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Review
. 2008 Nov;8(11):1667-74.
doi: 10.1586/14737175.8.11.1667.

Applications of virtual reality for pain management in burn-injured patients

Sam R Sharar  1 , William Miller, Aubriana Teeley, Maryam Soltani, Hunter G Hoffman, Mark P Jensen, David R Patterson
Affiliations
Review

Applications of virtual reality for pain management in burn-injured patients

Sam R Sharar et al. Expert Rev Neurother. 2008 Nov.

Abstract

The pain associated with burn injuries is intense, unremitting and often exacerbated by anxiety, depression and other complicating patient factors. On top of this, modern burn care involves the repetitive performance - often on a daily basis for weeks to months - of painful and anxiety-provoking procedures that create additional treatment-related pain, such as wound care, dressing changes and rehabilitation activities. Pain management in burn patients is primarily achieved by potent pharmacologic analgesics (e.g., opioids), but is necessarily complemented by nonpharmacologic techniques, including distraction or hypnosis. Immersive virtual reality provides a particularly intense form of cognitive distraction during such brief, painful procedures, and has undergone preliminary study by several research groups treating burn patients over the past decade. Initial reports from these groups are consistent in suggesting that immersive virtual reality is logistically feasible, safe and effective in ameliorating the pain and anxiety experienced in various settings of post-burn pain. Furthermore, the technique appears applicable to a wide age range of patients and may be particularly well-adapted for use in children, one of the most challenging populations of burn victims to treat. However, confirmation and extension of these results in larger numbers of patients in various types of burn-related pain is necessary to more clearly define the specific benefits and limitations of virtual reality analgesia in the burn care setting.

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Figures

Figure 1
Figure 1. Compared with distraction with a 2D video game (dark bars), immersive virtual reality (light bars) significantly reduced various subjective pain and anxiety ratings in a 17-year-old male undergoing bedside burn wound care
VAS: Visual Analog Scale. Reproduced with permission from [11].
Figure 2
Figure 2. A 40-year-old male undergoes burn wound care (bandage removal and wound cleaning) partially submerged in a hydrotank while experiencing immersive virtual reality delivered by a photonic, non-electric, ‘water-friendly’ virtual reality delivery system
The patient navigates and interacts with the virtual world using a hand-controlled joystick. ©Hunter Hoffman, University of Washington, DC, USA.
Figure 3
Figure 3. An adolescent male with a left upper extremity burn undergoes passive range-of-motion physical therapy while experiencing immersive virtual reality
The patient navigates the virtual world using a head position-tracking head-mounted-display and interacts with the virtual world using a fingertip-controlled mouse.
Figure 4
Figure 4. Mean subjective pain and mood (fun) ratings during post-burn, passive range-of-motion physical therapy in a population of 88 subjects (aged 6–65 years) receiving standard pharmacologic analgesia (dark bars) and standard pharmacologic analgesia plus immersive (light bars)
GRS: Graphic rating scale; VR: Virtual reality.
See this image and copyright information in PMC

References

    1. Gold JI, Belmont KA, Thomas DA. The neurobiology of virtual reality pain attenuation. Cyberpsychol Behav. 2007;10(4):536–544. Concise review of the potential psychological and neurophysiological mechanisms of virtual reality analgesia. - PubMed
    1. Wismeijer AAJ, Vingerhoets JJM. The use of virtual reality and audiovisual eyeglass systems as adjunct analgesic techniques: a review of the literature. Ann Behav Med. 2005;30(3):268–278. - PubMed
    1. Hoffman HG, Sharar SR, Coda B, et al. Manipulating presence influences the magnitude of virtual reality analgesia. Pain. 2004;111(1–2):162–168. Evidence demonstrating that changes in virtual reality system hardware and software can affect both the user’s sense of presence in the virtual environment, as well as the as analgesic response. - PubMed
    1. Hoffman HG, Richards TL, Coda B, et al. Modulation of thermal pain-related brain activity with virtual reality: evidence from fMRI. Neuroreport. 2004;15(8):1245–1248. - PubMed
    1. Hoffman HG, Richards TL, Van Oostrom T, et al. The analgesic effects of opioids and immersive virtual reality distraction: evidence from subjective and functional brain imaging assessments. Anesth Analg. 2007;105(6):1776–1783. Demonstration of the comparative independent and additive effects of immersive virtual reality and/or systemic opioid administration on the subjective pain experience and concurrent pain-related brain activity. - PubMed

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