Hoffman H G, Doctor J N, Patterson D R, Carrougher G J, Furness T A
Department of Psychology, University of Washington, Seattle, USA.
Pain. 2000 Mar;85(1-2):305-9. doi: 10.1016/s0304-3959(99)00275-4.
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.
对于日常烧伤伤口护理程序，仅使用阿片类镇痛药往往是不够的。由于大多数烧伤患者在伤口护理期间会经历重度至极痛，因此需要可与阿片类药物联合使用的镇痛药。本病例报告首次证明，进入沉浸式虚拟环境可作为一种强大的辅助性非药物镇痛方法。两名患者在伤口护理期间接受虚拟现实（VR）以分散对高度疼痛的注意力。第一名患者是一名16岁男性，右腿有深度闪光烧伤，需要进行手术和缝合钉固定。患者在两次伤口护理过程中，一部分时间处于VR环境中，另一部分时间在玩电子游戏。在一个100毫米的量表上，他给出了感觉和情感疼痛评分、焦虑程度以及对手术过程中思考疼痛时间的主观估计。与电子游戏对照情况相比，在VR治疗期间，第一次伤口护理时这些分数分别下降了80毫米、80毫米、58毫米和93毫米。在涉及拆除缝合钉的第二次护理时，分数也有所下降。第二名患者是一名17岁男性，面部、颈部、背部、手臂、手部和腿部有33.5%体表面积的深度闪光烧伤。仅使用传统阿片类药物时，他难以耐受伤口护理疼痛，与玩电子游戏相比，在VR期间疼痛评分显著下降（例如伤口护理期间疼痛强度下降47毫米）。我们认为，VR是一种独特的能够吸引注意力的媒介，能够最大限度地将注意力从“现实世界”转移开，使患者能够耐受痛苦的程序。这些初步结果表明，沉浸式VR作为一种治疗急性疼痛的潜在可行形式值得更多关注。
