The use of virtual reality to improve quality of recovery in women undergoing gynecological surgeries: a randomized controlled trial

Virtual reality (VR) is an emerging non-pharmacological intervention that has shown promise in reducing anxiety and pain, but its effect on post-operative recovery is less studied. We assessed the use of VR on postoperative recovery, anxiety, and pain in women undergoing gynecological surgery. This was a randomized controlled trial that recruited women undergoing gynecological surgery. Patients were randomized into two groups: no intervention; or VR calming scenarios with meditation and breathing exercises administered perioperatively. The primary outcome would measure the quality of recovery through the Quality of Recovery-40 (QoR-40) total scores at postoperative 24 h. Secondary outcomes included the perioperative visual analog scale-anxiety (VAS-A) scores, pain scores, and analgesic use. A total of 104 participants were randomized equally into the VR and control groups with no dropout. The VR group showed significantly greater QoR-40 total scores at postoperative 24 h (mean difference (MD) 7.23, 95% CI 1.44-13.02, p = 0.015), with notable improvements in physical comfort (MD 2.58, p = 0.015), and pain (MD 1.38, p = 0.005) dimensions when compared with control group. Anxiety scores were significantly lower in the VR group during preoperative period (MD 0.96, p = 0.034), and at postoperative 48 (MD 0.89, p = 0.01) and 72 h (MD 0.66, p = 0.03). Patient satisfaction with VR was high, with > 40% of patients reporting satisfaction of "good" or "excellent". VR significantly improved postoperative recovery scores at 24 h and was associated with reduced anxiety, pain, and analgesic use. While the improvements were statistically significant, the clinical relevance of the recovery score difference remains uncertain. These findings support the potential role of VR as a non-pharmacological adjunct to enhance recovery in gynecological surgery.Trial registration: This study was registered on clinicaltrials.gov registry (NCT03685422) with date of first registration on 24/09/2018.