Perioperative virtual reality and neuropsychiatric outcomes: a scoping review

Surgical procedures in older populations carry significant risks, including increased perioperative complications such as anxiety and delirium, which adversely affect outcomes and patient satisfaction. We sought to evaluate the efficacy and methods of virtual reality (VR) interventions in reducing perioperative anxiety and delirium in a scoping review. Searches were performed in Embase and PubMed from 2020 to 2025 for studies involving VR in adult surgical patients, focusing on anxiety, pain, and delirium outcomes. Twenty-three studies encompassing 2,227 patients were included, predominantly randomized controlled trials from various countries. No study directly evaluated VR's effect on delirium, but several showed VR's potential in reducing perioperative anxiety and pain, with mixed efficacy results. VR interventions varied in content, technological sophistication, frequency, and duration. Quality assessment indicated limitations due to unblinded designs. VR shows promise in reducing perioperative anxiety, with potential implications for delirium prevention. However, the effectiveness varies, and further research is needed to refine VR interventions and explore their role in preventing delirium.