The Effect of Immersive Virtual Reality on Serotonin Levels in Patients Undergoing Subarachnoid Block Anesthesia

Abstract

Background: Subarachnoid block (SAB) is a commonly used regional anesthesia technique for various surgical procedures. Immersive Virtual Reality (IVR) has demonstrated potential as a non-pharmacological modality to reduce anxiety and enhance perioperative patient comfort. Serotonin, as an important neurotransmitter in mood regulation and stress response, may serve as an objective biomarker for evaluating IVR effectiveness. Objective: This study aimed to analyze the effect of immersive virtual reality administration on serum and salivary serotonin level changes in patients undergoing subarachnoid block anesthesia. Methods: An experimental study with randomized controlled trial design was conducted on 30 patients undergoing surgery with SAB anesthesia, divided into two groups: intervention group receiving IVR (n=15) and control group without IVR (n=15). Serum and salivary serotonin measurements were performed at baseline in the premedication room and at 30 minutes post-SAB procedure using enzyme immunoassay (ELISA) method. Data were analyzed using Paired T-test and Independent T-test. Results: Demographic characteristics of both groups were homogeneous (p>0.05). Post-intervention serum serotonin levels in the IVR group (135.15±16.44 ng/mL) were significantly higher compared to the control group (120.15±19.49 ng/mL) with statistically significant difference (p=0.030). There was a significant difference between baseline and post-intervention serum serotonin levels in the IVR group (113.22±17.12 vs 135.15±16.44 ng/mL; p<0.001). No significant difference was observed in salivary serotonin levels between both groups (p=0.758). Conclusions: Immersive virtual reality significantly influences serum serotonin level elevation in patients undergoing subarachnoid block anesthesia, demonstrating the potential of IVR as a non-pharmacological adjuvant modality to enhance perioperative patient comfort.