Adjunctive virtual reality pain relief after traumatic injury: a proof-of-concept within-person randomized trial.

Autor:	Morris NA; Department of Neurology, University of Maryland School of Medicine, Baltimore, MD, United States.; Program in Trauma, R Adams Cowley Shock Trauma Center, Baltimore, MD, United States., Wang Y; Department of Pain and Translational Symptom Science, University of Maryland School of Nursing, Baltimore, MD, United States., Felix RB; Department of Neurology, University of Maryland School of Medicine, Baltimore, MD, United States.; Program in Trauma, R Adams Cowley Shock Trauma Center, Baltimore, MD, United States., Rao A; Department of Neurology, University of Maryland School of Medicine, Baltimore, MD, United States.; Department of Pain and Translational Symptom Science, University of Maryland School of Nursing, Baltimore, MD, United States., Arnold S; Department of Neurology, University of Maryland School of Medicine, Baltimore, MD, United States.; Program in Trauma, R Adams Cowley Shock Trauma Center, Baltimore, MD, United States., Khalid M; Department of Neurology, University of Maryland School of Medicine, Baltimore, MD, United States., Armahizer MJ; Department of Pharmacy, University of Maryland Medical Center, Baltimore, MD, United States., Murthi SB; Program in Trauma, R Adams Cowley Shock Trauma Center, Baltimore, MD, United States.; Departments of Surgery, University of Maryland School of Medicine, Baltimore, MD, United States., Colloca L; Department of Pain and Translational Symptom Science, University of Maryland School of Nursing, Baltimore, MD, United States.
Jazyk:	angličtina
Zdroj:	Pain [Pain] 2023 Sep 01; Vol. 164 (9), pp. 2122-2129. Date of Electronic Publication: 2023 Apr 19.
DOI:	10.1097/j.pain.0000000000002914
Abstrakt:	Abstract: In this study, we hypothesized that immersive virtual reality (VR) environments may reduce pain in patients with acute traumatic injuries, including traumatic brain injuries. We performed a randomized within-subject study in patients hospitalized with acute traumatic injuries, including traumatic brain injury with moderate pain (numeric pain score ≥3 of 10). We compared 3 conditions: (1) an immersive VR environment (VR Blu), (2) a content control with the identical environment delivered through nonimmersive tablet computer (Tablet Blu), and (3) a second control composed of donning VR headgear without content to control for placebo effects and sensory deprivation (VR Blank). We enrolled 60 patients, and 48 patients completed all 3 conditions. Objective and subjective data were analyzed using linear mixed-effects models. Controlling for demographics, baseline pain, and injury severity, we found differences by conditions in relieving pain (F 2,75.43 = 3.32, P = 0.042). VR Blu pain reduction was greater than Tablet Blu (-0.92 vs -0.16, P = 0.043), but VR Blu pain reduction was similar to VR Blank (-0.92 vs -1.24, P = 0.241). VR Blu was perceived as most effective by patients for pain reduction (F 2,66.84 = 16.28, P < 0.001), and changes in measures of parasympathetic activity including heart rate variability (F 2,55.511 = 7.87, P < 0.001) and pupillary maximum constriction velocity (F 2,61.41 = 3.50, 1-tailed P = 0.038) echoed these effects. There were no effects on opioid usage. These findings outlined a potential clinical benefit for mollifying pain related to traumatic injuries. (Copyright © 2023 International Association for the Study of Pain.)
Databáze:	MEDLINE
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