
A surgeon is giving patients VR instead of sedatives - pmcpinto
http://www.bbc.com/future/story/20170202-the-surgeon-using-virtual-reality-instead-of-sedatives?ocid=global_future_rss
======
jakobegger
Distraction works really well in general; even without VR.

The dentist discovered that my 3 year old son has a bit of caries; but she
said that filling a cavity for small kids like him is only possible under
anaesthesia. I thought this sounded ridiculous.

My girlfriend found a different dentist who specialized on treating kids. She
performed the procedure without any anaesthesia or sedatives by using lots of
distractions, including a magic wand and elaborate stories about dwarves
wandering in the forest of teeths.

I wish my dentist distracted me like that :)

~~~
Aaargh20318
As a kid, I had a dentist who refused to use local anaesthesia, he thought it
was 'bullshit' and I shouldn't be able to feel anything. The pain was
indescribable. I'm still traumatised by it and haven't been to the dentist in
years. I would literally shit my pants out of fear (not exaggerating here, I
would have to wear a diaper to undergo regular treatment even with local
anaesthetics).

Just the though of being operated on while fully conscious gives me the
shivers. The only thing I can image being scarier is when they have to do
brain surgery and they wake you up halfway through while your skull is open.

I'm currently on a waiting list for a specialist at the local hospital where
they can treat you under general anaesthesia. It's the only way I can be
treated after my childhood experiences. unfortunately the waiting list is
long. I just hope it's my turn before something starts to really hurt.

I had one treatment under GA before, about 8 years ago, and it was the first
and only non-traumatic dentist experience in my life. It was such a huge
difference with the 'regular' experience that I simply can't understand why
dentists insist on letting people experience the torture. I think they are all
secretly sadists that get off on hurting people.

I'm not trying to scare you, just make sure your kid is okay with it because
it could fuck him up for life.

~~~
BigJono
My guess would be that GA is an order of magnitude more dangerous than most
routine dentist procedures like root canals or teeth extraction. Most people
would rather suffer through the pain than add extra risk to the operation.

~~~
rscho
GA may be "an order of magnitude" more dangerous if you are already very sick
or have it administered by a non-specialist. In the hands of someone who knows
what he is doing, the risks are orders of magnitude lower than even crossing
the street to go to work every day.

There are two main real reasons why a dentist prefers to go without GA:

\- no need: most dental procedures are minor, and well-conducted local
anesthesia is sufficient. Unfortunately, dentists often underestimate the pain
and anxiety generated by some of their actions.

\- not alone anymore: if you want anesthesia, you have no other alternative
than getting a specialist, who will have to be paid. Furthermore, the
anesthesia provider will interfere in care decisions if required, making him a
pain for the dentist.

So yeah, mainly money...

~~~
SamReidHughes
Are you saying this with awareness of claims like this?

[http://www.medicalnewstoday.com/articles/294966.php](http://www.medicalnewstoday.com/articles/294966.php)

~~~
credit_guy
Is that difference statistically significant? For those who don't have time to
click the link, they looked at 53 kids who received GA and 53 who didn't. The
average IQ of the first group was 5-6 points below the second. Now the stdev
of one IQ is 15, so the stdev of the average of 53 is 15/sqrt(53)=2.06. The
stdev of the difference of two such averages is then 2.06*sqrt(2)=2.91. A
5-point difference is then a 1.72 sigma event and a 6-point move a 2.06 sigma
event, and the probabilities of more extreme events are 4.3% and 2%. I guess
that's statistically significant, but not by much.

~~~
SamReidHughes
Look, I didn't read the paper, and it's not the only one.

