Gold Jeffrey I, Kim Seok Hyeon, Kant Alexis J, Joseph Michael H, Rizzo Albert Skip
Clinical Anesthesiology & Pediatrics, USC Keck School of Medicine, Childrens Hospital Los Angeles, Los Angeles, California 90027-6062, USA.
Cyberpsychol Behav. 2006 Apr;9(2):207-12. doi: 10.1089/cpb.2006.9.207.
The objective of this study was to test the efficacy and suitability of virtual reality (VR) as a pain distraction for pediatric intravenous (i.v.) placement. Twenty children (12 boys, 8 girls) requiring i.v. placement for a magnetic resonance imaging/computed tomography (MRI/CT) scan were randomly assigned to two conditions: (1) VR distraction using Street Luge (5DT), presented via a head-mounted display, or (2) standard of care (topical anesthetic) with no distraction. Children, their parents, and nurses completed self-report questionnaires that assessed numerous health-related outcomes. Responses from the Faces Pain Scale-Revised indicated a fourfold increase in affective pain within the control condition; by contrast, no significant differences were detected within the VR condition. Significant associations between multiple measures of anticipatory anxiety, affective pain, i.v. pain intensity, and measures of past procedural pain provided support for the complex interplay of a multimodal assessment of pain perception. There was also a sufficient amount of evidence supporting the efficacy of Street Luge as a pediatric pain distraction tool during i.v. placement: an adequate level of presence, no simulator sickness, and significantly more child-, parent-, and nurse-reported satisfaction with pain management. VR pain distraction was positively endorsed by all reporters and is a promising tool for decreasing pain, and anxiety in children undergoing acute medical interventions. However, further research with larger sample sizes and other routine medical procedures is warranted.
本研究的目的是测试虚拟现实（VR）作为小儿静脉穿刺时疼痛分散方法的有效性和适用性。二十名因磁共振成像/计算机断层扫描（MRI/CT）扫描需要进行静脉穿刺的儿童（12名男孩，8名女孩）被随机分为两组：（1）使用街头雪橇（5DT）通过头戴式显示器呈现的VR分散注意力组，或（2）无分散注意力的标准护理组（局部麻醉）。儿童、其父母和护士完成了评估众多与健康相关结果的自我报告问卷。修订后的面部疼痛量表的回答表明，在对照组中情感性疼痛增加了四倍；相比之下，在VR组中未检测到显著差异。预期焦虑、情感性疼痛、静脉穿刺疼痛强度的多种测量与过去程序性疼痛测量之间的显著关联为疼痛感知的多模态评估的复杂相互作用提供了支持。也有足够的证据支持街头雪橇作为小儿静脉穿刺时疼痛分散工具的有效性：有足够的临场感水平，无模拟器不适，儿童、父母和护士报告的疼痛管理满意度显著更高。所有报告者都对VR疼痛分散给予了积极认可，它是一种有前景的工具，可减轻接受急性医疗干预儿童的疼痛和焦虑。然而，需要进行更大样本量以及针对其他常规医疗程序的进一步研究。
