Safy Othmane, Rousseaux Floriane, Faymonville Marie-Elisabeth, Libbrecht Dominique, Fontaine Robert, Raaf Melissa, Staquet Cécile, Tasset Hadrien, Bonhomme Vincent, Vanhaudenhuyse Audrey, Bicego Aminata
Sensation and Perception Research Group, GIGA-Consciousness, University of Liège, Liège, Belgium.
Medical Hypnosis Laboratory, MaisonNeuve-Rosemont Hospital Research Center, University of Montreal, Montreal, QC, Canada.
Front Psychol. 2024 Feb 27;15:1331826. doi: 10.3389/fpsyg.2024.1331826. eCollection 2024.
The management of chronic pain may involve an array of tools, including radiofrequency thermocoagulation (Rf-Tc) of sensory nerve terminals. Like many other invasive procedures, Rf-Tc can generate anxiety in a lot of patients, either during the expectation of the procedure or in the course of it. Virtual reality hypnosis (VRH) is a promising tool for managing anxiety and pain in several situations, but its anxiolytic property has not been investigated in participants with chronic pain and going through a Rf-Tc procedure.
The goal of this study was to evaluate the effectiveness of VRH for reducing self-assessed anxiety in participants with chronic pain, when received in preparation for Rf-Tc.
This prospective, controlled trial was conducted in the Interdisciplinary Algology Centre of the University Hospital of Liège (Belgium). Participants were assigned to two groups: VRH or control (usual care). Assessment was carried-out at 4 time points: T0 (one week before Rf-Tc); T1 (pre-intervention, on the day of Rf-Tc); T2 (immediately after the VRH intervention outside of the Rf-Tc room); and T3 (right after Rf-Tc). Medical, sociodemographic data, anxiety trait and immersive tendencies were collected at T0. Anxiety state and pain intensity were assessed at each time points. Satisfaction was examined at T3.
Forty-two participants were quasi-randomly assigned to the VRH or control group. No statistically significant interaction group by time was observed regarding all measured variables, including primary endpoint. However, a significant effect of time was found for anxiety and pain when considering both groups together, toward a progressive reduction.
In the context of our study, there appears to be no significant effect of VRH at reducing anxiety in participants with chronic pain undergoing Rf-Tc. Anxiety decreases along the procedure, while pain is attenuated by the local anesthetic infiltration of the Rf site. Our results suggest that the presence of a caregiver throughout the procedure might explain the progressive decrease in anxiety. Future randomized controlled trials are needed to precisely study the effectiveness of the VRH tool, and the possibility of using it as a complementary approach for anxiety during invasive procedures.
慢性疼痛的管理可能涉及一系列手段，包括对感觉神经末梢进行射频热凝术（Rf-Tc）。与许多其他侵入性手术一样，Rf-Tc会在许多患者手术前的预期阶段或手术过程中引发焦虑。虚拟现实催眠（VRH）在多种情况下都是管理焦虑和疼痛的一种有前景的工具，但其抗焦虑特性尚未在患有慢性疼痛且正在接受Rf-Tc手术的参与者中进行研究。
本研究的目的是评估在准备接受Rf-Tc手术时，VRH对减轻慢性疼痛参与者自我评估焦虑的有效性。
这项前瞻性对照试验在列日大学医院（比利时）的跨学科疼痛学中心进行。参与者被分为两组：VRH组或对照组（常规护理）。在4个时间点进行评估：T0（Rf-Tc手术前一周）；T1（干预前，Rf-Tc手术当天）；T2（在Rf-Tc手术室之外进行VRH干预后立即评估）；以及T3（Rf-Tc手术后立即评估）。在T0收集医疗、社会人口学数据、焦虑特质和沉浸倾向。在每个时间点评估焦虑状态和疼痛强度。在T3检查满意度。
42名参与者被准随机分配到VRH组或对照组。对于所有测量变量，包括主要终点，未观察到时间与组之间有统计学意义的交互作用。然而，将两组一起考虑时，发现焦虑和疼痛随时间有显著影响，呈逐渐减轻趋势。
在我们的研究背景下，VRH在减轻接受Rf-Tc手术的慢性疼痛参与者的焦虑方面似乎没有显著效果。焦虑在手术过程中逐渐降低，而疼痛通过Rf部位的局部麻醉浸润得到减轻。我们的结果表明，整个手术过程中有护理人员在场可能解释了焦虑的逐渐降低。未来需要进行随机对照试验来精确研究VRH工具的有效性，以及将其用作侵入性手术期间焦虑辅助治疗方法的可能性。