------
rscho
This kind of process is akin to clinical hypnosis (which falls within the
realm of anesthesia, not surgery). Anesthesiologists have had the opportunity
to specialize in clinical hypnosis for a few years now. However, the cost-
effectiveness is difficult to demonstrate, because it requires staff to be
totally involved in it, so you can no longer roam several ORs at once. I guess
this is where VR comes in...

~~~
nom
It is explicitly stated in the article that the patient received a local
anesthetic - the VR environment is only used to replaced the sedative
(commonly used to used to distract the patient, not to remove physical pain)

~~~
rscho
Hypnosis can be and is used with regional anesthesia for such indications. It
depends on the stress level of the patient, and whether specialized staff is
available. You are right about the article, of course.

~~~
sudhirj
Yeah, same as VR, I don't suppose hypnosis removes pain - probably just
provides a distraction to make sure the brain doesn't fill in the pain and
discomfort the eyes are saying should be here.

------
adventured
Reminds me of Mark Cuban's experiment with VR to relieve a health problem:

[http://blogmaverick.com/2016/07/16/virtual-reality-gave-
me-m...](http://blogmaverick.com/2016/07/16/virtual-reality-gave-me-my-brain-
back/)

------
derekdahmer
Not quite the same thing, but my dentist lets me watch Netflix with noise
cancelling headphones. I had a crown put in over 1.5 hours with anesthetic but
lots of drilling and I almost didn't notice it was happening. It felt like
barely 30 minutes had passed.

The place is called Studio Dental if you're looking in SF.

~~~
mdrzn
Wow, now I wish my dentist allowed that!

How did you watch Netflix? Cardboard set?

------
sandworm101
VR instead of sedatives, not instead of locals. This is vr mitigating mental
stress not dulling actual pain. There have already been many studies linking
vr to reduced requests for painkillers in childens hospitals, dulling real
pain. That it too works to distract old people is no great leap.

~~~
nom
Yeah, it's not really a surprise that VR benefits patients undergoing surgery.
What would you rather see during an operation? A sterile room with surgeons
roaming around you, or a virtual calming environment?

~~~
throwaway13298
Maybe I'm just a sick fuck, but I really enjoyed watching when they tore open
my big toe a bit to remove an ingrown nail. If I recall correctly, they even
put up a barrier so I wouldn't be able to see, but I asked them to take it
down.

I also like watching the needle go in when they draw blood or give me a shot.

~~~
pavel_lishin
I'm the opposite. I can't even watch fake needles go "into" arms on
television.

~~~
sandworm101
Lol. Ive been on one set where the needles were real. Hiring a EMT to do a
saline drip on a stand-in's arm for a closeup is cheaper than the fake rig.

~~~
pavel_lishin
This makes me wonder how often that's the case; how many real injections have
I seen?

------
daveguy
Eventually we will develop the game:

[https://en.m.wikipedia.org/wiki/The_Game_(Star_Trek:_The_Nex...](https://en.m.wikipedia.org/wiki/The_Game_\(Star_Trek:_The_Next_Generation\))

~~~
frobozz
Dammit! I hadn't lost the game in years.

~~~
nannal
[https://imgs.xkcd.com/comics/anti_mind_virus.png](https://imgs.xkcd.com/comics/anti_mind_virus.png)

It's over, you're welcome

~~~
NTripleOne
Also the game ended back in like 2010 when someone called quads and rolled
quads.

------
Agentlien
This makes me think of SnowWorld, a VR project which was used to help people
take their mind off the pain when recovering from severe burns. The idea is
that they play in virtual snow and it actually soothes the burn by distracting
them from the physical pain and making them think of cool snow and ice.

[https://www.hitl.washington.edu/projects/vrpain/](https://www.hitl.washington.edu/projects/vrpain/)

~~~
mdrzn
It's talked about in the article, but thanks for linking it.

------
Sinidir
This is highly related to the Master Project we are doing at university right
now. Trying to make games that have players using a relaxation technique in a
playful way. Reading through the papers on the topic at the beginning of the
project you could see that this stuff really works and works well. There are
even attempts to treat mental problems like PTSD with VR. Exciting stuff.

------
twoquestions
If this is effective on people getting cut open, I wonder how effective such a
thing could be to cut stress even in daily life!

Anyone know of any good "calming" games on Steam that might help to de-stress
after a long day? I used to play Journey to chill out, but I don't have a ps3
anymore, and even that game gets old after a while.

------
yaegers
Sounds fine for people who are resistent to motion sickness.

But, especially in a medical setting, what would they do if the patient became
nauseated during surgery? Surely that can't be beneficial.

And lying in bed while all senses tell your body you are stationary and only
your eyes say "no, we are actually standing and the world is moving around us"
will cause motion sickness. It is a normal response from the body.

So you would be basically switching the sedatives with drugs to combat motion
sickness when you want to use VR.

