Combining ketamine and virtual reality pain control during severe burn wound care: one military and one civilian patient.
Combining ketamine and virtual reality pain control during severe burn wound care: one military and one civilian patient.
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DOI：
10.1111/j.1526-4637.2011.01091.x
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发表时间：
2011-04
期刊：
影响因子：
--
通讯作者：
Desocio PA
中科院分区：
文献类型：
--
作者：
Maani CV;Hoffman HG;Fowler M;Maiers AJ;Gaylord KM;Desocio PA
在伊拉克受伤的美国士兵和平民烧伤患者在美国陆军外科研究所接受治疗。烧伤患者在伤口护理期间会经历极度疼痛，并且他们通常会接受阿片类镇痛药和抗焦虑药进行清创。虚拟现实（VR）已被用作阿片类镇痛药的辅助治疗程序性疼痛。我们描述了氯胺酮与沉浸式VR相结合的首次使用，以减少伤口护理期间的过度疼痛。一名驻扎在伊拉克的21岁男性美国陆军士兵和一名41岁的平民男性分别遭受13%和50%的全身表面积（TBSA）烧伤。每例患者接受40 mg氯胺酮静脉注射（IV）进行伤口护理。使用受试者内设计，护士进行了一半的伤口护理治疗的疼痛部分，没有VR，另一半则使用沉浸式VR。两种治疗条件的图形疼痛评级评分作为因变量。与氯胺酮+无VR相比，在氯胺酮+ VR期间，两名患者报告的所有三种疼痛评级的疼痛均较轻。两名患者在没有VR的情况下将伤口护理评为“一点也不有趣”，但这些患者在虚拟现实期间将伤口护理评为“非常有趣”或“非常有趣”，并将恶心评为“轻度”或“无”。前两个病例的结果表明，中等剂量的氯胺酮结合沉浸式虚拟现实分散注意力可能是一种有效的多模式镇痛方案，可减少严重烧伤伤口清洁期间的急性手术疼痛。
US soldiers injured in Iraq, and civilian burn trauma patients are treated at the US Army Institute of Surgical Research. Burn patients experience extrem pain during wound care, and they typically receive opioid analgesics and anxiolytics for debridement. Virtual Reality (VR) has been applied as an adjunct to opioid analgesics for procedural pain. We describe the first use of ketamine combined with immersive VR to reduce excessive pain during wound care. A 21-year-old male US Army soldier stationed in Iraq, and a 41-year-old civilian male sustained a 13% and 50% total body surface area (TBSA) burn, respectively. Each patient received 40 mg ketamine intraveneous (IV) for wound care. Using a within-subject design, nurses conducted half of a painful segment of wound care treatments with no VR and the other half with immersive VR. Graphic pain rating scores for each of the two treatment conditions served as the dependent variables. Compared to ketamine + no VR, both patients reported less pain during ketamine + VR for all three pain ratings. Both patients rated wound care during no VR as “no fun at all”, but those same patients rated wound care during virtual reality as either “pretty fun” or “extremely fun”, and rated nausea as either “mild” or “none”. Results from these first two cases suggest that a moderate dose of ketamine combined with immersive virtual reality distraction may be an effective multimodal analgesic regimen for reducing acute procedural pain during severe burn wound cleanings.
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影响因子：
2.5
作者：
Colloca, Luana;Benedetti, Fabrizio
通讯作者：
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影响因子：
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作者：
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通讯作者：
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DOI：
10.1089/cpb.2008.0056
发表时间：
2009-02-01
期刊：
CYBERPSYCHOLOGY & BEHAVIOR
影响因子：
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作者：
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DOI：
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发表时间：
1989-11-01
影响因子：
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作者：
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通讯作者：
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影响因子：
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作者：
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通讯作者：
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