Effects of virtual reality on relieving postoperative pain in surgical patients: A systematic review and meta-analysis

Ding, Lei; Hua, Hongxia; Zhu, Hanfei; Zhu, Shuqin; Lu, Jinling; Zhao, Kang; Xu, Qin

doi:10.1016/j.ijsu.2020.08.033

Cited by 57 publications

(48 citation statements)

References 38 publications

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“…Massage and physiotherapy have contributed to improved pain control in other settings and are being explored for perioperative applications [55]. Preoperative virtual reality technology has also been successfully employed to reduce perioperative anxiety and pain [161][162][163].…”

Section: Preoperative Phasementioning

confidence: 99%

Perioperative Pain Management and Opioid Stewardship: A Practical Guide

et al. 2021

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Surgical procedures are key drivers of pain development and opioid utilization globally. Various organizations have generated guidance on postoperative pain management, enhanced recovery strategies, multimodal analgesic and anesthetic techniques, and postoperative opioid prescribing. Still, comprehensive integration of these recommendations into standard practice at the institutional level remains elusive, and persistent postoperative pain and opioid use pose significant societal burdens. The multitude of guidance publications, many different healthcare providers involved in executing them, evolution of surgical technique, and complexities of perioperative care transitions all represent challenges to process improvement. This review seeks to summarize and integrate key recommendations into a “roadmap” for institutional adoption of perioperative analgesic and opioid optimization strategies. We present a brief review of applicable statistics and definitions as impetus for prioritizing both analgesia and opioid exposure in surgical quality improvement. We then review recommended modalities at each phase of perioperative care. We showcase the value of interprofessional collaboration in implementing and sustaining perioperative performance measures related to pain management and analgesic exposure, including those from the patient perspective. Surgery centers across the globe should adopt an integrated, collaborative approach to the twin goals of optimal pain management and opioid stewardship across the care continuum.

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Section: Preoperative Phasementioning

confidence: 99%

Perioperative Pain Management and Opioid Stewardship: A Practical Guide

et al. 2021

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“…While VR qualitatively helps in pain management, there is minimal consensus on its efficacy. Key benefits of VR therapy cited include the following: a) VR therapy reduces acute pain (Mallari et al, 2019 andChuan et al, 2020), (b) Its use in perioperative period could effectively relieve postoperative pain (Ding, et al, 2020 andGeorgescu et al, 2019), c) VR distraction providing immersive environments wherein patients interact with the virtual scenario appear most effective (Eijlers et al, 2019 andChuan et al, 2020), and d) VR use is effective for short-term pain relief in both acute and chronic pain (Pourmand et al, 2018 andLuo, 2019). These studies also cited serious limitations, which broadly fall under following themes: 1) Lack of systematic protocols in VR intervention, 2) Significant heterogeneity in study populations, pain conditions, and pain reporting mechanisms used in those underlying studies, 3) Limited number of studies for overcoming biases, and 4)…”

Section: Discussionmentioning

confidence: 99%

Virtual Reality for Pain Management to Tackle the Opioid Crisis

Ramanan

Yekkirala

2021

J Stud Res

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The opioid crisis is a serious public health issue of epidemic proportions, building over the past decades. Prescription opioid abuse is one of the key sources of this issue. While pain is usually managed using pharmacological approaches, such as opioids, they produce several unwanted side effects – including respiratory depression and addiction – non-pharmacological approaches can be significant with minimal or no side effects. Recent developments in technology, such as Virtual Reality (VR), show considerable promise for main-stream adoption as one of the non-pharmacological interventions. Preventing a patient’s transition from acute to chronic pain is one instance where VR can presumably be effective. However, challenges remain due to the inherent subjectivity and lack of clear baselines in clinical intervention studies. Here, we review recent studies on the application of VR as a treatment for acute and chronic pain management to primarily understand key technical challenges faced by VR. The secondary goal of this work is to identify possible options to tackle some of the key challenges. Design considerations emerge as one critical component in improving patient engagement.

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“…Moreover, VRT appeared effective at encouraging patients to respond to treatment as well (number needed to treat = 4) 15 . Importantly, these findings appear to be associated with low to negligible side effects and an improvement in patient experience 13 , 14 , 16 , 17 .…”

Section: Introductionmentioning

confidence: 88%

“…Recently, a meta-analysis demonstrated the ability of VR-mediated therapy (VRT) as an analgesic in the setting of POP following both minor and major surgery (haemorrhoidectomy, dental surgery, episiotomy repair, craniotomy/spine surgery and knee surgery), reporting a significant decrease in pain scores in this setting 13 . These findings were echoed by a recent systematic review demonstrating the efficacy of VR in reducing pain within inpatient populations for various pathologies, including: hydrotherapy for burns/wounds; venepuncture; and injections 14 .…”

Section: Introductionmentioning

confidence: 99%

Virtual reality and its use in post-operative pain following laparoscopy: a feasibility study

Payne

Smith

Rolnik

et al. 2022

Sci Rep

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Pain following laparoscopic surgery remains a neglected healthcare issue. Virtual reality-mediated therapy’s (VRT) analgesic potential could address this. However, its effect in this setting remains unexplored. We aimed to establish the feasibility and safety of VRT as an adjunct analgesic following gynaecological laparoscopy and explore differences between active distraction and passive meditation content. 35 women were enrolled into an open crossover pilot and randomised to either intervention group 1 (active then passive content) or intervention group 2 (passive then active content) following surgery. VRT was administered in two 10-min segments with a 10-min washout period in between. Pain scores, opioid requirements and side effects were recorded before and after each segment whilst questionnaires evaluated acceptability. We observed a significant reduction in pain over time for the entire study population (F = 8.63, p < 0.0005) but no differences between intervention groups, in contrast to many studies demonstrating an increase in pain during this time. During segment one, intervention group 1 (n = 18) were administered significantly less opioid than intervention group 2 (n = 17) [0.0 (0.0–7.5) vs. 3.0(0.0–10.0), p = 0.04]. Intervention group 1 rated the VRT experience significantly higher than intervention group 2 (7.97 vs. 6.62. p = 0.017). 97.1% (n = 34) would recommend VRT to a friend and use it as the standard-of-care in future procedures. These results demonstrate that post-operative VRT is feasible and safe. However, adequately powered studies are needed to appropriately determine its efficacy.

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Effects of virtual reality on relieving postoperative pain in surgical patients: A systematic review and meta-analysis

Cited by 57 publications

References 38 publications

Perioperative Pain Management and Opioid Stewardship: A Practical Guide

Perioperative Pain Management and Opioid Stewardship: A Practical Guide

Virtual Reality for Pain Management to Tackle the Opioid Crisis

Virtual reality and its use in post-operative pain following laparoscopy: a feasibility study

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