Abstract
Patients undergoing gynecologic laparoscopic surgery (GLS) often experience postoperative complications, including acute postoperative pain (APSP). This study aimed to assess the safety and efficacy of immersive virtual reality-based and aromatherapy-enhanced multisensory stimulation (IVR-MS) in patients undergoing GLS. This prospective, randomized controlled trial was registered at www.clinicaltrials.gov on 4/03/2025 (NCT06922838). Participants were randomly assigned to the IVR-MS group (received IVR combined with olfactory stimulation for enhanced multisensory stimulation), the IVR group (received IVR intervention), and the aromatherapy group (received lavender aromatherapy). From baseline to postoperative 24 hours, pain response, patient-controlled analgesia (PCA), anxiety, sleep quality, comfort level, rescue analgesic, and abdominal distension were evaluated in patients. Ultimately, 124 participants completed all analyses. Significant statistical differences were observed among the three groups in postoperative pain scores, PCA usage, anxiety levels, comfort, and sleep quality following the intervention. However, no significant differences were found in the classification of abdominal distension. Trial registration This trial was registered at www.clinicaltrials.gov (Registration Number: NCT06922838, Registration Date: april 03th, 2025).
Similar content being viewed by others
Data availability
The data supporting the findings of this study are available within the Mendeley database (https://doi.org/10.17632/mmwvpb42y6.3).
References
Scheib, S. A. & Fader, A. N. Gynecologic robotic laparoendoscopic single-site surgery: prospective analysis of feasibility, safety, and technique. Am. J. Obstet. Gynecol. 212, 179.e171–178 (2015).
Alessandri, F., Lijoi, D., Mistrangelo, E., Ferrero, S. & Ragni, N. Randomized study of laparoscopic versus minilaparotomic myomectomy for uterine myomas. J. Minim. invasive Gynecol. 13, 92–97 (2006).
Liu, J. et al. Is intravenous dextrose infusion during emergence from anesthesia effective in improving the PONV in gynecologic laparoscopy? A randomized controlled trial. J. Minim. Invasive Gynecol. 31, 285–294 (2024).
van Boekel, R. L. M. et al. Relationship between postoperative pain and overall 30-day complications in a broad surgical population: an observational study. Ann. Surg. 269, 856–865 (2019).
Powell, R. et al. Psychological preparation and postoperative outcomes for adults undergoing surgery under general anaesthesia. Cochrane Database Syst. Rev. 2016, Cd008646 (2016).
Glare, P., Aubrey, K. R. & Myles, P. S. Transition from acute to chronic pain after surgery. Lancet 393, 1537–1546 (2019).
Chemali, M. E. & Eslick, G. D. A meta-analysis: postoperative pain management in colorectal surgical patients and the effects on length of stay in an enhanced recovery after surgery (ERAS) setting. Clin. J. pain. 33, 87–92 (2017).
Kehlet, H., Jensen, T. S. & Woolf, C. J. Persistent postsurgical pain: risk factors and prevention. Lancet 367, 1618–1625 (2006).
Berkowitz, R. et al. The impact of complications and pain on patient satisfaction. Ann. Surg. 273, 1127–1134 (2021).
Shamali, M., Vilmann, P., Johansen, N. R. & Konradsen, H. Virtual reality intervention to improve quality of care during colonoscopy: a hybrid type 1 randomized controlled trial. Gastrointest. Endosc. 100, 914–922.e912 (2024).
Crouch, T. B. et al. Pain rehabilitation’s dual power: Treatment for chronic pain and prevention of opioid-related risks. Am. Psychol. 75, 825–839 (2020).
Gray, M. L. et al. Postoperative pain management after sinus surgery: a survey of the American Rhinologic Society. Int. Forum Allergy Rhinol. 8, 1199–1203 (2018).
Bradt, J., Dileo, C. & Shim, M. Music interventions for preoperative anxiety. Cochrane Database Syst. Rev. 2013, Cd006908 (2013).
Teh, J. J. et al. Efficacy of virtual reality for pain relief in medical procedures: a systematic review and meta-analysis. BMC Med. 22, 64 (2024).
Levit, T. et al. The effectiveness of virtual and augmented reality in surgical pain management: a systematic review of randomized controlled trials. Anesthes. Analgesia, https://doi.org/10.1213/ane.0000000000007051 (2024).
