Authors (including presenting author) :
Wong SY(1), Sin MW(1), Choi WK(1), Lo WC(1), Li YY(2), Szeto L(1)
Affiliation :
(1)Department of Anaesthesia & Operating Theatre Services, Tseung Kwan O Hospital, (2)Department of Surgery, Tseung Kwan O Hospital
Introduction :
Colorectal cancer is among the three most common cancers in Hong Kong. These patients often experience significant stress and anxiety, which can be exacerbated by the surgical experience. Emerging evidence indicates that preoperative anxiety is linked to elevated levels of stress hormone and haemodynamic stress, leading to postoperative complications. Currently, pharmacological interventions are the primary approach in the field. The use of anxiolytics can result in postoperative nausea and delirium. To address this issue, preoperative hypnosis through immersive virtual reality has been proposed.
Objectives :
(i)To investigate the effectiveness of preoperative hypnosis through immersive virtual reality in reducing preoperative anxiety
(ii)To incorporate innovative technology into preoperative care
Methodology :
An immersive virtual reality device, HypnoVR, was used to deliver the preoperative hypnosis service. The device offers multiple environment experience, for example environment of forest and beach, along with guided breathing exercise via a soothing audio guide. The preoperative hypnosis session lasted for 30 minutes and was delivered to patients 30 minutes prior to their surgery. Pre- and post-intervention data, including the State-Trait Anxiety Inventory-State (STAI-S) and physiological parameters (blood pressure and heart rate), were obtained before and after the session.
Result & Outcome :
From August to December 2024, twelve patients participated in the preoperative hypnosis service.
After the session, the mean STAI-S score decreased from 42.5 to 35.42 (mean difference (MD): 7.083, p=0.001). It indicates a significant reduction in anxiety levels. For the physiological parameters, the mean heart rate significantly decreased from 75.42 beats per minute (bpm) to 67.00 bpm (MD: 8.417 bpm; p<0.001). This suggests that the preoperative hypnosis intervention effectively reduced heart rate.
Additionally, the mean systolic blood pressure (SBP) reduced from 129.25 mmHg to 126.25 mmHg (MD: 3 mmHg) and the mean diastolic blood pressure (DBP) reduced from 71.5 mmHg to 69.92 mmHg (MD: 1.583 mmHg). However, both SBP and DBP shown no statistically significant difference. Meanwhile, the changes in blood pressure stayed within safe clinical ranges. It suggests that the intervention is effective for reducing preoperative anxiety, with the strongest effects on anxiety levels and heart rate, while maintaining stable blood pressure.
To conclude, preoperative hypnosis through immersive virtual reality is an effective tool to manage preoperative anxiety. This innovative approach offers a feasible alternative to pharmacological interventions and has the potential to improve clinical outcomes.
