UCSF Benioff Children's Hospital Oakland, Oakland, California.
KindVR, Oakland, California.
Pediatr Blood Cancer. 2019 Feb;66(2):e27525. doi: 10.1002/pbc.27525. Epub 2018 Oct 26.
Due to incomplete management of vaso-occlusive pain episodes (VOE) in patients with sickle cell disease (SCD), we sought to determine if immersive VR would be feasible for inpatients. Secondarily, we hypothesized that a single VR session would improve the VOE pain experience.
Consecutive patients with SCD eight years and older admitted for VOE were offered one 15-minute VR session, utilizing a relaxing underwater world specifically created for pediatric patients and to minimize potential simulator side effects. Safety and acceptability were evaluated with a brief survey before and after the session. Pain was evaluated utilizing the validated adolescent pediatric pain tool (APPT). Survey data and pain scores were analyzed using Wilcoxon signed-rank test as the data were nonnormally distributed.
Thirty patients, 21 female, with a median age of 16 years were enrolled, the majority having hemoglobin SS disease. The VR session had no reported side effects; all patients requested VR again in the future. Median pain intensity (pre-VR 7.3 [interquartile range, IQR, 6.1, 8.8], post-VR 5.8 [4.7, 7.9]), number of affected body areas (pre-VR 3.0 [2.0, 7.8], post-VR 2.0 [0, 4.8]), and qualitative measures including sensory, affective, evaluative, and temporal pain domains were all statistically reduced (i.e., P ≤0.01).
VR therapy was feasible in a cohort of patients with SCD admitted for VOE. In addition to standard therapies, VR may help reduce the pain experience with SCD VOE. Further study is required to determine the impact of VR therapy on opioid usage and length of stay in hospital.
由于镰状细胞病（SCD）患者的血管阻塞性疼痛发作（VOE）管理不完整，我们试图确定沉浸式虚拟现实（VR）是否适用于住院患者。其次，我们假设单次 VR 疗程将改善 VOE 疼痛体验。
连续入组因 VOE 而住院的 SCD 患者，年龄 8 岁以上，提供 1 次 15 分钟的 VR 疗程，使用专门为儿科患者创建的放松水下世界，以最大程度减少潜在的模拟器副作用。在疗程前后使用简短的调查问卷评估安全性和可接受性。使用经过验证的青少年儿科疼痛工具（APPT）评估疼痛。由于数据呈非正态分布，因此使用 Wilcoxon 符号秩检验分析调查数据和疼痛评分。
共入组 30 例患者，21 例为女性，中位年龄 16 岁，大多数患有血红蛋白 SS 疾病。VR 疗程无报告的副作用；所有患者均要求将来再次进行 VR。中位疼痛强度（VR 前 7.3[四分位距 IQR，6.1,8.8]，VR 后 5.8[4.7,7.9]）、受影响身体区域数（VR 前 3.0[2.0,7.8]，VR 后 2.0[0,4.8]），以及包括感觉、情感、评估和时间性疼痛等定性指标均有统计学意义的降低（即，P≤0.01）。
VR 治疗在因 VOE 住院的 SCD 患者中是可行的。除了标准治疗外，VR 可能有助于减轻 SCD VOE 的疼痛体验。需要进一步研究来确定 VR 治疗对阿片类药物使用和住院时间的影响。
