Virtual Reality Can Help With Pain in Inpatient Settings, Review Says

A recent review of available studies determined that virtual reality (VR) used in inpatient settings can help with acute pain relief as well as light sedation.

The literature search was conducted according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines on PubMed, Ovid Medline, EMBASE, and Cochrane Database of Systematic reviews.

Researchers searched on the terms virtual reality, VR, and pain, up to and including January 2019, looking for articles focused on acute pain in the clinical setting.

Articles that were reviews, case series, or case reports were excluded. Primary outcome measures included degree of analgesia, degree of anxiolysis, effect of virtual reality on physiological parameters, side effects precipitated by virtual reality, virtual reality content type, and type of equipment used.

After screening 1923 articles, 18 studies were included in the analysis. Of the 18, 22% measured pain reduction stemming from dressing changes or hydrotherapy for burns or wounds; 39% examined pain from venipuncture, port access, or injections; and 39% measured pain outcomes in patients having various invasive procedures or other miscellaneous acute conditions.

Using VR led to significant reductions in pain for participants in 12 of the 18 studies, the authors said.

The review also found:

• 44% (8/18) of studies assessed VR’s effects on procedural anxiety, with 50% (4/8) showing significant reductions
• 28% (5/18) of studies screened for side effects (such as nausea, vomiting, eye strain, and dizziness) with incidence rates of 0.5% to 8%
• 39% (7/18) looked at VR’s effects on autonomic arousal as a biomarker of pain, with 29% (2/7) demonstrating significant changes

Looking at the administration of VR, the authors said all of the studies used a head-mounted display; in 50% of them, the patient interacted with the VR environment, and in the other 50% the patient only passively observed the VR content.

The authors said the review shows a slight tilt towards active VR compared with passive VR and that the patient experience while undergoing procedures can be improved through its use.

Moreover, they noted that the pain-relieving effects of VR “are likely to vary by patient population and indication.”

“This highlights the need for individualized pilot testing of virtual reality therapy’s effects for each specific clinical use case rather than generalizing its use for the broad indication of facilitating analgesia,” they said.

Reference

Smith V, Warty RR, Sursas JA, et al. The effectiveness of virtual reality in managing acute pain and anxiety for medical inpatients: Systematic review. J Med Internet Res, 2020;22(11):e17980

doi: 10.2196/17980

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