Immersive Virtual Reality as Analgesia during Dressing Changes of Hospitalized Children and Adolescents with Burns: A Systematic Review with Meta-Analysis

Lauwens, Yannick; Rafaatpoor, Fatemeh; Corbeel, Kobe; Broekmans, Susan; Toelen, Jaan; Allegaert, Karel

doi:10.3390/children7110194

Cited by 18 publications

(13 citation statements)

References 61 publications

(215 reference statements)

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“…It validates the fundamental aspect of VR’s applicability in surgical procedures by offering sanctuary to an anxious patient in a not-so-friendly hospital environment. Distractibility’s potential of lowering dimensions of perceived pain was observed in the case of severely burned patients exposed to a virtual environment during known painful procedures such as dressing change or physical therapy in both adult [ 46 ] and children populations [ 47 ], in some cases lowering patient anxiety and pain is realised to the point of unnecessary conventional analgesia [ 48 ].…”

Section: Discussionmentioning

confidence: 99%

State-of-the-Art Review on Immersive Virtual Reality Interventions for Colonoscopy-Induced Anxiety and Pain

Găină

Szalontay

Ştefănescu

et al. 2022

JCM

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Background: Colonoscopy related fear impairs the current gold standard screening of colorectal cancer. Compared to other minimally invasive procedures for cancer screening, colonoscopy-induced anxiety exceeds the procedure through bowel preparation. Immersive virtual reality’s (iVR) role in alleviating the complex stress–pain relationship encountered during medical procedures is directly proportional to the rising affordability of state-of-the-art Head-Mounted-Displays (HMDs). Objective: to assess the effect of iVR on patients’ colonoscopy-induced anxiety and pain. Materials and methods: A systematic search was conducted in PubMed, Cochrane Central Register of Controlled Trials, Web of Science, Embase and Scopus databases up to January 2022. Clinical trials evaluating anxiety as an outcome were included without language restriction. Results: Four clinical trials were included: three on the patients’ intraprocedural anxiety and one on patient education. Intraprocedural iVR interventions for colonoscopy-induced anxiety and pain revealed a similar effect as conventional sedation, while a statistically significant reduction was reported for non-sedated patients. iVR patient education improved the quality of bowel preparation and reduced patient anxiety before colonoscopy. Conclusions: The current research highlights the need to use high-end HMDs and appropriate interactive iVR software content for colonoscopy-induced anxiety. Methodological frameworks regarding the eligibility of participants, double-blinding and randomization of iVR studies can facilitate the development of iVR implementation for anxiety and pain management.

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Section: Discussionmentioning

confidence: 99%

State-of-the-Art Review on Immersive Virtual Reality Interventions for Colonoscopy-Induced Anxiety and Pain

Găină

Szalontay

Ştefănescu

et al. 2022

JCM

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“…In accordance with our finding of an overall positive effect of VR on pain, previous reviews with a more narrow scope also demonstrated beneficial effects for the different conditions and populations included. 1,2,5,9,15,25,29,33,37,38…”

Section: Discussionmentioning

confidence: 99%

“…14,15,38,41 In the context of the worldwide opioid crisis, VR may contribute to improved quality of life and self-efficacy of patients with chronic pain by nonpharmacological means. 2,9,14,15,25,30,38,46 Early VR applications have mainly made use of distraction methods, ie, by immersing the subject inside a computer-generated world and thus distracting attention away from pain. 32 Depending on the type of application, VR can also be used as a pain education tool or as an intervention with integrated psychological therapies, with effects that may last beyond the application period.…”

Section: Introductionmentioning

confidence: 99%

Effect modifiers of virtual reality in pain management: a systematic review and meta-regression analysis

