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Rate ePoster

Head and Neck Surgery

(534) Utilizing Digital Interventions for Postoperative Recovery: 4-Arm Randomized Controlled Trial

Monday, October 2, 2023
2:45 PM – 3:45 PM East Coast USA Time
Has Audio
Disclosure(s):
Vivek C. Pandrangi, MD: No relevant relationships to disclose.
Ana V. Araujo: No relevant relationships to disclose.
Michelle Buncke, MD: No relevant relationships to disclose.
Ryan J. Li, MD, MBA: No relevant relationships to disclose.


Introduction: Enhanced recovery after surgery (ERAS) protocols were introduced as a method to optimize perioperative patient care. The purpose of this study was to examine the implementation of virtual reality (VR) and Fitbit wearable activity devices in postoperative recovery protocols after surgery.

Methods: Prospective, 4-arm, randomized controlled trial at a single tertiary academic center among patients undergoing inpatient surgery with the Oregon Health & Science (OHSU) Department of Otolaryngology-Head and Neck Surgery from November 2021 to July 2022. Patients were randomized to control, VR, Fitbit, or combined VR and Fitbit groups. Patients in the VR groups were brought VR headsets to use. Patients in the Fitbit groups were encouraged to achieve 2,000 daily steps. The primary outcome measure was average daily opioid use, measured as milligram morphine equivalents (MME). Secondary outcomes included pain scores, anxiety, depression, sleep quality, and satisfaction.

Results: There were 80 patients included. The majority of patients were male (n=55, 68.8%) and mean ± standard deviation age was 58.8 ± 14.4 years. While there was overall no difference in daily opioid use between the four groups (p>0.05), after outlier removal there was a significant difference between VR and Fitbit vs. control patients (median [interquartile range]: 8.8 [26.0] MME vs. 34.5 [47.0] MME, p=0.02). Patients receiving any intervention also had higher satisfaction than control patients (p=0.004), with no other difference in secondary outcomes (p>0.05). Among all patients, days in which VR was used or patients achieved 2,000 steps per day (n=88, 15.0 [34.7] MME) were associated with reduced opioid use compared to days without achievement of goal device use or absence of device use (n=236, 30.0 [52.5] MME, p=0.001).

Conclusions: Use of VR and wearable activity devices in postoperative recovery after inpatient surgery may be associated with reduced opioid use and improved patient satisfaction. Implementation of digital interventions in postoperative care may be a cost-effective means to facilitate recovery and patient quality of life.