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虚拟现实对心脏介入手术患者疼痛和焦虑的影响:系统评价和随机对照试验的荟萃分析。

Effectiveness of virtual reality on pain and anxiety in patients undergoing cardiac procedures: A systematic review and meta-analysis of randomized controlled trials.

机构信息

Clinical and interventional cardiology, University Hospital, Sassari, Italy.

Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, Italy.

出版信息

Curr Probl Cardiol. 2024 May;49(5):102532. doi: 10.1016/j.cpcardiol.2024.102532. Epub 2024 Mar 19.

Abstract

BACKGROUND

Cardiac procedures often induce pain and anxiety in patients, adversely impacting recovery. Pharmachological approaches have limitations, prompting exploration of innovative digital solutions like virtual reality (VR). Although early evidence suggests a potential favourable benefit with VR, it remains unclear whether the implementation of this technology can improve pain and anxiety. We aimed to assess by a systematic review and meta-analysis the effectiveness of VR in alleviating anxiety and pain on patients undergoing cardiac procedures.

METHODS

Our study adhered to the PRISMA method and was registered in PROSPERO under the code CRD42024504563. The search was carried out in the PubMed, Web of Science, Scopus, and the Cochrane Library databases in January 2024. Four randomized controlled trials were included (a total of 382 patients). Risk of bias was employed to assess the quality of individual studies, and a random-effects model was utilized to examine the overall effect.

RESULTS

The results showed that VR, when compared to the standard of care, had a statistically significant impact on anxiety (SMD = -0.51, 95 % CI: -0.86 to -0.16, p = 0.004), with a heterogeneity I2 = 57 %. VR did not show a significant difference in terms of pain when compared to standard care (SMD= -0.34, 95 % CI: -0.75 to -0.07, p = 0.10). The included trials exhibited small sample sizes, substantial heterogeneity, and variations in VR technology types, lengths, and frequencies.

CONCLUSIONS

VR effectively lowers anxiety levels in patients undergoing cardiac procedures, however, did not show a statistically significant difference on pain.

摘要

背景

心脏手术常引起患者疼痛和焦虑,这对康复产生不利影响。药物治疗方法存在局限性,促使人们探索虚拟现实(VR)等创新的数字解决方案。尽管早期证据表明 VR 可能具有潜在的有益效果,但尚不清楚该技术的实施是否能改善疼痛和焦虑。我们旨在通过系统评价和荟萃分析评估 VR 在缓解心脏手术患者焦虑和疼痛方面的有效性。

方法

我们的研究遵循 PRISMA 方法,并在 PROSPERO 中以 CRD42024504563 代码进行了注册。搜索于 2024 年 1 月在 PubMed、Web of Science、Scopus 和 Cochrane 图书馆数据库中进行。共纳入 4 项随机对照试验(共 382 名患者)。采用风险偏倚评估个体研究的质量,并采用随机效应模型评估总体效果。

结果

结果表明,与标准护理相比,VR 对焦虑具有统计学显著影响(SMD=-0.51,95%CI:-0.86 至-0.16,p=0.004),异质性 I2=57%。与标准护理相比,VR 在疼痛方面没有显著差异(SMD=-0.34,95%CI:-0.75 至-0.07,p=0.10)。纳入的试验样本量较小,存在较大的异质性,以及 VR 技术类型、长度和频率的变化。

结论

VR 有效降低心脏手术患者的焦虑水平,但在疼痛方面没有统计学上的显著差异。

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