Projector-based virtual reality dome environment for procedural pain and anxiety in young children with burn injuries: a pilot study

Abstract

BackgroundVirtual reality (VR) is a non-pharmacological method to distract from pain during painful procedures. However, it was never tested in young children with burn injuries undergoing wound care.AimWe aimed to assess the feasibility and acceptability of the study process and the use of VR for procedural pain management.MethodsFrom June 2016 to January 2017, we recruited children from 2 months to 10 years of age with burn injuries requiring a hydrotherapy session in a pediatric university teaching hospital in Montreal. Each child received the projector-based VR intervention in addition to the standard pharmacological treatment. Data on intervention and study feasibility and acceptability in addition to measures on pain (Face, Legs, Activity, Cry, Consolability scale), baseline (Modified Smith Scale) and procedural (Procedure Behavior Check List) anxiety, comfort (OCCEB-BECCO [behavioral observational scale of comfort level for child burn victims]), and sedation (Ramsay Sedation Scale) were collected before, during, and after the procedure. Data analyses included descriptive and non-parametric inferential statistics.ResultsWe recruited 15 children with a mean age of 2.2±2.1 years and a mean total body surface area of 5% (±4). Mean pain score during the procedure was low (2.9/10, ±3), as was the discomfort level (2.9/10, ±2.8). Most children were cooperative, oriented, and calm. Assessing anxiety was not feasible with our sample of participants. The prototype did not interfere with the procedure and was considered useful for procedural pain management by most health care professionals.ConclusionThe projector-based VR is a feasible and acceptable intervention for procedural pain management in young children with burn injuries. A larger trial with a control group is required to assess its efficacy.

Adjunctive virtual reality for procedural pain management of burn patients during dressing change or physical therapy: A systematic review and meta‐analysis of randomized controlled trials

“…There were 11 case reports/series regarding the application of VR among burn patients going through wound care or physical therapy sessions. VR demonstrated a pain‐reducing effect in 9 of the 11 studies . In the other two reports, VR was used to deliver hypnotic analgesia; in these studies, VR was effective and made hypnosis less effortful.…”

Immersive Virtual Reality as an Adjunctive Non-opioid Analgesic for Pre-dominantly Latin American Children With Large Severe Burn Wounds During Burn Wound Cleaning in the Intensive Care Unit: A Pilot Study

“…Regardless of the mechanism, several small clinical studies have shown encouraging preliminary evidence that adjunctive VR can help reduce pain during burn wound care in adults (Hoffman et al, 2004a, 2011; van Twillert et al, 2007; Maani et al, 2011a,b; McSherry et al, 2018), and in children with small burns, (Hoffman, 1998; Hoffman et al, 2000; Faber et al, 2013; Jeffs et al, 2014; Khadra et al, 2018). There is also preliminary evidence that VR is more effective than conventional distractions such as video games or movies.…”

Self-Administered Skills-Based Virtual Reality Intervention for Chronic Pain: Randomized Controlled Pilot Study

“…VR has been used in numerous clinical settings and health conditions to treat anxiety and mental disorders [ 20 - 22 ], aids physical rehabilitation [ 23 , 24 ], and supports postsurgical recovery. Evidence suggests that VR is effective for managing acute pain, including pain elicited during medical procedures [ 25 - 29 ], and burn wound care [ 30 , 31 ] and in hospitalized patients [ 32 , 33 ].…”