Virtual Reality as a Distraction Intervention to Relieve Pain and Distress During Medical Procedures: A Comprehensive Literature Review

@article{Indovina2018VirtualRA,
  title={Virtual Reality as a Distraction Intervention to Relieve Pain and Distress During Medical Procedures: A Comprehensive Literature Review},
  author={Paola Indovina and Daniela Barone and Luigi Gallo and Andrea Chirico and Giuseppe De Pietro and Antonio Giordano},
  journal={The Clinical Journal of Pain},
  year={2018},
  volume={34},
  pages={858–877}
}
Objectives: This review aims to provide a framework for evaluating the utility of virtual reality (VR) as a distraction intervention to alleviate pain and distress during medical procedures. We first describe the theoretical bases underlying the VR analgesic and anxiolytic effects and define the main factors contributing to its efficacy, which largely emerged from studies on healthy volunteers. Then, we provide a comprehensive overview of the clinical trials using VR distraction during… Expand

Paper Mentions

Interventional Clinical Trial
This study examines the impact of virtual reality compared to sedation (midazolam and/or fentanyl) and no intervention on pain experienced from an epidural steroid injection (ESI… Expand
ConditionsLower Back Pain, Lumbar Radiculopathy
InterventionDevice, Drug, Other
Interventional Clinical Trial
Currently, most analgesic regimens for painful bedside procedures rely on pharmacologic sedation or high doses of opioids (e.g.: nurse-administered IV opioids, anxiolytics, and… Expand
ConditionsAcute Pain
InterventionDevice, Drug
Interventional Clinical Trial
Immersive virtual reality (iVR) has been used successfully to manage pain with distraction. It is a non-invasive treatment modality unassociated with worrisome well-known side effects… Expand
ConditionsPerioperative Care, Procedural Anxiety, Procedural Pain
InterventionDevice, Procedure
Interventional Clinical Trial
The management of chronic pain is a significant public health issue related to escalating treatment costs, lost productivity, disability and medication use. The prevalence of chronic… Expand
ConditionsChronic Low Back Pain
InterventionCombination Product
Effect of virtual reality therapy in reducing pain and anxiety for cancer related medical procedures: A systematic narrative review.
TLDR
There is inconclusive evidence on the significance of immersive VR in reducing pain or anxiety for cancer patients undergoing medical interventions or receiving chemotherapy. Expand
Use of Virtual Reality to Reduce Anxiety and Pain of Adults Undergoing Outpatient Procedures
TLDR
This quality improvement project demonstrated the successful translation of research into practice by implementing and evaluating immersive VR as a non-pharmacological intervention to reduce pain and anxiety in those adults undergoing outpatient procedures under monitored anesthesia care. Expand
Transient reductions in postoperative pain and anxiety using virtual reality in children
TLDR
Virtual reality (VR) is beneficial in transiently reducing pain intensity, unpleasantness, and anxiety in children with acute postoperative pain and anxiety. Expand
Using Virtual Technology for Fear of Medical Procedures: A Systematic Review of the Effectiveness of Virtual Reality-Based Interventions.
TLDR
Evidence on the effectiveness of VR suggests that it does decrease fear of medical procedures in some situations, however, the RoB assessment illustrated a poor quality of studies across those included in this review, limiting the ability to draw firm general conclusions from the study findings. Expand
The use of virtual reality for Peri-procedural pain and anxiety at an outpatient spine clinic injection visit: an exploratory controlled randomized trial.
TLDR
The virtual reality intervention was acceptable and feasible to integrate into a clinic setting, however, to maximize effectiveness, the content delivered to this population should be targeted and delivered over a longer duration. Expand
Guided relaxation-based virtual reality transiently reduces acute postoperative pain and anxiety in a pediatric population
TLDR
A single, short VR-GR session produced immediate and acute reductions in pain intensity, pain unpleasantness, and anxiety in children and adolescents with acute postoperative pain. Expand
Guided relaxation-based virtual reality versus distraction-based virtual reality or passive control for postoperative pain management in children and adolescents undergoing Nuss repair of pectus excavatum: protocol for a prospective, randomised, controlled trial (FOREVR Peds trial)
TLDR
The primary aim of this study is to assess the impact of daily VR-GR, VR-D and 360 video (passive control) on pain intensity, and the effect of psychological factors (anxiety sensitivity and pain catastrophising) onPain following VR. Expand
Mobile virtual reality distraction reduces needle pain and stress in children?
TLDR
The present study focused on comparing the effect sizes of active and passive VR interventions, and confirmed feasibility of using Multiple Object Tracking paradigm as a method of attention distraction in VR. Expand
Guided relaxation-based virtual reality versus distraction-based virtual reality or passive control for postoperative pain management in children and adolescents undergoing Nuss repair of pectus excavatum: protocol for a prospective, randomized, controlled trial (FOREVR Peds trial)
TLDR
This study assesses the impact of daily VR-GR, VR-D, and 360 video (passive control) on pain intensity and opioid consumption in children/adolescents presenting for Nuss repair of pectus excavatum, a single center, prospective, randomized, clinical trial. Expand
Virtual Reality as a Non-Pharmacological Adjunct to Reduce the Use of Analgesics in Hospitals
TLDR
How immersion, presence, and agency encapsulate the VR experience is presented and the methods by which VR can relieve pain by changing users’ cognition and perception of pain are investigated. Expand
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References

