The Centre for Children's Burns and Trauma Research, Queensland Children's Medical Research Institute, The Department of Paediatrics and Child Health, The University of Queensland, Royal Children's Hospital, Brisbane, Australia.
Burns. 2012 Aug;38(5):650-7. doi: 10.1016/j.burns.2011.11.010. Epub 2012 Feb 18.
Effective pain management remains a challenge for adolescents during conscious burn wound care procedures. Virtual reality (VR) shows promise as a non-pharmacological adjunct in reducing pain.
This study assessed off-the-shelf VR for (1) its effect on reducing acute pain intensity during adolescent burn wound care, and (2) its clinical utility in a busy hospital setting.
Forty-one adolescents (11-17 years) participated in this prospective randomized controlled trial. Acute pain outcomes including adolescent self-report, nursing staff behavioral observation, caregiver observation and physiological measures were collected. Length of procedure times and adolescent reactions were also recorded to inform clinical utility.
Nursing staff reported a statistically significant reduction in pain scores during dressing removal, and significantly less rescue doses of Entonox given to those receiving VR, compared to those receiving standard distraction. For all other pain outcomes and length of treatment, there was a trend for lower pain scores and treatment times for those receiving VR, but these differences were not statistically significant.
Despite only minimal pain reduction achieved using off-the-shelf VR, other results from this trial and previous research on younger children with burns suggest a customized, adolescent and hospital friendly device may be more effective in pain reduction.
青少年在接受清醒烧伤创面护理时,有效止痛仍然是一个挑战。虚拟现实(VR)作为一种非药物辅助手段,在减轻疼痛方面显示出很大的潜力。
本研究评估现成的 VR 在以下方面的效果:(1)在青少年烧伤创面护理过程中减轻急性疼痛强度;(2)在繁忙的医院环境中的临床实用性。
41 名青少年(11-17 岁)参与了这项前瞻性随机对照试验。收集了青少年自我报告、护理人员行为观察、照顾者观察和生理测量等急性疼痛结果。还记录了手术时间和青少年的反应,以了解其临床实用性。
与接受标准分散注意力的青少年相比,护理人员报告在去除敷料时 VR 组的疼痛评分明显降低,并且给予 VR 组的 Entonox 急救剂量明显减少。对于所有其他疼痛结果和治疗时间,接受 VR 的青少年的疼痛评分和治疗时间都有较低的趋势,但这些差异没有统计学意义。
尽管使用现成的 VR 仅能轻微减轻疼痛,但本试验和之前对烧伤儿童的研究中的其他结果表明,定制的、适合青少年和医院的设备可能在减轻疼痛方面更有效。