Do Extended Reality Interventions Benefit Patients Undergoing Elective Cardiac Surgical and Interventional Procedures? A Systematic Review and Meta-analysis.

All studies in the meta-analyses were rated as having some or high risk of bias, and some samples were small, so the pooled effects could be exaggerated. The pre-procedural anxiety result had very high heterogeneity (I2 95.5%), meaning the studies were too different to give a single dependable effect. Only two randomised trials contributed to the peri-procedural anxiety meta-analysis, so that finding rests on a small evidence base. The review could not identify which VR type, content or dose worked best because education, relaxation, distraction and exercise interventions were mixed together. Many studies gave limited technical detail about the headset, audio, immersion or interactivity, making it hard to know what was delivered. VR was not always tolerated: 3% to 14% reported cybersickness in seven studies, and 30.5% or 62.5% removed the headset in two studies. Pain measurement was not always real time; one study assessed peri-procedural pain one day after the procedure.

The authors declared no conflicts of interest. The supplied publication types note non-U.S. government research support.

Do not use VR as a pain-relief strategy based on this review. The pooled pain effect was null (standardised mean difference -0.11, 95% CI -0.36 to 0.13; p=0.372), and the anxiety benefits came from small, high-risk-of-bias studies with very high heterogeneity for pre-procedural anxiety.