Effect of Virtual Reality Glasses and Melody on Cortisol and Adrenocorticotropic Hormone Levels in Patients With Knee Replacement Surgery Under Combined Spinal Epidural Anaesthesia.

Autor:	Singh N; Anesthesia and Critical Care, King George's Medical University, Lucknow, IND., Kanaujia SK; Anesthesia and Critical Care, King George's Medical University, Lucknow, IND., Singh MK; Anesthesia and Critical Care, King George's Medical University, Lucknow, IND., Shukla N; Anaesthesiology, Integral Institute of Medical Sciences and Research, Lucknow, IND., Siddiqui AK; Anesthesia and Critical Care, King George's Medical University, Lucknow, IND., Kohli M; Anesthesia and Critical Care, King George's Medical University, Lucknow, IND.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2024 Jun 24; Vol. 16 (6), pp. e63017. Date of Electronic Publication: 2024 Jun 24 (Print Publication: 2024).
DOI:	10.7759/cureus.63017
Abstrakt:	Background: With advanced virtual reality (VR) technology, its usage in health care is creating an impact on patient outcomes. Patients undergoing knee replacement surgery are already anxious due to the surgery, anaesthesia, and unfamiliar environment of the operation theatre. In addition to that, the unpleasant noise of tools makes it worse. Peri-operative anxiety correlates with increased anaesthesia requirements and prolonged recovery. It causes the release of stress hormones such as cortisol, adrenaline, and norepinephrine, which can lead to difficult intravascular access due to vasoconstriction and heightened cardiovascular responses. Studies on music therapy have shown a reduction in cortisol levels, contributing to anxiety alleviation. VR glasses create immersive environments to distract patients from various stress factors. Investigating the use of VR/music on serum cortisol and adrenocorticotropic hormone (ACTH) levels in knee replacement surgery can improve peri-operative care, improving patient outcomes. Aim: The study was done to investigate the impact of virtual reality glasses and music therapy on serum cortisol and ACTH levels in patients undergoing knee replacement surgery under combined spinal epidural anaesthesia. Methods: In this prospective randomised control, single-centric study, patients of either sex, aged between 18 and 65 years, undergoing knee replacement surgery under combined spinal and epidural (CSE) anaesthesia, were included. The primary objective was to compare serum cortisol and ACTH levels, while the secondary objective was to compare the State-Trait Anxiety Inventory for State Anxiety (STAI-SA) score and Patient Satisfaction Score (PSS) in the peri-operative period. A total of 100 patients were assessed for eligibility, and 66 patients met the inclusion and exclusion criteria and were finally randomised and equally assigned to group M-VR (music-virtual reality) and group C (control). Three blood samples were collected for serum cortisol and serum ACTH levels one hour before surgery (T1), one hour after skin incision (T2), and two hours after the completion of surgery (T3). STAI-SA was measured one hour before surgery (T1) and two hours after the completion of surgery (T2), while PSS was recorded two hours after the completion of surgery. Hemodynamic parameters were noted during the entire peri-operative period. Results: The demographic and anthropometric parameters were comparable in both groups. Hemodynamic parameters (heart rate [HR], mean arterial pressure [MAP]) were found to be comparable in the pre-operative period, while significant differences (p > 0.05) were noted after 30 minutes of surgery and continued till the end of surgery. Serum cortisol and serum ACTH levels were comparable in the pre-operative period but showed significantly lower variations in group M-VR in comparison to group C in the intra-operative period. PSS was significantly higher in group M-VR in comparison to group C. Conclusion: This study substantiates the role of virtual reality and music therapy (VR/music) on anxiety reduction, improved satisfaction scores, and lesser ACTH/cortisol level variations in knee replacement surgery. It further emphasises larger randomised controlled studies in various other surgical populations, along with long-term follow-up and outcome assessment. Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. King George’s Medical University Institutional Ethics Committee issued approval XIV-PGTSC-IIA/P41. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work. (Copyright © 2024, Singh et al.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu