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虚拟现实分心和反刺激对儿童牙科焦虑和疼痛感知的比较评估。

Comparative evaluation of virtual reality distraction and counter-stimulation on dental anxiety and pain perception in children.

作者信息

Nunna Mahesh, Dasaraju Rupak Kumar, Kamatham Rekhalakshmi, Mallineni Sreekanth Kumar, Nuvvula Sivakumar

机构信息

Department of Paedodontics and Preventive Dentistry, Narayana Dental College, Nellore, India.

Department of Paedodontics and Preventive Dentistry, Priyadarshini Dental College and Hospital, Thiruvallur, India.

出版信息

J Dent Anesth Pain Med. 2019 Oct;19(5):277-288. doi: 10.17245/jdapm.2019.19.5.277. Epub 2019 Oct 30.

Abstract

BACKGROUND

This study evaluated the efficacy of virtual reality (VR) distraction and counter-stimulation (CS) on dental anxiety and pain perception to local anesthesia in children.

METHODS

A prospective, randomized, single-blinded interventional clinical trial with a parallel design was used. Seventy children 7-11 years old who required local anesthesia (LA) for pulp therapy or tooth extraction were recruited and allocated to two groups with equal distribution based on the intervention. Group CS (n = 35) received CS and Group VR (n = 35) received VR distraction with ANTVR glasses. Anxiety levels (using pulse rate) were evaluated before, during, and after administration of local anesthesia, while pain perception was assessed immediately after the injection. Wong-Baker faces pain-rating scale (WBFPS), visual analog scale (VAS), and Venham's clinical anxiety rating scale (VCARS) were used for pain evaluation. Student's t-test was used to test the mean difference between groups, and repeated measures ANOVA was used to test the mean difference of pulse rates.

RESULTS

Significant differences in mean pulse rates were observed in both groups, while children in the VR group had a higher reduction (P < 0.05), and the mean VCARS scores were significant in the VR group (P < 0.05). Mean WBFPS scores showed less pain perception to LA needle prick in the CS group while the same change was observed in the VR group with VAS scores.

CONCLUSIONS

VR distraction is better than CS for reducing anxiety to injection in children undergoing extraction and pulpectomy.

摘要

背景

本研究评估了虚拟现实(VR)分散注意力和反刺激(CS)对儿童牙科焦虑和局部麻醉疼痛感知的疗效。

方法

采用前瞻性、随机、单盲干预性平行设计临床试验。招募70名7 - 11岁因牙髓治疗或拔牙需要局部麻醉(LA)的儿童,并根据干预措施将其平均分配到两组。CS组(n = 35)接受反刺激,VR组(n = 35)使用ANTVR眼镜进行VR分散注意力。在局部麻醉给药前、给药期间和给药后评估焦虑水平(使用脉搏率),注射后立即评估疼痛感知。使用面部表情疼痛评分量表(WBFPS)、视觉模拟量表(VAS)和韦纳姆临床焦虑评定量表(VCARS)进行疼痛评估。采用学生t检验来检验组间均值差异,重复测量方差分析用于检验脉搏率的均值差异。

结果

两组的平均脉搏率均有显著差异,VR组儿童的降低幅度更大(P < 0.05),且VR组的平均VCARS评分有显著差异(P < 0.05)。平均WBFPS评分显示CS组对LA针刺的疼痛感知较轻,而VR组在VAS评分上也有相同变化。

结论

对于接受拔牙和牙髓摘除术的儿童,VR分散注意力在减轻注射焦虑方面优于CS。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/09e6/6834716/b31f2c12c9ca/jdapm-19-277-g001.jpg

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