Please confirm that an ethics committee approval has been applied for or granted: Not relevant

Background and Aims The prospect of ‘hearing and seeing everything’ in the operating theatre can be a source of great anxiety and discomfort for the patient leading to dissatisfaction and possibly failure of the regional anaesthesia technique.(1) iPads have been shown to be an effective audio-visual distraction aid to minimise anxiety and improve patient satisfaction. (2) Our project reviews whether the use of a VR headset would as effective as using iPads during invasive procedures performed under regional anaesthesia.

Methods Following informed consent, we prospectively collected feedback from 5 patients undergoing Orthopaedic surgery under regional anaesthesia with the virtual reality headset Oculus Quest 2. Feedback from the Anaesthetist was also recorded.

Results None of the respondents reported to being uncomfortable or anxious at any time. 1 respondent felt the headset to be heavy. All the respondents said they would recommend this to other patients. Challenges faced were unreliable hospital wifi, inability to manage case and setup when solo Anaesthetist on the list and difficulty to adjust the display settings particularly when the patient was lying flat.

Conclusions Although bespoke medical VR solutions exist, they are expensive and limited in what distraction they provide. Here we used a consumer device and played youtube videos of the patient’s choice. Hence, more economical. We observed high satisfaction with audio-visual distraction using a VR headset, but technical challenges of the specific headset limited utility. A new headset, Quest 3 has now been released which we believe will overcome some of the technical challenges .