Mallari Brian, Spaeth Emily K, Goh Henry, Boyd Benjamin S
Department of Physical Therapy, St. Mary's Medical Center, San Francisco, CA, USA.
Castro Valley Yoga, Castro Valley, CA, USA.
J Pain Res. 2019 Jul 3;12:2053-2085. doi: 10.2147/JPR.S200498. eCollection 2019.
Previous studies have shown that virtual reality (VR) is effective in reducing acute and chronic pain both in adults and in children. Given the emergence of new VR technology, and the growing body of research surrounding VR and pain management, an updated systematic review is warranted. The purpose of this systematic review is to compare the effectiveness of VR in reducing acute and chronic pain in adults. A search was conducted in three databases (PubMed, CINAHL, Trip) using standardized search terms. Twenty experimental and quasi-experimental trials published between January 2007 and December 2018 were included based on prespecified inclusion and exclusion criteria. Pain intensity was the primary outcome. We extracted data and appraised the quality of articles using either the PEDro or Modified Downs and Black risk of bias tools. The majority of studies supported the use of VR to reduce acute pain both during the procedure and immediately after. Numerous studies found VR reduced chronic pain during VR exposure but there is insufficient evidence to support lasting analgesia. There was considerable variability in patient population, pain condition and dosage of VR exposure. Due to heterogeneity, we were unable to perform meta-analyses for all study populations and pain conditions. VR is an effective treatment for reducing acute pain. There is some research that suggests VR can reduce chronic pain during the intervention; however, more evidence is needed to conclude that VR is effective for lasting reductions in chronic pain.
先前的研究表明，虚拟现实（VR）在减轻成人和儿童的急性和慢性疼痛方面均有效。鉴于新的VR技术的出现，以及围绕VR与疼痛管理的研究不断增加，有必要进行一次更新的系统评价。本系统评价的目的是比较VR在减轻成人急性和慢性疼痛方面的有效性。使用标准化检索词在三个数据库（PubMed、CINAHL、Trip）中进行了检索。根据预先设定的纳入和排除标准，纳入了2007年1月至2018年12月发表的20项实验性和半实验性试验。疼痛强度是主要结局。我们使用PEDro或改良的唐斯和布莱克偏倚风险工具提取数据并评估文章质量。大多数研究支持在手术过程中及术后立即使用VR减轻急性疼痛。许多研究发现VR在VR暴露期间可减轻慢性疼痛，但缺乏支持持久镇痛的证据。患者人群、疼痛状况和VR暴露剂量存在相当大的差异。由于存在异质性，我们无法对所有研究人群和疼痛状况进行荟萃分析。VR是减轻急性疼痛的有效治疗方法。有一些研究表明VR在干预期间可减轻慢性疼痛；然而，需要更多证据才能得出VR对持久减轻慢性疼痛有效的结论。
