Virtual reality in perioperative medicine: An evidence-based systematic review and meta-analysis

Background: Virtual reality (VR) has emerged as an innovative tool in perioperative medicine, with its growing interest in its potential to improve patient outcomes. This systematic review and meta-analysis aimed to critically assess the effectiveness of VR interventions in perioperative medicine, focussing on anxiety reduction, pain management, patient education, and satisfaction. Methods: A comprehensive search was conducted across PubMed, Cochrane Library, Scopus, Web of Science, Embase, and ClinicalTrials.gov for peer-reviewed studies published between January 2000 and December 2024. Studies involving adult and paediatric surgical patients, utilising VR interventions compared to standard care or alternative approaches, were included. Data extraction and risk of bias assessment were performed using standardised forms and appropriate tools. Meta-analysis was conducted for continuous outcomes using mean differences (MDs) and standardised mean differences (SMDs). Results: From 193 identified records, 47 studies were included in qualitative synthesis, with 15 studies providing quantitative data for meta-analysis. VR interventions consistently reduced perioperative anxiety {MD - 1.53 on visual analogue scale (VAS), 95% confidence interval (CI) -2.21 to -0.85; MD -3.85 on State-Trait Anxiety Inventory (STAI), 95% CI -5.69 to -2.01} and procedural anxiety in paediatric populations (SMD -0.70, 95% CI -0.94 to -0.47). VR also demonstrated a modest but significant effect on postoperative pain (MD -0.67, 95% CI -1.31 to -0.04) and significantly improved patient satisfaction (SMD 0.70, 95% CI 0.45 to 0.95). Immersive VR modalities and therapeutic content were most effective, especially in minor surgical procedures and paediatric populations. No significant adverse events were reported. Conclusion: VR interventions are effective in reducing perioperative anxiety and pain, improving patient satisfaction, and are well tolerated across diverse surgical settings.