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The health trust using immersive experiences to guide patients through surgery

Monday, 07 September, 2020
The health trust using immersive experiences to guide patients through surgery

In a medical first for the region, Northumbria Healthcare NHS Foundation Trust is using virtual reality headsets to relax and distract patients during ‘awake’ limb surgery. 

Embracing innovation and the latest technology, a group of clinicians have introduced the novel solution during operating lists in the trust. Patients can choose to wear a virtual reality headset in combination with a nerve block while undergoing surgery on their arms or legs, such as a knee replacement operation. This has reduced the number of people needing to have a general anaesthetic or heavy sedation during surgery.

The total immersion offered by virtual reality promotes relaxation, and has improved patient experience. Dr Caveh Madjdpour, Consultant Anaesthetist at the trust explains: “There is a clear, evidence-based link between the reduction of perioperative anxiety and lower postoperative pain, and the use of virtual reality is becoming more common in healthcare because of its ability to help people relax. With surgery under nerve block, a general anaesthetic or sedation doesn’t have to be given, and this avoids the extra risk of things like nausea, being groggy for the rest of the day, or allergic reactions to the anaesthetic. While these complications are rare, and the patients choice is most important, virtual reality gives our patients another way to pass the time during their operation that didn’t previously exist and isn’t widely available.” 

Described best as a small television that sits in front of the eyes, the technology provides a full immersive experience, and is a great alternative to sedation or music alone. The team have been offering relaxation software where patients can sit in virtual woodland, on a tropical beach or out on the plains of Africa watching the wildlife, with a focus on breathing techniques and mindfulness during these experiences. There are also a selection of music concerts and films available as well such as Mamma Mia, Shaun the Sheep, Sleepless in Seattle and Bohemian Rhapsody – there really is something for everyone! 

Dan Lawrence, Anaesthesia Associate, reflects on where the idea came from: “It started as a bit of a chat between Dr Madjdpour and I, as I have my own VR headset at home so I’m really familiar with the technology. It was something along the lines of ‘wouldn’t it be great if we could give patients a form of mental distraction other than sedation, something such as virtual reality’ and it all went from there.” 

The team, with a pitch from Dr Ed Ireland, obtained funding from the trust’s Bright charity and after doing a lot of research, went ahead and purchased the equipment. After launching the pilot at the beginning of the year, the response has been really positive, with ten patients choosing ‘nerve block and VR’ in February. Theatres already use an Apple Music subscription for patients when delivering care, following pre-existing evidence between music and relaxation. This latest development is seen as the next step in the transformative journey. 

Dr Jonathan Fortune, Consultant Anaesthetist adds: “Immersing yourself into a narrative experience like a movie to pass the time is a progressive alternative to traditional sedation for the right patients. We’ve got plans to expand the use of virtual reality to anxiety reduction for more patients like those with severe hospital phobias. It’s all about changing mindset and breaking away from tradition – here at Northumbria Healthcare we’re ready for it!” 

Ian McDonaugh, 74, from Alnmouth recently underwent a total knee replacement, opting to wear the VR headset: “It was an absolutely fantastic experience – as an artist myself, I find it fascinating how the two worlds of art and health can come together and offer such a progressive solution. I actually had a full knee replacement in my other leg five years ago, and I was familiar with the surgeon so I guess that helped a bit. But comparing the recovery process, the ‘none sedative’ approach was far more pleasant and far quicker to recover from. I chose to watch Bohemian Rhapsody and it really did take my mind off everything around me – of course I was aware of some tugging and pulling, which is slightly strange. I would certainly recommend it as an alternative and in fact I already have done so on several occasions, including to a medical friend!”. 

Brenda Longstaff, Head of Northumbria’s Bright charity said: “It’s always good to be able to support innovation within our health trust and this is a great example. The charity is keen to support projects that can really improve the experience of our patients and the VR consoles have done just that. A huge success for all involved!”

The initiative is favourable in the post COVID-19 world too, as a nerve block with no sedation means the patient spends much less time in hospital recovering, and is discharged home sooner.