Li Angela, Montaño Zorash, Chen Vincent J, Gold Jeffrey I
Children's Hospital Los Angeles, Departments of Anesthesiology Critical Care Medicine & Radiology, 4650 West Sunset Boulevard, MS#12, Los Angeles, CA 90027, USA.
Pain Manag. 2011 Mar;1(2):147-157. doi: 10.2217/pmt.10.15.
Virtual reality (VR) has been used to manage pain and distress associated with a wide variety of known painful medical procedures. In clinical settings and experimental studies, participants immersed in VR experience reduced levels of pain, general distress/unpleasantness and report a desire to use VR again during painful medical procedures. Investigators hypothesize that VR acts as a nonpharmacologic form of analgesia by exerting an array of emotional affective, emotion-based cognitive and attentional processes on the body's intricate pain modulation system. While the exact neurobiological mechanisms behind VR's action remain unclear, investigations are currently underway to examine the complex interplay of cortical activity associated with immersive VR. Recently, new applications, including VR, have been developed to augment evidenced-based interventions, such as hypnosis and biofeedback, for the treatment of chronic pain. This article provides a comprehensive review of the literature, exploring clinical and experimental applications of VR for acute and chronic pain management, focusing specifically on current trends and recent developments. In addition, we propose mechanistic theories highlighting VR distraction and neurobiological explanations, and conclude with new directions in VR research, implications and clinical significance.
虚拟现实（VR）已被用于应对与各种已知的痛苦医疗程序相关的疼痛和痛苦。在临床环境和实验研究中，沉浸在VR中的参与者疼痛程度降低，总体痛苦/不适感减轻，并表示希望在痛苦的医疗程序中再次使用VR。研究人员推测，VR通过对身体复杂的疼痛调节系统施加一系列基于情感、基于情绪的认知和注意力过程，起到非药物镇痛的作用。虽然VR作用背后的确切神经生物学机制尚不清楚，但目前正在进行研究，以检查与沉浸式VR相关的皮层活动的复杂相互作用。最近，包括VR在内的新应用已被开发出来，以增强基于证据的干预措施，如催眠和生物反馈，用于治疗慢性疼痛。本文对文献进行了全面综述，探讨了VR在急性和慢性疼痛管理中的临床和实验应用，特别关注当前趋势和最新进展。此外，我们提出了强调VR分心和神经生物学解释的机制理论，并以VR研究的新方向、意义和临床重要性作为结论。