Pandrangi, V. C. et al. Effect of virtual reality on pain management and opioid use among hospitalized patients after head and neck surgery: a randomized clinical trial. JAMA Otolaryngol. Head. Neck Surg. 148, 724–730 (2022).
Wong, C. L. & Choi, K. C. Effects of an immersive virtual reality intervention on pain and anxiety among pediatric patients undergoing venipuncture: a randomized clinical trial. JAMA Netw. Open 6, e230001 (2023).
Eijlers, R. et al. Virtual reality exposure before elective day care surgery to reduce anxiety and pain in children: a randomised controlled trial. Eur. J. Anaesthesiol. 36, 728–737 (2019).
Gao, Y., Xu, Y., Liu, N. & Fan, L. Effectiveness of virtual reality intervention on reducing the pain, anxiety and fear of needle-related procedures in paediatric patients: a systematic review and meta-analysis. J. Adv. Nurs. 79, 15–30 (2023).
Lier, E. J., de Vries, M., Steggink, E. M., Ten Broek, R. P. G. & van Goor, H. Effect modifiers of virtual reality in pain management: a systematic review and meta-regression analysis. Pain 164, 1658–1665 (2023).
Simonetti, V. et al. Effectiveness of virtual reality in the management of paediatric anxiety during the peri‑operative period: a systematic review and meta-analysis. Int. J. Nurs. Stud. 125, 104115 (2022).
Ahmadpour, N., Keep, M., Janssen, A., Rouf, A. S. & Marthick, M. Design strategies for virtual reality interventions for managing pain and anxiety in children and adolescents: scoping review. JMIR Serious Games 8, e14565 (2020).
Chiu, P. L. et al. Virtual reality-based intervention to reduce preoperative anxiety in adults undergoing elective surgery: a randomized clinical trial. JAMA Netw. Open 6, e2340588 (2023).
Ho, K. Y. et al. Psychometric properties of the Chinese version of the Pittsburgh Sleep Quality Index (PSQI) among Hong Kong Chinese childhood cancer survivors. Health Qual. Life Outcomes 19, 176 (2021).
Wang, Q. et al. Clinical safety of daridorexant in insomnia treatment: analysis of FDA adverse event reports. J. Affect. Disord. 362, 552–559 (2024).
Cheng, L. et al. Safety and effectiveness of multimodal opioid-free anaesthesia for pain and recovery after laparoscopic surgery: a systematic review and meta-analysis. BMJ open 15, e085988 (2025).
Sharar, S. R. et al. Circumplex model of affect: a measure of pleasure and arousal during virtual reality distraction analgesia. Games Health J. 5, 197–202 (2016).
Cao, W. et al. Effect of virtual reality intervention on hospitalized patients with acute pain after thoracoscopic surgery: a pilot randomized clinical trial. Int. J. Surg. 111, 2752–2756 (2025).
Kehlet, H. Postoperative pain, analgesia, and recovery-bedfellows that cannot be ignored. Pain 159, S11–s16 (2018).
El Mathari, S. et al. The effect of virtual reality on postoperative anxiety and pain in patients following cardiac surgery: a randomized controlled trial. Eur. J. Cardio-Thorac. Surg. Official J. Eur. Assoc. Cardio-Thorac. Surg. 66, https://doi.org/10.1093/ejcts/ezae440 (2024).
Piette, J. D. et al. Patient-centered pain care using artificial intelligence and mobile health tools: a randomized comparative effectiveness trial. JAMA Intern. Med. 182, 975–983 (2022).
Rooney, T. et al. A synthesis of meta-analyses of immersive virtual reality interventions in pain. Clin. Psychol. Rev. 117, 102566 (2025).
Xiang, H. et al. Efficacy of smartphone active and passive virtual reality distraction vs standard care on burn pain among pediatric patients: a randomized clinical trial. JAMA Netw. Open 4, e2112082 (2021).
Gao, Y., Wang, N. & Liu, N. Effectiveness of virtual reality in reducing preoperative anxiety in adults: A systematic review and meta-analysis. J. Adv. Nurs. 79, 3678–3690 (2023).
Li, J. et al. The analgesic effects and neural oscillatory mechanisms of virtual reality scenes based on distraction and mindfulness strategies in human volunteers. Br. J. Anaesth. 131, 1082–1092 (2023).
