虚拟现实技术在减轻儿童操作性疼痛中的应用进展

近年来,基于虚拟现实技术分散注意力的方法逐渐被应用到儿童操作性疼痛管理中。该文对虚拟现实技术在儿童操作性疼痛中的应用现状进行综述,包括操作性疼痛的常见原因、虚拟现实技术的分类、虚拟现实技术在减轻儿童操作性疼痛中应用方法及效果等,总结了相关不足并提出了展望,以期为临床实践提供指导。     

沉浸式虚拟现实技术在创面操作性疼痛管理中的应用进展

操作性疼痛对患者的生理、心理及伤口愈合具有不良影响，有效缓解换药时的创面操作性疼痛是亟需解决的难题。沉浸式虚拟现实技术可缓解创面操作性疼痛。该文介绍了沉浸式虚拟现实技术的镇痛机制及其在创面操作性疼痛管理中的应用形式，总结了沉浸式虚拟现实技术在创面操作性疼痛管理中的应用优势与效果，并分析了现阶段研究与应用中存在的不足，以期为推动沉浸式虚拟现实技术在创面操作性疼痛管理中的应用提供借鉴。     

虚拟现实技术缓解急性疼痛的作用机制及应用进展

对虚拟现实技术（virtual reality,VR）概念、发展史、缓解急性疼痛的作用机制、急性疼痛评估工具以及在急性疼痛管理中的应用现状及不足进行综述,以期为该技术在我国临床中的推广和应用提供参考。     

虚拟现实技术在术后疼痛管理中的应用进展

术后疼痛管理越来越受人关注。目前针对术后疼痛的治疗,常见的方式是药物疗法,与单用药物镇痛相比,非药物疗法辅助镇痛在疼痛管理中效果显著。虚拟现实技术辅助镇痛兼具趣味性与实用性,是近年来备受推崇的非药物疗法。本文综述了虚拟现实技术的分类、镇痛机制、在术后急慢性疼痛管理中的应用现状,存在问题等,为虚拟现实技术在术后疼痛管理的临床实践提供参考     

虚拟现实技术在乳腺癌患者症状管理中的应用进展

对虚拟现实技术的概况、种类、在医学领域中的应用现状进行综述,重点围绕虚拟现实技术对乳腺癌患者焦虑、抑郁、疲乏、疼痛、认知功能障碍、淋巴水肿等症状的管理效果进行介绍,以期为临床实践提供指导。     

虚拟现实技术在烧伤康复中的应用进展北大核心CSCD

本文综述虚拟现实技术在辅助烧伤患者上、下肢功能训练,疼痛管理,心理治疗等方面的应用,并分析该技术在我国烧伤中心推广的困难和机遇。     

虚拟现实技术在烧伤康复中的应用进展

本文综述虚拟现实技术在辅助烧伤患者上、下肢功能训练,疼痛管理,心理治疗等方面的应用,并分析该技术在我国烧伤中心推广的困难和机遇。     

虚拟现实技术应用于重症患者的研究进展

本文对虚拟现实技术概念、类型、在医疗护理领域的应用现状进行综述,重点围绕虚拟现实技术对重症患者疼痛、认知障碍、焦虑、抑郁、睡眠质量、肢体功能等方面的应用效果进行介绍,并指出不足及展望,以期为该技术在我国重症患者中的应用提供参考。     

虚拟现实技术在安宁疗护中的应用进展

目的 对虚拟现实技术在安宁疗护的应用研究进展进行综述,以供国内实践参考。方法 通过检索国内外相关研究文献,从虚拟现实技术的种类和设备,虚拟现实技术在安宁疗护中的症状管理、预先护理计划、家属哀伤辅导、护理团队培养的应用等角度进行综述。结果 虚拟现实技术在安宁疗护中具有重要的应用价值,帮助生命末期患者减轻疼痛、焦虑和抑郁;有助于培养安宁疗护护理团队;以及提升预先护理计划的有效性和家属哀伤辅导。结论 随着虚拟现实技术的成熟,应将虚拟现实技术在国内安宁疗护中投入应用与研究。     

虚拟现实技术在家庭康复中的应用研究进展

从虚拟现实技术的概念、分类、应用效果和面临的挑战进行综述，重点围绕虚拟现实技术对家庭康复病人运动和肢体功能、平衡能力、认知障碍、焦虑、抑郁、疼痛、成本效益等方面的应用效果进行介绍，并指出不足及展望，为该技术在我国居家康复病人中的应用提供参考。     

