Predicting the effectiveness of virtual reality relaxation on pain and anxiety when added to PCA morphine in patients having burns dressings changes
| Autor: | Simon Stafrace, Alex Konstantatos, Heather Cleland, V. Costello, M. Angliss |
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| Rok vydání: | 2009 |
| Předmět: |
Adult
Male medicine.medical_specialty Imagery Psychotherapy Visual analogue scale medicine.medical_treatment Pain Anxiety Relaxation Therapy Critical Care and Intensive Care Medicine Dressing change law.invention Randomized controlled trial law Humans Medicine Computer Simulation In patient Prospective Studies Pain Measurement Morphine Relaxation (psychology) business.industry Patient-controlled analgesia Analgesia Patient-Controlled General Medicine Bandages Combined Modality Therapy Surgery Analgesics Opioid Treatment Outcome Therapy Computer-Assisted Anesthesia Emergency Medicine Female sense organs medicine.symptom Burns business medicine.drug |
| Zdroj: | Burns. 35:491-499 |
| ISSN: | 0305-4179 |
| Popis: | Background Pain arising in burns sufferers is often severe and protracted. The prospect of a dressing change can heighten existing pain by impacting both physically and psychologically. In this trial we examined whether pre-procedural virtual reality guided relaxation added to patient controlled analgesia with morphine reduced pain severity during awake dressings changes in burns patients. Methods We conducted a prospective randomized clinical trial in all patients with burns necessitating admission to a tertiary burns referral centre. Eligible patients requiring awake dressings changes were randomly allocated to single use virtual reality relaxation plus intravenous morphine patient controlled analgesia (PCA) infusion or to intravenous morphine patient controlled analgesia infusion alone. Patients rated their worst pain intensity during the dressing change using a visual analogue scale. The primary outcome measure was presence of 30% or greater difference in pain intensity ratings between the groups in estimation of worst pain during the dressing change. Findings Of 88 eligible and consenting patients having awake dressings changes, 43 were assigned to virtual reality relaxation plus intravenous morphine PCA infusion and 43 to morphine PCA infusion alone. The group receiving virtual reality relaxation plus morphine PCA infusion reported significantly higher pain intensities during the dressing change (mean = 7.3) compared with patients receiving morphine PCA alone (mean = 5.3) ( p = 0.003) (95% CI 0.6–2.8). Interpretation The addition of virtual reality guided relaxation to morphine PCA infusion in burns patients resulted in a significant increase in pain experienced during awake dressings changes. In the absence of a validated predictor for responsiveness to virtual reality relaxation such a therapy cannot be recommended for general use in burns patients having awake dressings changes. |
| Databáze: | OpenAIRE |
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