Jerdan, S. W., Grindle, M., van Woerden, H. C. & Kamel Boulos, M. N. Head-mounted virtual reality and mental health: critical review of current research. JMIR Serious Games 6, e14 (2018).
Honzel, E. et al. Virtual reality, music, and pain: developing the premise for an interdisciplinary approach to pain management. Pain 160, 1909–1919 (2019).
Ding, L. et al. Effects of virtual reality on relieving postoperative pain in surgical patients: A systematic review and meta-analysis. Int. J. Surg. 82, 87–94 (2020).
Hoffman, H. G. et al. The analgesic effects of opioids and immersive virtual reality distraction: evidence from subjective and functional brain imaging assessments. Anesth. Analg. 105, 1776–1783 (2007).
Pourmand, A., Davis, S., Marchak, A., Whiteside, T. & Sikka, N. Virtual reality as a clinical tool for pain management. Curr. Pain. Headache Rep. 22, 53 (2018).
Cui, J. et al. Inhalation aromatherapy via brain-targeted nasal delivery: natural volatiles or essential oils on mood disorders. Front. Pharmacol. 13, 860043 (2022).
Xiao, X., Rui, Y., Jin, Y. & Chen, M. Relationship of sleep disorder with neurodegenerative and psychiatric diseases: an updated review. Neurochem. Res. 49, 568–582 (2024).
Gold, J. I., SooHoo, M., Laikin, A. M., Lane, A. S. & Klein, M. J. Effect of an immersive virtual reality intervention on pain and anxiety associated with peripheral intravenous catheter placement in the pediatric setting: a randomized clinical trial. JAMA Netw. Open 4, e2122569 (2021).
Bekelis, K., Calnan, D., Simmons, N., MacKenzie, T. A. & Kakoulides, G. Effect of an immersive preoperative virtual reality experience on patient reported outcomes: a randomized controlled trial. Ann. Surg. 265, 1068–1073 (2017).
Yang, J. H., Ryu, J. J., Nam, E., Lee, H. S. & Lee, J. K. Effects of preoperative virtual reality magnetic resonance imaging on preoperative anxiety in patients undergoing arthroscopic knee surgery: a randomized controlled study. Arthrosc. J. Arthroscopic Relat. Surg. Off. Publ. Arthrosc. Assoc. North Am. Int. Arthrosc. Assoc. 35, 2394–2399 (2019).
Luo, J., Wang, M. & Chen, L. The effects of using a nature-sound mobile application on psychological well-being and cognitive performance among university students. Front. Psychol. 12, 699908 (2021).
Zhu, R. et al. Effects of natural sound exposure on health recovery: a systematic review and meta-analysis. Sci. Total Environ. 921, 171052 (2024).
Bruni, O., Ferini-Strambi, L., Giacomoni, E. & Pellegrino, P. Herbal remedies and their possible effect on the GABAergic system and sleep. Nutrients 13, https://doi.org/10.3390/nu13020530 (2021).
Gold, J. I., Kim, S. H., Kant, A. J., Joseph, M. H. & Rizzo, A. S. Effectiveness of virtual reality for pediatric pain distraction during i.v. placement. Cyberpsychol. Behav. Impact Internet Multimed. Virtual Real. Behav. Soc. 9, 207–212 (2006).
Acknowledgements
This study is particularly grateful to the Shandong Second Medical University for their guidance and assistance. This study was supported by the Project of the Chinese Neurology Special Fund (Z-2016-20-2101-11).
Author information
Authors and Affiliations
Contributions
J.L. and Y.X.L. contributed equally to this study. Manuscript writing: J.L.; Manuscript review: Y.J.S., L.N.B., L.Z.; Intervention process: S.R.F., F.X.Z.; Investigation process: X.Z., J.Y.Z.; Statistically analysis: F.C.H., M.Y.H., T.W.; All authors have reviewed and agreed to submit the manuscript by the corresponding author.
Corresponding author
Ethics declarations
Competing interests
The authors declare no competing interests.
Additional information
Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/.
About this article
Cite this article
Liu, J., Liu, Y., Bi, L. et al. Effects of multisensory stimulation based on immersive virtual reality in postoperative neuropsychiatric recovery after gynecological laparoscopy. npj Digit. Med. (2026). https://doi.org/10.1038/s41746-026-02515-7
Received:
Accepted:
Published:
DOI: https://doi.org/10.1038/s41746-026-02515-7
