During surgery for funnel chest, one or more curved metal bars are inserted under the sternum through small incisions on both sides of the chest, then rotated to lift the sunken chest. Because of the constant pressure on the chest wall, the postoperative period is often quite painful.
The randomized controlled trial, carried out at the university’s Pediatric Center, included 50 patients aged 13 to 18 who were scheduled to undergo surgery for funnel chest (pectus excavatum), a chest wall deformity. Half of the participants were randomly assigned to use a VR headset for one hour before surgery, while the other half received standard preoperative care.
In the VR group, male patients tended to choose action and adventure videos and games, while female participants mostly selected meditation and relaxation apps.
“We wanted to assess whether VR could reduce preoperative anxiety, which can later lead to problems in children such as nightmares, bedwetting, or separation anxiety,” said Dr Sarolta H. Trinh, a PhD candidate at the Pediatric Center of Semmelweis University and first author of the study.
The results showed that VR did not significantly reduce anxiety. Anxiety levels increased in both groups from admission to the operating room, with no meaningful difference between them. According to the researchers, this may be due to all patients routinely receiving a sedative before surgery, which could have masked the additional effect of VR.
At the same time, a temporary difference was seen in postoperative pain. In the first hour after surgery, patients in the VR group reported lower pain scores on a 0–10 scale (median 5 vs. 7.5). However, this difference did not persist at later time points. The researchers stress that the study was primarily designed to assess anxiety, so this finding should be interpreted with caution.
“The difference in postoperative pain was surprising, but it was only seen in the first hour and we did not observe a longer effect, so its clinical relevance is limited. Still, it suggests that the role of VR in surgical care is worth exploring further,” said Dr Ágnes Jermendy, assistant professor at the Pediatric Center of Semmelweis University and shared last author of the study.
According to the researchers, VR works primarily by distraction. Its benefits are already well established in younger children for both pain relief and reducing anxiety, but further research is needed to determine its effectiveness in adolescents.
This randomized controlled trial provides new data in an age group that has been underrepresented in the literature.
Based on the findings, VR could become a useful addition to pediatric and adolescent surgical care in the future.
“Integrating VR into perioperative care would not replace painkillers or proper anesthesia, but it could help improve the organization of surgical workflows and enhance the patients’ experience. This may represent a promising direction for future research,” added Dr Balázs Hauser, senior anesthesiologist at the university’s Department of Anesthesiology and Perioperative Patient Care, head of the anesthesiology team involved in the study and shared last author.
Future research could also examine how VR can be used during recovery, for example in early rehabilitation or to reduce hospital-related stress. Further studies are needed to determine which patient groups could benefit most.
Photos: Boglárka Zellei, Attila Kovács – Semmelweis University