Lier¹,

Vries²,

Steggink³

et al. 2023

PAIN

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There is a rapidly growing body of evidence for the application of virtual reality (VR) in pain management, however, with varying effectiveness. Little is known about patient-related and VR-related factors affecting efficacy of VR. A systematic review and meta-analysis was performed including 122 randomised controlled trials (9138 patients), reporting on subjectively reported pain scores comparing an immersive VR intervention to a non-VR control group. Virtual reality significantly reduced pain in the pooled analysis (standardized mean difference = −0.65, 95% CI −0.76 to −0.54, P < 0.001). Subgroup analyses showed no significant differences between type of pain, ie, VR effects were similar in acute, chronic, and procedural pain conditions. Univariate and multivariate meta-regression analyses were performed to investigate the effect of intervention, patient, and pain characteristics on VR. Virtual reality effectively reduced pain, especially in patients reporting moderate to severe pain and in younger subjects. Studies comparing VR with a control group receiving no distraction methods were associated with higher effect sizes. The effect of VR was not related to a specific frequency or duration of use. Type of software and interaction level were related to VR effects in the univariable, but not in the multivariable, meta-regression analysis. Heterogeneity was considerable for all meta-analyses, and risk of bias was moderate to high in most included studies. Studies on mechanisms behind VR analgesia in younger patients and patients reporting moderate to severe pain are recommended to confirm our hypotheses while taking into account risk of bias and the comparator. Optimal application of VR using treatment modules for long-term pain conditions are an important issue for future research.

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“…Another important limitation is the sample size. Meta-analyses summarizing studies on VR and pain reported sample sizes ranging from as low as 2 (Lauwens et al, 2020) to as high as 97 (Chow et al, 2020). The low sample size may be attributed to the fact that data collection occurred during the summer months in a city with a highly transient student population.…”

Section: Sample Sizementioning

confidence: 99%

The Effects of VR Use on Pain Experienced During a Tattoo Procedure: A Pilot Study

Pimentel

Kalyanaraman

Fillingim

et al. 2021

Front. Virtual Real.

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One of the most socially impactful applications of virtual reality (VR) is its use as a non-pharmacological remedy for both acute and chronic pain. Yet, despite robust findings establishing the analgesic effects of VR, use cases almost exclusively involve (a) patients with acute/chronic pain, which are often difficult to access and vary widely in terms of pain location/severity, or (b) experimentally induced pain, which can have low lab-to-life generalizability. One understudied pain context that may reconcile these limitations is body modification, specifically tattoo procedures. Examining the use of VR during a tattoo offers several benefits to VR and pain research. First, tattoo recipients as a participant pool are more accessible. Second, tattoo pain is presumably more standardized and uniform as it is administered by a machine at a consistent force. Thus, to test these assumptions and expand the scope of VR applications in this domain, we present a mixed-methods investigation testing the effects of VR on pain experienced during a tattoo. Leveraging qualitative interviews with tattoo artists and customers, a 3-month on-site field experiment at a tattoo parlor was conducted. Customers' self-reported pain ratings (N = 16) were collected during 1-h tattooing sessions and compared between a treatment (VR) and control group. As expected, VR significantly reduced pain ratings during the procedure, and increased pain resilience. By suggesting that the analgesic effects of VR extend to volitional pain during a tattoo, we argue that tattoo pain warrants attention by both VR content developers and researchers interested in studying how immersive content influences real-world pain perception. The study also yields specific guidelines to help designers create and deploy VR experiences for this context. Overall, the results suggest that tattoo sessions present a promising context worthy of further investigation across a variety of VR research programs.

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Immersive Virtual Reality as Analgesia during Dressing Changes of Hospitalized Children and Adolescents with Burns: A Systematic Review with Meta-Analysis

Cited by 18 publications

References 61 publications

State-of-the-Art Review on Immersive Virtual Reality Interventions for Colonoscopy-Induced Anxiety and Pain

State-of-the-Art Review on Immersive Virtual Reality Interventions for Colonoscopy-Induced Anxiety and Pain

Effect modifiers of virtual reality in pain management: a systematic review and meta-regression analysis

The Effects of VR Use on Pain Experienced During a Tattoo Procedure: A Pilot Study

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