Feasibility of implementing a virtual reality program as an adjuvant tool for peri-operative pain control; Results of a randomized controlled trial in minimally invasive foregut surgery.

BACKGROUND: Post-operative pain control and narcotic over-utilization are challenging issues for surgeons in all fields. While virtual reality (VR) has been increasingly applied in various fields, its feasibility and efficacy in the peri-operative period has not been evaluated. The aim of this study was to examine the experience of an integrated VR protocol in the perioperative setting. METHODS: Patients undergoing minimally invasive foregut surgery at a single institution were randomized to receive a series of VR meditation/mindfulness sessions (VR) or to standard care after surgery (non-VR). Post-operative pain levels, narcotic utilization and patient satisfaction were tracked. RESULTS: Fifty-two patients were enrolled with 26 in each arm. Post-operative pain scores, total narcotic utilization, and overall satisfaction scores were not significantly different between the two groups. For patients in the VR arm, sessions were able to be incorporated into the perioperative routine with little disruption. Most (73.9 %) were able complete all six VR sessions and reported low pain, anxiety, and nausea scores while using the device. A high proportion responded that they would use VR again (76.2 %) or would like a VR program designed for pain (62.0 %). There were no complications from device usage. CONCLUSION: VR is a safe and simple intervention that is associated with high patient satisfaction and is feasible to implement in the perioperative setting. While the current study is underpowered to detect difference in narcotic utilization, this device holds promise as an adjuvant tool in multimodal pain and anxiety control in the peri-operative period.

Anthocyanin-rich purple wheat prolongs the life span of Caenorhabditis elegans probably by activating the DAF-16/FOXO transcription factor.

Colored cereals attract public attention due to their potential antioxidant properties and corresponding health benefits. Purple wheat, rich in anthocyanins, is one of the newly developed cereals on the market. Cyanidin-3-O-glucoside (42.6%) is the predominant anthocyanin in purple wheat, followed by peonidin-3-O-glucoside (39.9%) and malvidin-3-O-galactoside (17.4%). To investigate the potential antiaging and antioxidant properties of purple wheat, the nematode Caenorhabditis elegans was chosen as an experimental model organism. It was found that an anthocyanin-rich methanolic extract of purple wheat extended the mean life span of wild type worms and of mev-1(hn1) mutants, which are sensitive to oxidative stress, by 10.5 and 9.2%, respectively. Life span extension depends on the transcription factor DAF-16; no significant increase of longevity was seen in daf-16 (mgDf50) mutant worms. Translocation of DAF-16/FOXO to the nucleus implies that the transcription factor DAF-16/FOXO was activated under purple wheat treatment by inhibition of the insulin/IGF-1-like signaling pathway which includes the insulin receptor DAF-2. Moreover, purple wheat increased stress response in C. elegans as well as reduced oxidative stress. Anthocyanins of purple wheat apparently exhibit beneficial effects in C. elegans. They may exert similar properties in humans, which is an issue to be explored in future studies.