Virtual Reality for Management of Pain in Hospitalized Patients: Results of a Controlled Trial.
Virtual Reality for Management of Pain in Hospitalized Patients: Results of a Controlled Trial.
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DOI：
10.2196/mental.7387
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发表时间：
2017-03-29
影响因子：
5.2
通讯作者：
Spiegel B
中科院分区：
文献类型：
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作者：
Tashjian VC;Mosadeghi S;Howard AR;Lopez M;Dupuy T;Reid M;Martinez B;Ahmed S;Dailey F;Robbins K;Rosen B;Fuller G;Danovitch I;IsHak W;Spiegel B
软件和设计的改进以及成本的降低使虚拟现实（VR）成为一种实用的工具，用于沉浸式、三维（3D）、多感官体验，使患者从痛苦的刺激中分散注意力。该研究的目的是衡量一次性3D VR干预与二维（2D）分心视频对住院患者疼痛的影响。我们在一家大型城市教学医院进行了一项比较队列研究，研究对象是由任何原因引起的平均疼痛评分≥3/10的住院患者。恶心、呕吐、痴呆、晕动病、中风、癫痫和癫痫患者以及被隔离的患者被排除在外。干预组的患者使用三星Gear Oculus VR头显观看了旨在减轻疼痛的3D VR体验；对照组患者在14英寸床边屏幕上观看高清2D自然视频。记录干预前和干预后的疼痛评分。比较两组之间的差异得分和达到半标准差疼痛反应的比例。每个队列有50名受试者（N=100）。VR组的平均疼痛减轻程度大于对照组（分别为- 1.3和- 0.6点，P= 0.008）。在VR队列中，共有35名（65%）患者达到疼痛缓解，而对照组为40% （P= 0.01；需要治疗的人数=4）。VR无不良事件报告。在住院患者中使用VR与控制性分心条件相比可显著减轻疼痛。这些结果表明，虚拟现实是一种有效和安全的辅助治疗疼痛的急性住院设置；未来的随机试验应证实不同的可视化和暴露时间的益处。Clinicaltrials.gov NCT02456987;https://clinicaltrials.gov/ct2/show/NCT02456987（由WebCite在http://www.webcitation.org/6pJ1P644S存档）
Improvements in software and design and reduction in cost have made virtual reality (VR) a practical tool for immersive, three-dimensional (3D), multisensory experiences that distract patients from painful stimuli. The objective of the study was to measure the impact of a onetime 3D VR intervention versus a two-dimensional (2D) distraction video for pain in hospitalized patients. We conducted a comparative cohort study in a large, urban teaching hospital in medical inpatients with an average pain score of ≥3/10 from any cause. Patients with nausea, vomiting, dementia, motion sickness, stroke, seizure, and epilepsy and those placed in isolation were excluded. Patients in the intervention cohort viewed a 3D VR experience designed to reduce pain using the Samsung Gear Oculus VR headset; control patients viewed a high-definition, 2D nature video on a 14-inch bedside screen. Pre- and postintervention pain scores were recorded. Difference-in-difference scores and the proportion achieving a half standard deviation pain response were compared between groups. There were 50 subjects per cohort (N=100). The mean pain reduction in the VR cohort was greater than in controls (−1.3 vs −0.6 points, respectively; P=.008). A total of 35 (65%) patients in the VR cohort achieved a pain response versus 40% of controls (P=.01; number needed to treat=4). No adverse events were reported from VR. Use of VR in hospitalized patients significantly reduces pain versus a control distraction condition. These results indicate that VR is an effective and safe adjunctive therapy for pain management in the acute inpatient setting; future randomized trials should confirm benefit with different visualizations and exposure periods. Clinicaltrials.gov NCT02456987; https://clinicaltrials.gov/ct2/show/NCT02456987 (Archived by WebCite at http://www.webcitation.org/6pJ1P644S)