Virtual Reality as an Adjunctive Non-pharmacologic Analgesic for Acute Burn Pain During Medical Procedures (original) (raw)
Related papers
Applications of virtual reality for pain management in burn-injured patients
Expert Review of Neurotherapeutics, 2008
The pain associated with burn injuries is intense, unremitting and often exacerbated by anxiety, depression and other complicating patient factors. On top of this, modern burn care involves the repetitive performance-often on a daily basis for weeks to months-of painful and anxietyprovoking procedures that create additional treatment-related pain, such as wound care, dressing changes and rehabilitation activities. Pain management in burn patients is primarily achieved by
EFFECT OF VIRTUAL REALITY ON WOUND CARE RELATED PAIN AMONG PATIENTS WITH BURN
Xi'an ShiyouDaxueXuebao (ZiranKexue Ban)/ Journal of Xi'an Shiyou University, Natural Sciences Edition, 2023
Background: Burns are one of the most devastating injuries worldwide, burn injuries are a type of skin and tissue damage. Moreover, wound care of burned skin are frequently caring procedure but it is usually accompanied by pain. Virtual reality (VR) technology has been widely used in recent years, as an effective and safe strategy for management of pain associated with burn wound care. Head mounted displays (HMD) has made VR now more feasible for clinical use. Aim of the study: The aim is to evaluate the effect of virtual reality technology on wound care pain among patients with burn. Design: One-group pretest-posttest quasi-experimental design was used in the study. Setting: The study was conducted in two settings, the first was the burn units affiliated to Cairo university hospitals, while the other was the burn unit affiliated to a governmental hospital affiliated to Ministry of health, Egypt. Sample: A convenient sample of 60 male and female adult conscious patients with burn who fulfilled the eligibility criteria was recruited. Tools: Two tools were utilized to collect data; Demographic and Medical Data Questionnaire (DMDQ), Short-Form McGill Pain Questionnaire (SF-MPQ). Results: The mean age of the study sample was 35.40 ± 14.603 years and 43.3% of study sample their age ranged between 18 < 31 years; the female gender represented about 53.3 %. Concerning pain scores; there are high statistical significant differences between Visual Analog Scale (VAS) in the 2 nd wound care without using VR and 3 rd and 4 th wound care with VR, where T= 18.271 P=.000, T= 23.516 P=.000 respectively. Conclusion: The application of VR technology during burns wound care decrease pain severity of burn wound care. Recommendation: Application of VR technology during burn wound care is an effective non-pharmacological pain management strategy/technique.
Virtual reality as an adjunctive pain control during burn wound care in adolescent patients
Pain, 2000
For daily burn wound care procedures, opioid analgesics alone are often inadequate. Since most burn patients experience severe to excruciating pain during wound care, analgesics that can be used in addition to opioids are needed. This case report provides the ®rst evidence that entering an immersive virtual environment can serve as a powerful adjunctive, nonpharmacologic analgesic. Two patients received virtual reality (VR) to distract them from high levels of pain during wound care. The ®rst was a 16-year-old male with a deep¯ash burn on his right leg requiring surgery and staple placement. On two occasions, the patient spent some of his wound care in VR, and some playing a video game. On a 100 mm scale, he provided sensory and affective pain ratings, anxiety and subjective estimates of time spent thinking about his pain during the procedure. For the ®rst session of wound care, these scores decreased 80 mm, 80 mm, 58 mm, and 93 mm, respectively, during VR treatment compared with the video game control condition. For the second session involving staple removal, scores also decreased. The second patient was a 17-year-old male with 33.5% total body surface area deep¯ash burns on his face, neck, back, arms, hands and legs. He had dif®culty tolerating wound care pain with traditional opioids alone and showed dramatic drops in pain ratings during VR compared to the video game (e.g. a 47 mm drop in pain intensity during wound care). We contend that VR is a uniquely attentioncapturing medium capable of maximizing the amount of attention drawn away from the`real world', allowing patients to tolerate painful procedures. These preliminary results suggest that immersive VR merits more attention as a potentially viable form of treatment for acute pain.
