Virtual anesthesia: The use of virtual reality for pain distraction during acute medical interventions

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Pediatric pain management for routine medical interventions continues to receive considerable attention. To date, investigators have demonstrated the efficacy of simple pain distraction strategies for acute procedures (ie, venipuncture) as well as more invasive interventions (ie, wound care, chemotherapy). Recent technological advances in the field of virtual reality (VR) have produced more engaging forms of pain distraction. Although clinical case studies and randomized control trials have begun to explore the utilization of VR anesthesia, this research is still in its infancy. In spite of some limitations, VR researchers have successfully demonstrated its feasibility, satisfaction, and innovation for decreasing pain associated with medical interventions. VR anesthesia also has the potential to minimize pharmacological therapy, thereby reducing risks associated with sedation. Future directions in VR anesthesia are contingent on further technological advances, sound methodology, and appropriate participant-to-intervention match. This manuscript reviews current literature on state-of-the-art pain distraction and future directions in VR.

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Virtual reality and pain distraction

Over the last 15 years, the use of virtual reality (VR) has been utilized for various educational (computer assisted learning), training (simulation), and research purposes with nurses, physicians, and other healthcare providers. However, more recently, the technology has been modified for child and adult use in clinical settings. Many investigators have begun to use the technology to entertain, educate, and divert attention away from the associated symptoms of painful medical interventions.

Clinical case studies applying virtual reality for pain management

The first “virtual reality mirror box” was introduced by Ramachandran and Rogers-Ramachandran to examine the effects of visual input on phantom sensations.19 They introduced an inexpensive new device called a “virtual reality box” to visually resurrect the phantom limb in order to study inter-sensory effects. Six of the 10 patients recruited for the study reported kinesthetic sensations in their phantom limb after viewing a mirror-image of movement in their normal hand; movement of the normal

VR and randomized control trials

Several controlled group studies have demonstrated the beneficial effects of VR distraction in medical settings. Hoffman et al. explored the utilization of immersive VR to distract patients from pain during physical therapy.27 Twelve patients (aged 19 to 47 years), with an average of 21% total body surface area burned, performed range-of-motion exercises under the supervision of an occupational therapist. Patients spent 3 minutes of physical therapy with no distraction and 3 minutes of physical

VR in healthy populations

The efficacy of VR pain distraction has also been examined in clinically healthy populations stimulated with experimentally induced pain. Seventy-two college students undergoing experimentally induced ischemia demonstrated a significant increase in both pain threshold and pain tolerance when viewing nature scenes on a VR eyeglass display as opposed to wearing the glasses and viewing a blank screen.39

Hoffman and colleagues found that, in addition to enhancing pain endurance, VR also has the

Summary of VR and pain distraction

The previous review essentially exhausts the current literature on state-of-the-art applications of VR anesthesia for patients undergoing invasive medical procedures. Although numerous studies have begun to explore the utilization of VR as a pain distraction for acute medical procedures, this type of research is still in its infancy. Investigators to date have continued to build on the theoretical framework of both Gate Control Theory (GCT)6 and the limited-capacity of attention,7, 8, 9 while

VR applications in anesthesia

Ten years ago, a review of VR in anesthesia noted a substantial gap between the existing technology and potential VR applications.41 Since that time, there have been significant developments seeking to bridge that gap, including high performance video cards, enhanced LCD displays, and object-oriented programming. Additionally, the past decade has witnessed a flourishing of collaborative efforts on the part of industries and academia, especially concerning research training and methodology;

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