Extended Reality for Neuraxial Anesthesia and Pain Procedures: A Scoping Review

Background Extended reality technology, encompassing augmented reality, mixed reality, and virtual reality, has the potential to enhance the teaching and performance of neuraxial procedures. The diverse applications of extended reality include immersive simulations and novel modes of procedural navigation. Objectives This scoping review aims to explore the preclinical, clinical, and educational applications of extended reality for neuraxial procedures while suggesting directions for future research. Evidence review A systematic search was conducted across PubMed, Embase, Web of Science, Cochrane Central Register of Controlled Trials, and Google Scholar until December 2023. Additional sources were identified via citation searching of relevant articles. The findings are reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Findings 41 studies, including three pending clinical trials were included. The majority of included studies were published after 2015. Extended reality technology was applied in diverse ways for teaching, simulation, and navigation, but only four of the completed studies described clinical use. For the display of visuals, computer screens were most commonly used, followed by head-mounted devices, laser projectors, and semi-transparent mirrors. Conclusions Interest in utilizing extended reality technology for neuraxial procedures is growing. Preliminary work shows promise for this technology in both education and clinical practice, but achieving accurate image registration without disrupting existing workflows remains an ongoing barrier to clinical testing. Additional research is needed to assess the cost-effectiveness and reliability of this technology.