Postoperative Cognitive Impairment and Pain Perception after Abdominal Surgery-Could Immersive Virtual Reality Bring More? A Clinical Approach

Abstract

Background and Objectives: Impaired cognition and pain after surgery contribute to prolonged hospital stays and increased mortality rates. Thus, the development of preemptive algorithms for reducing their impact should be prioritized. The main objectives of the present study were to evaluate the efficiency of using virtual reality (VR) to treat postoperative cognitive decline and pain perception. Materials and Methods: The study was a prospective, monocentric, clinical study that included 51 patients who have undergone major abdominal surgery. The patients were divided into two groups: Control (n = 25) and VR (n = 26). The VR sessions consisted of 5-8 min exposure at 24-48 h after surgery. We considered the outcome variables, the mini-mental state examination, and visual analogue scale at 24-48 h after surgery. The dependent variables were age, social status, educational level, and duration of surgery. Results: We did not observe any differences in postoperative cognition deficit with regard to VR. The VR, however, successfully reduced postoperative pain intensity. Moreover, the patients' age, surgery duration, level of education, and social status influenced the MMSE score at 24-48 h after surgery. Conclusions: Even if using VR does not alleviate short-term postoperative cognitive impairments, it could affect pain perception. Further studies are needed to support the use of VR in perioperative contexts.

Keywords: general anesthesia; postoperative cognitive dysfunction; postoperative delirium; postoperative pain; virtual reality.

Figure 1

The impact of VR on MMSE (A,B) and VAS scores (C,D) at 24 and 48 h after surgery. The results are expressed as mean ±SEM. * represents a p value between 0.05 and 0.01, and ns means non-significant.

Figure 2

The MMSE scores at 24 and 48 h after surgery with regard to social status (A,B) and educational level (C,D). The results are expressed as mean ± SEM. * represents a p value between 0.05 and 0.01, **—p value between 0.01 and 0.001, ***—p value between 0.001 and 0.0001, ****—p value ˂ 0.0001, and ns means non-significant.

Figure 3

The correlation between patient age (A,B) and surgery duration (C,D) and MMSE score at 24–48 h after surgery. R^ represents the correlation coefficient.