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Background and Objectives@#Virtual reality (VR) users have prevalently experienced motion sickness called cybersickness. Recently, it has been suggested that stimulating the mastoid by vibration relieves cybersickness. This study aimed to verify this proposition.Subjects and Method Fifty-four young male adults (aged 18 to 27 years) without any experience of severe motion sickness or cybersickness participated in this study. Participants were divided in half into two groups, the experimental group and control group. The experimental group used VR with mastoid vibration, and the control group experienced VR without mastoid vibration. Participants responded to the simulator sickness questionnaire (SSQ) to quantify cybersickness. @*Results@#The total severity scores of cybersickness in the experimental group ranged from 0 to 183.3 with the mean value of 46.7±49.0. The total severity scores of cybersickness in the control group ranged from 0 to 194.9 with the mean value of 44.9±45.1. There were no significant differences between the two groups. @*Conclusion@#There was no improvement of cybersickness in the VR participants when the mastoid was stimulated by vibration. However, cybersickness might be relieved with changes in the VR condition or vibration settings.
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Enhanced recovery after surgery (ERAS) is a multimodal and multidisciplinary approach to maintaining physiologic function and improving recovery for surgical patients. The ERAS protocol is based on a range of empirical evidence, and consensus ERAS guidelines for various surgical procedures have been published. The elements of the ERAS protocol include minimal preoperative fasting and carbohydrate treatment instead of overnight fasting; no routine use of preoperative bowel preparation; minimally invasive surgical techniques; standard anesthetic protocol; optimal fluid management rather than generous intravenous fluid administration; prevention and treatment of postoperative nausea and vomiting; active prevention of perioperative hypothermia; multimodal approaches to controlling postoperative pain; and early oral intake and mobilization. Implementation of ERAS shortened hospital stays by 30% to 50% and reduced postoperative complications by 50%. A recent study reported that, when patient compliance with the colorectal ERAS protocol was over 70%, 5-year mortality fell by 42% compared with when compliance was below 70%. Auditing process compliance and patient outcomes are key measures for assisting clinicians implementing the ERAS program. As a perioperativist, an anesthesiologist can play a crucial role in implementing the ERAS program and contribute to protocol establishment, auditing, team education and team leadership. While the ERAS protocol was first implemented for colorectal surgery, as a result of its efficacy, it is now being used in nearly all major surgical specialties.