… Clinical journal of pain, 2009
The authors' concluded that virtual reality may be an effective non-pharmacologic non-invasive adjunct analgesic technique to pain management for burn injury patients receiving wound dressing changes or physiotherapy treatment. The conclusions reflected the results presented. However, as the limited available evidence came from small studies, the conclusions should be interpreted cautiously. Authors' objectives To evaluate the effectiveness of virtual reality combined with pharmacologic analgesia in reducing pain and anxiety in burn injury patients undergoing wound dressing changes and physiotherapy.
Virtual Reality Analgesia for Children With Large Severe Burn Wounds During Burn Wound Debridement
Frontiers in Virtual Reality, 2020
The objective of this study was to compare the effect of adjunctive virtual reality vs. standard analgesic pain medications during burn wound cleaning/debridement. Participants were predominantly Hispanic children aged 6–17 years of age, with large severe burn injuries (TBSA = 44%) reporting moderate or higher baseline pain during burn wound care. Using a randomized between-groups design, participants were randomly assigned to one of two groups, (a) the Control Group = pain medications only or (b) the VR Group = pain medications + virtual reality. A total of 50 children (88% Hispanic) with large severe burns (mean TBSA > 10%) received severe burn wound cleaning sessions. For the primary outcome measure of worst pain (intensity) on Study Day 1, using a between groups ANOVA, burn injured children in the group that received virtual reality during wound care showed significantly less pain intensity than the No VR control group, [mean worst pain ratings for the No VR group = 7.46 (SD ...
Virtual Reality Pain Control During Burn Wound Debridement in the Hydrotank
The Clinical Journal of Pain, 2008
Most burn-injured patients rate their pain during burn wound debridement as severe to excruciating. We explored the adjunctive use of water-friendly, immersive virtual reality (VR) to distract patients from their pain during burn wound debridement in the hydrotherapy tank (hydrotank). Setting: This study was conducted on inpatients at a major regional burn center. Patients: Eleven hospitalized inpatients ages 9 to 40 years (mean age, 27 y) had their burn wounds debrided and dressed while partially submerged in the hydrotank. Intervention: Although a nurse debrided the burn wound, each patient spent 3 minutes of wound care with no distraction and 3 minutes of wound care in VR during a single wound care session (within-subject condition order randomized). Outcome Measures: Three 0 to 10 graphic rating scale pain scores (worst pain, time spent thinking about pain, and pain unpleasantness) for each of the 2 treatment conditions served as the primary dependent variables. Results: Patients reported significantly less pain when distracted with VR [eg, ''worst pain'' ratings during wound care dropped from ''severe'' (7.6) to ''moderate'' (5.1)]. The 6 patients who reported the strongest illusion of ''going inside'' the virtual world reported the greatest analgesic effect of VR on worst pain ratings, dropping from severe pain (7.2) in the no VR condition to mild pain (3.7) during VR. Conclusions: Results provide the first available evidence from a controlled study that immersive VR can be an effective nonpharmacologic pain reduction technique for burn patients experiencing severe to excruciating pain during wound care. The potential applications of VR analgesia to other painful procedures (eg, movement or exercise therapy) and other pain populations are discussed.
Opioids are the most frequently used pain medications by US burn centers to control severe procedural pain during wound care. Concerns for long-term opioid use have prompted the exploration of non-pharmaceutical interventions, such as virtual reality (VR), for procedural pain management. The primary objective of this pilot study was to evaluate the feasibility and efficacy of VR pain alleviation treatment on reducing adult burn patients’ perceived pain during burn dressing changes. Adult patients aged 18-70 years were recruited from the inpatient unit of a single American Burn Association–verified burn center between May 2019 and February 2020 and randomly assigned to one of three arms. Active VR participants played four VR games; passive VR participants were immersed in the same VR environment without the interaction elements; and a standard of care control group. 71 patients were screened for eligibility and 33 were deemed eligible to approach for informed consent, with 14 agreein...
