Effect of Virtual Reality Immersion on Patient's Anxiety During Pre-oxygenation Before General Anaesthesia

Inclusion Criteria:

• All non-ambulatory patients undergoing elective surgery or procedure under generalanaesthesia with intravenous induction

• Minimal age of 18 year old

• Able to give informed consent for the study as documented by signature

Exclusion Criteria:

• Lacking capacity or ability to complete the consent form and/or questionnaire andinterview method and/or incapacity to respond to the required obligations linked tothe study protocol (assessed by the operator)

• Known cognitive dysfunction, previous history of neurological/psychiatric diseaselike epilepsy

• Depression or anxiety under treatment

• Non-Italian speaking patients

• Anticipated difficult airway management

• Injuries to the head/face that would prohibit wearing headsets

• Active nasal bleeding or occlusion, nasal abnormality or recent nasal trauma, recentnasal surgery, significant raised intracranial pressure and base of skull fractures

• Any pre-operative premedication, including pharmacological premedication

• Rapid sequence induction

• Haemodynamic instability

• Infectious skin conditions on the head/face

• Undrained pneumothorax

• Contact isolation due to bacteria and viruses

• Symptoms of vertigo or motion sickness

• Reduced visual or auditory acuity

• BMI > 35 kg/m2

• Pregnancy

• Claustrophobia

• Pre-existing hypoxemia (baseline oxygen saturation < 92% when breathing room air)

• Need for an arterial line before general anaesthesia induction