Analyzing the Efficacy of a Restorative Virtual Reality Environment using HRV Biofeedback for Pain and Anxiety Management

Approximately 50 million surgeries are performed in the US annually, and about 70% of patients are middle age and older adults. Pain and anxiety are common accompaniments of surgery, and opioids have been the mainstay of pain management for decades. However, opioid abuse and addiction now place the US in an “opioid epidemic,” with one in 16 surgical patients prescribed opioids becoming a long-term user. To mitigate surgical pain and anxiety, we developed a virtual reality experience based on Attention Restoration Theory and affective computing techniques to deliver adaptive content based on the user's heart rate variability biofeedback. A randomized control study among 12 patients undergoing Total Knee Arthroplasty at Pate wood Memorial Hospital, Greenville, SC demonstrated that patients in the VR group reported a 29.6% and 31.2% decrease in surgical pain and anxiety, respectively, compared to a control group.