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一项比较沉浸式虚拟现实游戏与一氧化二氮在小儿外科常见门诊手术中减轻疼痛效果的随机对照试验。

A randomized controlled trial comparing immersive virtual reality games versus nitrous oxide for pain reduction in common outpatient procedures in pediatric surgery.

作者信息

Scherer Cordula, Lanz Ladina A, Liebs Thoralf R, Kaiser Nadine, Zindel Mirjam, Berger Steffen M

机构信息

Department of Pediatric Surgery, Inselspital University Hospital, Bern, CH, 3010, Switzerland.

Clinic for Pediatric Surgery Inselspital Bern, Bern University Hospital, Bern, CH, 3010, Switzerland.

出版信息

Trials. 2025 Jan 20;26(1):21. doi: 10.1186/s13063-025-08718-9.

Abstract

BACKGROUND

Children often experience anxiety and pain during minor surgical procedures, prompting the search for effective pain management strategies beyond traditional pharmaceutical approaches. This study aims to evaluate the efficacy of virtual reality (VR) as a pain reduction method in pediatric outpatient surgical interventions compared to the standard use of nitrous oxide. The research questions explore pain reduction levels, patient preferences, enjoyment during VR use, and the time limit of the VR application.

METHODS

The study employs a randomized controlled trial design, utilizing VR technology and nitrous oxide in separate groups in 100 children at the age from 6 to 15 undergoing minor surgical procedures. Outcomes are monitored directly after the intervention and two weeks following the procedure. The primary outcome measure is the pain level, assessed using visual face and visual analog scales. Secondary outcomes are the fun and/or fear experienced during the intervention, the willingness to undergo the same procedure again (if necessary), and whether there is a time limit with the VR application compared to nitrous oxide. The study also considers adverse events and safety measures.

DISCUSSION

The study aims to address a significant research gap in pediatric pain management strategies, as it is the first randomized controlled trial designed to compare pain levels using VR versus a control group with nitrous oxide analgosedation in children undergoing minor surgical procedures. Preliminary evidence suggests VR may offer a viable alternative to traditional pain management methods, as VR technology could be an effective distraction and pain management tool for pediatric patients undergoing outpatient surgical procedures.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05510141. Registered on August 22, 2022. Virtual Reality Games in Pediatric Surgery-Full Text View-ClinicalTrials.gov.

TRIAL SPONSOR

The principal investigator, Cordula Scherer act as the Sponsor, Clinic for pediatric surgery, Inselspital, Bern University Hospital, CH 3010 Bern, Switzerland.

摘要

背景

儿童在小型外科手术过程中常经历焦虑和疼痛,这促使人们寻找超越传统药物方法的有效疼痛管理策略。本研究旨在评估虚拟现实(VR)作为一种减轻疼痛的方法,在儿科门诊手术干预中与标准使用一氧化二氮相比的效果。研究问题探讨了疼痛减轻程度、患者偏好、VR使用过程中的愉悦感以及VR应用的时间限制。

方法

本研究采用随机对照试验设计,在100名6至15岁接受小型外科手术的儿童中,将VR技术和一氧化二氮分别用于不同组。在干预后及手术后两周直接监测结果。主要结局指标是疼痛程度,采用面部表情视觉量表和视觉模拟量表进行评估。次要结局包括干预过程中体验到的乐趣和/或恐惧、再次接受相同手术(如有必要)的意愿,以及与一氧化二氮相比VR应用是否存在时间限制。该研究还考虑了不良事件和安全措施。

讨论

本研究旨在填补儿科疼痛管理策略方面的重大研究空白,因为这是第一项旨在比较VR与接受小型外科手术儿童的一氧化二氮镇痛镇静对照组疼痛程度的随机对照试验。初步证据表明,VR可能为传统疼痛管理方法提供一种可行的替代方案,因为VR技术对于接受门诊手术的儿科患者可能是一种有效的分散注意力和疼痛管理工具。

试验注册

ClinicalTrials.gov NCT05510141。于2022年8月22日注册。儿科手术中的虚拟现实游戏 - 全文视图 - ClinicalTrials.gov。

试验资助者

主要研究者Cordula Scherer担任资助者,瑞士伯尔尼大学医院因塞尔医院儿科外科诊所,瑞士伯尔尼CH 3010。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d4da/11744987/d28d0f2184ed/13063_2025_8718_Fig1_HTML.jpg

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