Real Bodies Not Required? Placebo Analgesia and Pain Perception in Immersive Virtual and Augmented Reality

Pain represents an embodied experience, wherein inferences are not only drawn from external sensory inputs, but also from bodily states. Previous research has demonstrated that a placebo administered to an embodied rubber hand can effectively induce analgesia, providing first evidence that placebos can work even when applied to temporarily embodied, artificial body parts. Using a heat pain paradigm, the present study investigates placebo analgesia and pain perception during virtual embodiment. We examined whether a virtual placebo (a sham heat protective glove) can successfully induce analgesia, even when administered to a virtual body. The analgesic efficacy of the virtual placebo to the real hand (augmented reality setting) or virtual hand (virtual reality setting) was compared to a physical placebo administered to the own, physical body (physical reality setting). Furthermore, pain perception and subjective embodiment were compared between settings. In this mixed design experiment, healthy participants (n = 48) were assigned to either an analgesia-expectation or control-expectation group, where subjective and objective pain was measured at pre- and post-intervention time points. Results demonstrate that pre-intervention pain intensity was lower in the virtual reality setting, and that participants in the analgesia-expectation group, after the intervention, exhibited significantly higher pain thresholds, and lower pain intensity and unpleasantness ratings than control-expectation participants, independent of the setting. Our findings show that a virtual placebo can elicit placebo analgesia comparable to that of a physical placebo, and that administration of a placebo does not necessitate physical bodily interaction to produce analgesic responses.PerspectiveThis study demonstrates that a virtual placebo treatment, even when administered to a virtual body, can produce placebo analgesia. These findings indicate that the efficacy of a virtual placebo is comparable to that of a physical placebo, which could pave the way for effective new non-pharmacological approaches for pain management.     

Seeing an Embodied Virtual Hand is Analgesic Contingent on Colocation

Seeing one's own body has been reported to have analgesic properties. Analgesia has also been described when seeing an embodied virtual body colocated with the real one. However, there is controversy regarding whether this effect holds true when seeing an illusory-owned body part, such as during the rubber-hand illusion. A critical difference between these paradigms is the distance between the real and surrogate body part. Colocation of the real and surrogate arm is possible in an immersive virtual environment, but not during illusory ownership of a rubber arm. The present study aimed at testing whether the distance between a real and a virtual arm can explain such differences in terms of pain modulation. Using a paradigm of embodiment of a virtual body allowed us to evaluate heat pain thresholds at colocation and at a 30-cm distance between the real and the virtual arm. We observed a significantly higher heat pain threshold at colocation than at a 30-cm distance. The analgesic effects of seeing a virtual colocated arm were eliminated by increasing the distance between the real and the virtual arm, which explains why seeing an illusorily owned rubber arm does not consistently result in analgesia. These findings are relevant for the use of virtual reality in pain management.

Effectiveness of virtual reality-based pain control with multiple treatments

OBJECTIVE: The current study explored whether immersive virtual reality continues to reduce pain (via distraction) with repeated use. SETTING: The study was conducted in a burn care unit at a regional trauma center. PATIENTS: Seven patients aged 9-32 years (mean age of 21.9 years; average of 23.7% total body surface area burned [range, 3-60%]) performed range-of-motion exercises of their injured extremity under an occupational therapist's direction on at least 3 separate days each. INTERVENTION: For each physical therapy session, each patient spent equal amounts of time in virtual reality and in the control condition (no distraction). The mean duration of physical therapy in virtual reality was 3.5, 4.9, and 6.4 minutes for the first, second, and third session, respectively. Condition order was randomized and counter-balanced. OUTCOME MEASURES: For each of the three physical therapy sessions, five visual analog pain scores for each treatment condition served as the dependent variables. RESULTS: Pain ratings were statistically lower when patients were in virtual reality, and the magnitude of pain reduction did not diminish with repeated use of virtual reality. The results of this study may be examined in more detail at www.vrpain.com. CONCLUSIONS: Although the small sample size limits generalizability. results provide converging preliminary evidence that virtual reality can function as a strong nonpharmacological pain reduction technique for burn patients during physical therapy. Results suggest that virtual reality does not diminish in analgesic effectiveness with three (and possibly more) uses. Virtual reality may also have analgesic potential for other painful procedures or pain populations. Practical implications are discussed.     