~~~
chipperyman573
I don't know much about what causes motion sickness - My only experience was
when I was developing a game for the Vive and I manually moved the CameraRig.
How hard do you have to try to trick the body? Would sitting so your back and
head are upright (and legs bent at ~90 degree angle) be enough? What if you
were laying down but sitting up?

------
CHC-Cares
We need help:

Children's Hospital Colorado (CHC) serves from the Mexican to the Canadian
border via it's Flight for Life program [1] that air-lifts children and adults
in dire need to the ICU in Aurora. One of the not so nice parts of a
children's ICU ward, and ICU care in general, is the issue of ICU psychosis
[2][3]. In short, to keep you alive after severe trauma physicians must run
the risk of inducing mental trauma (please read the citations for further
information). Children can also undergo ICU psychosis. To compensate, anti-
depressants and pain medications are prescribed to lessen the mental trauma,
but these drugs also have interactions with other drugs and are thought to
prolong recovery.

Virtual Reality devices like the MS Hololens and the Occulus Rift _may_ be
able to help lessen the toll on these poor children by lessening the use of
psychoactive drugs, increasing the rate of recovery, and decreasing the length
of stay in critical care. AirBnB has a system like Google-Street view, but for
apartment listings; you can take a virtual tour of the listing in VR and see
if you like it. CHC could really use something like this for the kids.

Imagine you are a 7 year old. Your last memory before waking up in the ICU was
your mother and father being killed in an automobile accident. You wake up
surrounded by strange beeping machines, you are no longer breathing, there are
tubes in every hole in your body pumping in and out vital fluids and gasses,
the doctors may have even made new holes in you to keep your blood moving, you
are restrained in the bed to keep you from tearing out these life-saving
methods, you are likely drugged to deal with the pain and mostly incoherent.
This is a nightmare for just about any person, but it is especially terrible
for children. Many people come out of ICU care with PTSD, many children come
out with PTSD. VR devices could allow these patients to 'take five' and return
virtually to their homes via the AirBnB like systems. These children could run
in their back-yards or play in their rooms again, if only for an hour.

C.S. Mott Children's Hospital in Michigan has run some pilot research with
children [4] and the results are optimistic. The US Army has run some other
pilot studies using VR for PTSD with returning Vets via the Bravemind program
[5] and these results indicate success in using VR as a PTSD treatment. The
limited results thus far indicate that VR in the ICU may be a viable method
for recovery from severe trauma.

This is where we need your help, HackerNews. Children are suffering. We need
hackers, programmers, and administrative people to help get VR devices into
hospitals and determine the efficacy of using these devices as treatment. I am
not a 'CS' person, not like you all are. We need your expertise. Honestly, we
don't know what is going to happen in the end, but we have to give it a shot.
The kids need for us to give it the ol' college try.

If you are interested in helping _and have the time to dedicate_ , please
email me (email is in my user-account). Thank you for reading this and for
your time, we all appreciate it.

[1] [https://www.childrenscolorado.org/doctors-and-
departments/de...](https://www.childrenscolorado.org/doctors-and-
departments/departments/flight-for-life/)

[2][http://www.medicinenet.com/icu_psychosis/article.htm](http://www.medicinenet.com/icu_psychosis/article.htm)

[3][https://www.theatlantic.com/health/archive/2015/06/the-
overl...](https://www.theatlantic.com/health/archive/2015/06/the-overlooked-
danger-of-delirium-in-hospitals/394829/)

[4]
[https://www.youtube.com/watch?v=RIgxRhz6lmM](https://www.youtube.com/watch?v=RIgxRhz6lmM)

[5] [http://ict.usc.edu/prototypes/pts/](http://ict.usc.edu/prototypes/pts/)

