Incidence in Participants
The incidence of postoperative infections in participants from surgery until discharge. Infections will be identified based on clinical evaluation and standard medical criteria, and recorded for each participant.
Change in Hospital Stay Duration
The total duration of the hospital stay, including both preoperative and postoperative periods.
Change in Opioid Usage Postoperatively
The total amount of opioids used postoperatively, measured in standardized doses.
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Aykut Turgut
Lead sponsor
Abant Izzet Baysal University
Sponsor institution
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