Virtual Reality Based Guided Meditation for Patients with Opioid Tolerance and Opioid Use Disorders

BackgroundThe management of acute pain in patients with pre-existing opioid tolerance or opioid use disorders presents unique challenges. In light of the concerns regarding opioid use, safe and effective alternatives to opioid medications are of increasing interest.AimsThis study was conducted to determine if the use of guided meditation delivered through immersive virtual reality can reduce pain in patients with opioid tolerance or opioid use disorders, including opioid abuse or opioid dependence.DesignA quasi-experimental pre-test and post-test study design was used.SettingsA 31-bed inpatient orthopedic/trauma unit in the southeastern United States.Participants/SubjectsSubjects of the pilot study were hospitalized adults over the age of 18 with pre-existing opioid tolerance or opioid use disorder who were experiencing acute pain.MethodsThis pilot study examined the effect of a 10-minute guided meditation activity through immersive virtual reality on the reported acute pain of hospitalized adults (n = 11) with pre-existing opioid tolerance or opioid use disorders. The Calm® application on an Oculus Go® virtual reality head-mounted display was used for the meditation activity.ResultsBefore the intervention, the mean patient-reported pain rating was 6.68, and the mean pain score after the virtual reality experience was 3.36. Using the Wilcoxon signed rank test, this was a statistically significant difference (p = .003). Patients were also observed and queried regarding any significant side effects or other incidental findings, none of which were reported.ConclusionsThis study demonstrates that the use of guided meditation through virtual reality can result in statistically significant reductions in patient-reported pain scores.     

虚拟现实分散患者注意力舒缓拔牙疼痛的效果

目的 探讨虚拟现实分散患者注意力缓解智齿拔除术中疼痛的效果.方法 将122例18～60岁需拔除上颌智齿的成人患者纳入试验,按就诊先后顺序分配到试验组和对照组各61例.试验组患者在进行常规拔牙时,于拔牙前5min至拔牙结束使用虚拟现实系统分散患者注意力.对照组患者接受常规方法拔牙,未使用虚拟现实系统分散患者注意力.使用视觉模拟量表(VAS)、牙科焦虑问卷对两组患者拔牙过程中的疼痛和焦虑进行评估.结果 试验组患者VAS得分为(2.09±1.68)分,对照组为(3.07±2.34)分,两组比较,差异有统计学意义(t=-2.677,P＜0.05);试验组拔牙时焦虑问卷得分为(4.44±3.26)分,对照组为(5.06±3.00)分,两组比较,差异无统计学意义(t=-1.093,P＞0.05).结论 虚拟现实分散患者注意力能有效缓解智齿拔除术中的疼痛.     

Effects of Hypnotic Analgesia and Virtual Reality on the Reduction of Experimental Pain Among High and Low Hypnotizables

This research compared a no-treatment control condition and 3 experimentally induced pain treatment conditions: (a) virtual reality distraction (VRD), (b) hypnotic analgesia (HA), and (c) HA + VRD in relieving finger-pressure pain. After receiving baseline pain stimulus, each participant received hypnosis or no hypnosis, followed by VRD or no VRD during another pain stimulus. The data analysis indicated that, overall, all 3 treatments were more effective compared to the control group, irrespective of whether it involved hypnotic analgesia, virtual reality distraction, or both (hypnosis and virtual reality). Nevertheless, the participants responded differently to the pain treatment, depending on the hypnotizability level. High hypnotizables reported hypnotic analgesia, but low hypnotizables did not show hypnotic analgesia. VR distraction reduced pain regardless of hypnotizability.     

Virtual Reality Hypnosis for Pain Associated With Recovery From Physical Trauma

Pain following traumatic injuries is common, can impair injury recovery and is often inadequately treated. In particular, the role of adjunctive nonpharmacologic analgesic techniques is unclear. The authors report a randomized, controlled study of 21 hospitalized trauma patients to assess the analgesic efficacy of virtual reality hypnosis (VRH)—hypnotic induction and analgesic suggestion delivered by customized virtual reality (VR) hardware/software. Subjective pain ratings were obtained immediately and 8 hours after VRH (used as an adjunct to standard analgesic care) and compared to both adjunctive VR without hypnosis and standard care alone. VRH patients reported less pain intensity and less pain unpleasantness compared to control groups. These preliminary findings suggest that VRH analgesia is a novel technology worthy of further study, both to improve pain management and to increase availability of hypnotic analgesia to populations without access to therapist-provided hypnosis and suggestion.