Virtual reality as an adjunctive pain control during burn wound care in adolescent patients
Virtual reality as an adjunctive pain control during burn wound care in adolescent patients
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DOI：
10.1016/s0304-3959(99)00275-4
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发表时间：
2000-03-01
期刊：
影响因子：
7.4
通讯作者：
Furness, TA
中科院分区：
文献类型：
--
作者：
Hoffman, HG;Doctor, JN;Furness, TA
对于日常烧伤伤口护理程序，单独使用阿片类镇痛剂往往是不够的。由于大多数烧伤患者在伤口护理过程中会经历严重到难以忍受的疼痛，因此需要除阿片类药物外还可使用的镇痛剂。这个病例报告提供了第一个证据，表明进入一个沉浸式的虚拟环境可以作为一个强大的预防性，非药物镇痛。两名患者接受了虚拟现实VR，以分散他们在伤口护理过程中的高度疼痛。第一例患者为16岁男性，右腿深度闪光烧伤，需要手术和吻合钉置入。有两次，患者在VR中进行了一些伤口护理，还有一些在玩视频游戏。在100 mm的量表上，他提供了感觉和情感疼痛评级、焦虑和主观估计的手术期间思考疼痛所花的时间。对于第一次伤口护理，与视频游戏对照条件相比，VR治疗期间这些评分分别下降80 mm、80 mm、58 mm和93 mm。对于涉及缝钉取出的第二次治疗，评分也有所下降。第二例患者为17岁男性，面部、颈部、背部、手臂、手部和腿部有33.5%的全身表面积的深度烧伤。他难以单独耐受传统阿片类药物的伤口护理疼痛，并且与视频游戏相比，在VR期间疼痛评分显着下降（例如，在伤口护理期间疼痛强度下降47 mm）。我们认为，VR是一种独特的注意力捕捉媒介，能够最大限度地减少人们对“真实的世界”的注意力，使患者能够忍受痛苦的过程。这些初步结果表明，沉浸式VR作为治疗急性疼痛的潜在可行形式值得更多关注。(C)2000年国际疼痛研究协会。由Elsevier Science B.V.出版，版权所有。
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 first 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 first was a 16-year-old male with a deep flash 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 first 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 hash bums on his face, neck, back, arms, hands and legs. He had difficulty 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 attention-capturing 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. (C) 2000 International Association for the Study of Pain. Published by Elsevier Science B.V. All rights reserved.