Virtual Reality After Breast Reconstruction Surgery (VR4BR)

VR 4 BR: Effects of Virtual Reality on Women Undergoing Mastectomy and Breast Reconstruction, A Pilot Study

This is a pilot study of virtual reality (VR) non-opioid management for women undergoing mastectomy and implant-based reconstruction. Study participants will receive specialized VR interventions, administered via VR headsets, to manage pain.

The primary objective of this study is to estimate the effect of utilizing VR on reducing opioid use in study participants undergoing mastectomy with implant-based reconstruction compared to the control group. Investigators will follow patients throughout the course of their hospitalization and monitor outcomes including pain levels, medication requests, and satisfaction. Eligible participants will receive a VR headset and instructed to use the VR every time they feel pain and before asking for a pain medication. They can take pain medications, if they choose to do so. At their post-op visit, study participants will be interviewed and asked questions regarding their experience with VR. Pain level and medication use will be compared with similar individuals who undergo the same procedure but are not provided with a VR headset.

Opioid usage is defined as mean total milligrams of morphine equivalent (MME), calculated by first multiplying the quantity of each prescribed medication by the strength of that medication (milligrams of given opioid per unit dispensed), and then multiplying this quantity-strength product by conversion factors derived from published sources to estimate the milligrams of morphine equivalent to the opioids dispensed in the prescription.

Pain collected via ecological momentary assessment by hospital staff. Study participants will be asked by their assigned nurse to rate their pain using a standard 11-point numeric rating scale (NRS), where 0 is "no pain" and 10 is "worst imaginable pain."

Inclusion Criteria: Age ≥ 18 years Women who plan to undergo mastectomy and implant-based reconstruction Written informed consent obtained from subject and ability for subject to comply with the requirements of the study. Able to read and comprehend English Exclusion Criteria: Current diagnosis of epilepsy, dementia, or other neurologic disease that may prevent use of VR headset and software Sensitivity to flashing light Diagnosis of motion sickness Pregnancy or a medical condition where the study participant is prone to frequent nausea or dizziness Current or recent (less than 6 months) use of opioids Individuals with psychiatric disorders, including those with delirium or other disorders that may involve hallucinations or psychosis