Designing effective virtual reality environments for pain management in burn-injured patients
2021
Burn patients engage in repetitive painful therapeutic treatments, such as wound debridement, dressing changes, and other medical processes high in procedural pain. Pharmacological analgesics have been used for managing pain, but with ineffective results and negative side effects. Studies on pain management for burn patients suggested that Virtual Reality can treat procedural pain. This paper describes the process of designing, testing, and deploying a Virtual Reality system into a hospital setting. Firstly, a workshop was conducted to identify the most suitable types of Virtual Reality contents for the needs of burn-injured patients. Then, an experimental study, with 15 healthy adults, explored the analgesic impact of the Virtual Reality contents. The pain was induced through a cold pressor. Finally, we deployed the Virtual Reality system into the hospital to examine its efficiency on burn-injured inpatients. This study presents factors for the effective design and deployment of Vi...
Physical Therapy and Rehabilitation, 2019
Objective: the purpose of this study was to evaluate effectiveness of virtual reality (VR) in decreasing pain and facilitating physical therapy (PT) procedures for adolescent burned Patients. Methods: A two-weeks randomized controlled study including fifty-six adolescent burned patients who randomly divided into two groups. VR group received VR during PT session while control group received PT without VR. Pain was assessed by adolescent pediatric pain tool (APPT) and ROM was assessed by goniometer at the end of each session. Results: The results of study reported highly significant and substantial declines in all pain outcomes (mean total painful areas, pain intensity, sensory, affective, evaluative and temporal dimensions of pain) in VR group compared to control group, p value ≤0.001. The percentage of decrement of pain intensity in VR group was 55.6% while for control group was 15.6%. Regarding ROM measurement, for the first three sessions, the results of the study showed that there was no significant difference between both groups in mean ROM of hip extension, hip abduction, knee extension and ankle dorsiflexion, p value >0.05, however for the last three sessions, there was highly significant difference between both groups, p value <0.05. The percentage of improvement in ROM of Hip extension, hip abduction, dorsiflexion and knee extension in VR group were 14.2%, 85.2%, 26.1% and 82.2% respectively, while for control group the percentage of improvement were 8.3%, 24.7%, 11.8% and 24.1% respectively. Conclusion: Based on the obtained results and previous studies results, our study concluded that virtual reality is powerful analgesic non-pharmacological adjunctive tool that helps in decreasing procedural pain during PT procedures. Its analgesic effects have beneficial effects on ROM of lower extremity of adolescent burned patients.
2009
Background Albeit Virtual Reality (VR) has been shown to be a useful adjunct in the reduction of pain during burn care and therapy, the current VR systems are expensive and may not be economically feasible for developing countries such as South Africa, where health budgets are stringent. Objective The purpose of this study was to ascertain the effect of a lowcost VR system (eMagin Z800 3DVisor), used in conjunction with pharmacologic analgesics, on reducing pain and anxiety in adult burn injury patients undergoing physiotherapy treatment, compared to pharmacologic analgesics alone at a South African hospital. Study design Single-blinded, within-subject study design. Methods Pain and anxiety outcome measures were measured by a blinded assessor using the Numeric Pain Rating Scale and Burn Specific Pain and Anxiety Scale. Descriptive statistics, Chi-square tests as well as the Student's paired t-test were used to analyze data. Main findings Eleven eligible adult burn injury patients consented to participate in this study (3 female, 8 male; median age 33 years: range 23-54 years). A marginal (p=0.06) to insignificant (p=0.13) difference between the two conditions (analgesics with VR and analgesics alone) in reducing pain was found. No significant difference (p=0.58) was found between the two conditions (analgesics with VR and analgesics alone) for anxiety. Interpretation There is a trend that a low-cost VR system, when added to routine pharmacologic analgesics, is an economically feasible and safe adjunct therapy and could be of considerable benefit if implemented into the current pain management regimen of burn injury patients at a South African Hospital.