Key result
Audiovisual distraction cuts propofol dose ~22% vs sham during mitral TEER.
Why the study?
Balancing patient comfort with sedative-related hemodynamic and neurocognitive risks remains challenging during conscious sedation for M-TEER in frail older adults.
Does audiovisual distraction reduce the need for analgesic sedation and increase patient satisfaction in patients undergoing mitral valve clipping?
RCT (n=60)
Blinded
1:1
Does audiovisual distraction reduce the need for analgesic sedation and increase patient satisfaction in patients undergoing mitral valve clipping?
Answers are grounded in this paper and cite their sources.
Audiovisual distraction with video glasses is a safe and effective adjunct during M-TEER that reduces propofol requirements and improves patient satisfaction.
BACKGROUND: Conscious sedation is increasingly used for mitral transcatheter edge-to-edge repair (M-TEER), but balancing patient comfort with sedative-related hemodynamic and neurocognitive risk remains challenging in frail older adults. OBJECTIVES: We investigated whether audiovisual distraction (AVD) with video glasses reduces propofol requirements and improves patient experience during M-TEER performed under conscious sedation. METHODS: In this prospective randomized controlled trial, 60 patients undergoing M-TEER were assigned 1:1 to AVD (video glasses with nature documentaries and headphones) or sham control (identical inactive device). Propofol-based sedation was managed according to a uniform blinded protocol using a pragmatic Richmond Agitation-Sedation Scale target of -2 to -3. The primary endpoint was the mean propofol dose (mg/kg/h). Secondary endpoints included norepinephrine use, anxiety and pain on numerical rating scales, overall patient satisfaction (measured by the German adaptation of the Client Satisfaction Questionnaire), and in-hospital outcomes. RESULTS: The mean propofol dose was lower with AVD than control (4.6 ± 1.6 vs 5.9 ± 1.4 mg/kg/h; P = 0.002). Norepinephrine use was numerically lower (0.5 ± 1.1 vs 1.7 ± 3.4 μg/kg/h; P = 0.08). Procedural duration, hemodynamic fluctuations, and hospital length of stay were similar. AVD reduced postprocedural anxiety (1.1 ± 1.0 vs 2.5 ± 1.7; P = 0.001) and improved satisfaction (24.7 ± 3.0 vs 22.5 ± 2.8; P = 0.005). Safety events, including bleeding, pneumonia, conversion to general anesthesia, and clinically documented delirium, were comparable. CONCLUSIONS: AVD with video glasses is a safe, pragmatic adjunct to conscious sedation in M-TEER that reduces propofol requirements and improves patient-reported comfort and satisfaction without compromising procedural efficiency or in-hospital safety. (Does audiovisual distraction reduce the need for analgesic sedation and increase patient satisfaction in patients undergoing mitral valve clipping? A randomized controlled trial; DRKS00037370).
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Rawish et al. (2026) conducted an RCT in Mitral transcatheter edge-to-edge repair (M-TEER) (n=60). Audiovisual distraction (AVD) with video glasses vs. Sham control (identical inactive device) was evaluated on mean propofol dose (mg/kg/h) (p=0.002). Audiovisual distraction with video glasses reduced the mean propofol dose compared to sham control during mitral transcatheter edge-to-edge repair (4.6 vs 5.9 mg/kg/h; P=0.002).
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