Virtual reality as an adjunctive pain control during burn wound care in adolescent patients

Abstract

For daily burn wound care procedures, opioid analgesics alone are often inadequate. Since most burn patients experience severe to excruciating pain during wound care, analgesics that can be used in addition to opioids are needed. This case report provides the first evidence that entering an immersive virtual environment can serve as a powerful adjunctive, nonpharmacologic analgesic. Two patients received virtual reality (VR) to distract them from high levels of pain during wound care. The first was a 16-year-old male with a deep flash burn on his right leg requiring surgery and staple placement. On two occasions, the patient spent some of his wound care in VR, and some playing a video game. On a 100 mm scale, he provided sensory and affective pain ratings, anxiety and subjective estimates of time spent thinking about his pain during the procedure. For the first session of wound care, these scores decreased 80 mm, 80 mm, 58 mm, and 93 mm, respectively, during VR treatment compared with the video game control condition. For the second session involving staple removal, scores also decreased. The second patient was a 17-year-old male with 33.5% total body surface area deep flash burns on his face, neck, back, arms, hands and legs. He had difficulty tolerating wound care pain with traditional opioids alone and showed dramatic drops in pain ratings during VR compared to the video game (e.g. a 47 mm drop in pain intensity during wound care). We contend that VR is a uniquely attention-capturing medium capable of maximizing the amount of attention drawn away from the 'real world', allowing patients to tolerate painful procedures. These preliminary results suggest that immersive VR merits more attention as a potentially viable form of treatment for acute pain.

Virtual Reality as a Distraction Technique in Chronic Pain Patients

“…[2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] It appears that VR may change how the brain physically registers pain, not just the perception of pain stimuli. 2 An interesting study showed that 86% of patients undergoing wound care from a burn injury reported severe to excruciating pain even with therapeutic levels of opioids.…”

A Novel Application of Virtual Reality for Pain Control: Virtual Reality-Mirror Visual Feedback Therapy

“…Hoffman et al first reported that VR could alleviate pain perception during painful burn care in adolescent patients [6]. The application of VR for pain control during burn care has been the most intensively studied application [7][8].…”

Transformation of flow in rehabilitation: The role of advanced communication technologies

“…However, it is well-known that distraction-for example, having the patient listen to music-can help to reduce pain for some people. Hoffman, Doctor, Patterson, Carrougher, and Furness (2000) conducted a controlled study of the efficacy of VR as an advanced distraction by comparing it with the efficacy of a popular Nintendo video game. The results showed dramatic reductions in pain ratings during VR in comparison with those during the video game.…”

“…In particular, they found direct modulation of pain responses within the brain during VR distraction. The degree of reduction in pain-related brain activity ranged from 50% to 97% (Hoffman, Doctor, et al, 2000).…”