Netflix Streaming Services in the Operating Room During Total Knee Replacement - a Feasibility Study

Study Overview
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Brief Summary
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The purpose of this research study is to test the safety, tolerability, and effectiveness of watching streamed videos through virtual reality (VR) goggles during surgery. The results of this study will be used to evaluate whether video-streaming services on VR goggles are worthwhile additions to standard anesthesia care during total knee surgery.

Detailed Description
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Usual anesthetic care for total knee replacement involves intravenous sedation as well as spinal anesthesia. In this study, participants will receive usual care, and in addition, will be asked to wear VR goggles once they arrive in the operating room. Participants will choose from a selection of 10 shows and movies to watch for the duration of the surgery (approximately 2 hours).

Official Title
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Netflix Streaming Services in the Operating Room During Total Knee Replacement - a Feasibility Study

Conditions
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Surgery

Intervention / Treatment
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* Behavioral: VR


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: undergoing a primary elective total knee replacement by one of the orthopedic joint surgeons at Virginia Commonwealth University Medical Center 18 years of age or older eligible for spinal anesthesia mentally capable of understanding instructions on how to request anesthesia medication Exclusion Criteria: identified as a member of regulated vulnerable population ineligibility for spinal anesthesia morbid obesity (body mass index greater than 40) allergy to propofol or midazolam pre-operative daily opioid consumption of more than 10 mg oxycodone every 6 hours (over 60 morphine miligram equivalents per day) daily benzodiazepine consumption history of alcohol or recreational drug abuse hearing or visually impaired individuals

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Virtual Reality<br>Wear VR glasses and watch movies during surgery | Behavioral: VR<br>* Participants will be asked to do the following things: Wear VR goggles for the duration of the surgery Answer questions about their experience with the VR goggles Give permission for the researchers to collect information about the anesthesia medications used, pain medications used, and reported pain scores during the surgery and during recovery in the hospital<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Sedation requirement | Micrograms of propofol per kilogram per minute | approximately 2 hours | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Participant pain rating | Average pain score measured immediately after surgery and every 4 hours afterwards for 24 hour. Pain will be rated on a 0 to 10 scale with 0 being no pain and 10 being the worst pain imaginable. | 24 hours | 
| Opioid consumption | Total miligram morphine equivalents of opioid pain medication administered during 24 hours post surgery. | 24 hours | 
| Time to first opioid request | Time in minutes between leaving the operating room and administration of first oral opioid. | up to 24 hours |