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Use of Virtual Reality as a Distractor for Painful Procedures in a Patient with Pediatric Cancer: A Case Study
TLDR
Benefit from using VR distraction is suggested, as indicated by lower pain and anxiety ratings, reduced pulse, and fewer observed behavioral indices of distress. Expand
The effectiveness of virtual reality distraction for pain reduction: a systematic review.
TLDR
Overall, controlled research suggests that VR distraction may be a useful tool for clinicians who work with a variety of pain problems. Expand
Virtual Reality as an Adjunctive Non-pharmacologic Analgesic for Acute Burn Pain During Medical Procedures
TLDR
Burn patients report 35–50% reductions in procedural pain while in a distracting immersive virtual reality, and fMRI brain scans show associated reductions in pain-related brain activity during VR. Expand
Innovative Technology Using Virtual Reality in the Treatment of Pain: Does It Reduce Pain via Distraction, or Is There More to It?
TLDR
It is demonstrated that in addition to distraction, there are novel mechanisms for VR treatment in pain, such as producing neurophysiologic changes related to conditioning and exposure therapies, which may have the ability to help reduce opioid use and misuse among chronic pain patients. Expand
The Effectiveness of Virtual Reality on Reducing Pain and Anxiety in Burn Injury Patients: A Systematic Review
TLDR
Used as an adjunct to the current burn pain management regimens, VR could possibly assist health professionals in making the rehabilitation process for burn patients less excruciating, thereby improving functional outcomes. Expand
Factors influencing the efficacy of virtual reality distraction analgesia during postburn physical therapy: preliminary results from 3 ongoing studies.
TLDR
Immersive VR distraction is a safe and effective nonpharmacologic technique with which to provide adjunctive analgesia to facilitate patient participation in rehabilitation activities and provides a clinically meaningful degree of pain relief to burn patients undergoing passive ROM PT. Expand
Virtual Reality as a Pediatric Pain Modulation Technique: A Case Study
TLDR
This case report provides the first evidence that VR may serve as a powerful non-pharmacologic analgesic for children following surgery, with a 16-year-old patient with cerebral palsy participating in a twice-daily physiotherapy program following Single Event Multi-Level Surgery. Expand
Improving Dental Experiences by Using Virtual Reality Distraction: A Simulation Study
TLDR
It is suggested that VR distractions can be considered as a relevant intervention for cycles of care in which people’s previous experiences affect their behaviour for future events. Expand
Treatment efficacy of virtual reality distraction in the reduction of pain and anxiety during cystoscopy.
TLDR
There was no benefit to VR distraction mitigating pain in male patients during cystoscopy, and no data endpoints showed a statistically significant difference between the 2 groups. Expand
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