Brown Theodore, Dee Alli, McCullough Meghan, Santos Pedro, Kulber David
From the Department of Orthopaedic Surgery, Cedars Sinai Medical Center, Los Angeles, Calif.
Ohana One, International Surgical Aid and Education, Los Angeles, Calif.
Plast Reconstr Surg Glob Open. 2024 Oct 11;12(10):e6226. doi: 10.1097/GOX.0000000000006226. eCollection 2024 Oct.
The paucity of pain management options in resource-limited settings is a significant and systemically unaddressed problem. To improve global health equity, it is important to bridge this gap in care without introducing the peril of opioid dependence. We present a proof-of-concept case series wherein virtual reality (VR) was successfully used to manage discomfort in patients undergoing burn dressing changes in sub-Saharan Africa.
Nine patients presenting with burn injuries of variable severity underwent routine stabilization and dressing as part of standard-of-care treatment. During dressing changes, a VR intervention consisting of the interactive game displayed on an Oculus Quest 2 headset was offered to patients. Patient mood scores were collected before VR initiation and at the conclusion of the dressing change by a translator using the Youth Feelings Scale.
There were no adverse events associated with use of the VR headset and no patients elected to terminate the VR during their procedure. Patients and physicians subjectively reported satisfaction with the device's utility in the procedure. Before VR initiation, the 95% confidence interval for patient mood score was 4.89 ± 1.725. After VR initiation, the 95% confidence interval for patient mood score was 8.78 ± 1.40.
Our results of this proof-of-concept case series to suggest both feasibility of use and positive influence on patient discomfort and periprocedural satisfaction. We propose that VR should be explored as an analgesic alternative and/or adjunct to narcotics in resource-limited countries, particularly for high-pain, low-duration procedures.
资源有限地区疼痛管理选择匮乏是一个重大且尚未得到系统性解决的问题。为改善全球卫生公平性，在不引发阿片类药物依赖风险的情况下弥合这一护理差距至关重要。我们展示了一个概念验证病例系列，其中虚拟现实（VR）成功用于管理撒哈拉以南非洲地区接受烧伤换药患者的不适。
9名不同严重程度烧伤患者接受了常规稳定治疗和换药，作为标准护理治疗的一部分。在换药期间，向患者提供了一种VR干预，即在Oculus Quest 2头戴式设备上显示的互动游戏。在开始VR前和换药结束时，由一名翻译使用青少年情感量表收集患者情绪评分。
使用VR头戴式设备未出现不良事件，且在操作过程中没有患者选择终止VR。患者和医生主观报告了对该设备在操作中效用的满意度。开始VR前，患者情绪评分的95%置信区间为4.89±1.725。开始VR后，患者情绪评分的95%置信区间为8.78±1.40。
我们这个概念验证病例系列的结果表明了使用的可行性以及对患者不适和围手术期满意度的积极影响。我们建议，在资源有限的国家，应探索将VR作为一种镇痛替代方法和/或麻醉辅助手段，特别是用于高疼痛、低持续时间的手术。
