Q: I’m going to have hand surgery next year to help with carpal tunnel, and I’m not happy about having anesthesia. I’ve read about surgeons whose patients use VR headsets to reduce the need for anesthesia. Does it really work?
A: The use of anesthesia in surgical procedures dates back to ancient times. Historical records show that the Incas used plant extracts like datura and coca to reduce pain and induce unconsciousness, and early Chinese doctors offered patients opium-based potions. Centuries later, efforts to refine and improve the process continue. And a little wonder.
Anesthesia is a complex practice with multiple and sometimes contradictory objectives. Treatment should put the patient to sleep and suppress their response to pain, but not interfere with essential physiological functions of the body, including heart rate, breathing, and maintaining stable blood pressure. Although modern anesthesia is safer than ever, it still carries an element of risk. This is why the search for new drugs and new techniques continues.
In recent years, this research has included investigations into the use of virtual reality, or VR, as a complementary therapy. This approach is being explored in conjunction with what is called regional anesthesia. Unlike general anesthesia, where the patient is completely unconscious, a person undergoing regional anesthesia is sedated, but remains conscious. Nerve blocks are used to inhibit sensation in a specific, limited part of the body. The technique is often used in surgery on an extremity, such as an arm, hand, leg, or foot.
Since the patient remains awake during regional anesthesia, managing their stress and anxiety is crucial. Many patients are given sedation so they can relax or even doze off during the procedure. With the advent of computer-generated virtual reality, which uses special headsets to immerse the user in an immersive 3D world, researchers began to wonder if it might reduce a surgical patient’s need for sedation.
The most recent study on this idea has yielded some intriguing results. For eight months, researchers at a Boston medical center assessed the anesthesia needs of 34 patients undergoing hand surgery. The patients were divided into two groups. All received drugs to completely block the pain response and all received intravenous sedation. But one group also received VR headsets with a selection of programs specifically designed to promote relaxation and a sense of calm. These included nature scenes, like a secluded meadow or mountain peak, guided meditations, or immersive visuals, like a starry night sky.
At the end of the study, the data showed that patients who used VR headsets during their surgery needed significantly less sedation than the control group without VR. Additionally, the post-surgical recovery period for the VR group, during which patients wait for the effects of sedation to wear off, was significantly shorter.
Although the research is promising, it is important to note that both surgical teams and patients understood that virtual reality could reduce the need for sedation, which could have influenced the results. In your own case, it is crucial that you discuss your anesthesia concerns with your surgeon. Understanding the process, risks, and benefits can help ease your concerns.
What is synesthesia?
Q: When our grandson first learned his colors, he sang them to music. We thought he was copying this song to learn the ABC. But as he got older, he began to say he “heard” colors. We were told it was called synesthesia. How and why does this happen?
A: Synesthesia is quite a rare and quite fascinating phenomenon. It is a neurological condition in which sensory inputs are crossed in the brain. The result is that incoming information that would normally be interpreted by one sense overflows and stimulates another unrelated sense.
While this blending of the senses has been described and referenced throughout the centuries, the emergence of the word “synesthesia” dates back to the late 1800s.
For some people with the condition, the sounds will also activate the brain’s vision centers. For others, colors can also have flavor, flavors can evoke physical form, numbers can have colors, and reading printed words can elicit distinct aromas.
Depending on how the senses combine, there can be up to 60 different forms of synesthesia. Estimates of the number of people who experience some form of synesthesia range from 1 in 20,000 people to 1 in 23 people.
Another ongoing discussion, which has not been definitively resolved, concerns whether the disease occurs more often in women than in men. The audio-visual variety described by your grandson is considered one of the most common forms. The rarest is known as lexical-gustatory synesthesia, which causes speakers to “taste” the words they say.
Someone is either born with synesthesia or develops the condition at an early age. The condition does not affect an individual’s general health, nor is it related to any diseases or physical disorders. It is important to note that despite the very different way a person with synesthesia experiences and processes the world, it is not a form or sign of mental illness. In fact, studies and anecdotal data suggest that people with synesthesia are often very intelligent and perform better on memory tests than those without.
Interestingly, there is also evidence that people with the condition can often have a poor sense of direction.
As for the cause, it remains unknown. Ever since synesthesia was first named and described, researchers have pondered its origins. Some suspect that the sensory crossover occurs due to the presence of additional neurons, which may link the affected senses. Another theory involves changes in how the brain receives information, as well as how that information is processed.
The condition has also been shown to run in families. Up to 40% of people with synesthesia are found to have a close relative who also has some form of the condition. It is therefore likely that heredity and genetics play a role.
Meanwhile, advances in imaging technologies continue to aid in synesthesia research. Chances are we’ll have more answers in the not-too-distant future.
• Dr. Eve Glazier is an internist and associate professor of medicine at UCLA Health. Dr. Elizabeth Ko is an internist and assistant professor of medicine at UCLA Health. Send your questions to firstname.lastname@example.org.
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