Virtual Reality for Pain Relief in the Emergency Room (VIPER) – a prospective, interventional feasibility study
Abstract Background Pain is one of the most common, yet challenging problems leading to emergency department (ED) presentation, despite the availability of a wide range of pharmacological therapies. Virtual reality (VR) simulations are well studied in a wide variety of clinical settings, including a...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-06-01
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| Series: | BMC Emergency Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12873-022-00671-z |
| _version_ | 1818547187823411200 |
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| author | T. Birrenbach F. Bühlmann A. K. Exadaktylos W. E. Hautz M. Müller T. C. Sauter |
| author_facet | T. Birrenbach F. Bühlmann A. K. Exadaktylos W. E. Hautz M. Müller T. C. Sauter |
| author_sort | T. Birrenbach |
| collection | DOAJ |
| description | Abstract Background Pain is one of the most common, yet challenging problems leading to emergency department (ED) presentation, despite the availability of a wide range of pharmacological therapies. Virtual reality (VR) simulations are well studied in a wide variety of clinical settings, including acute and chronic pain management, as well as anxiety disorders. However, studies in the busy environment of an adult ED are scarce. The aim of this study is to explore the feasibility and effectiveness of a VR simulation for pain and anxiety control in a convenience sample of adult ED patients presenting with traumatic and non-traumatic pain triaged 2–5 (i.e., urgent to non-urgent) with a pain rating of ≥ 3 on a numeric rating scale (NRS 0–10). Methods Prospective within-subject, repeated measures interventional feasibility pilot study at a Swiss University ED. The intervention consisted of a virtual reality simulation in addition to usual care. Pain and anxiety levels were measured using a verbally administered numeric rating scale (NRS) before and after the intervention. Information on patient experience was collected using established rating scales. Results Fifty-two patients were enrolled. The most common pain localisations were extremities (n = 15, 28.8%) and abdomen (n = 12, 23.1%). About one third of patients presented with trauma-associated pain (n = 16, 30.8%). Duration of pain was mainly acute (< 24 h) (n = 16, 30.8%) or subacute (> 24 h) (n = 32, 61.5%). The majority of patients were triage category 3, i.e. semi-urgent (n = 48, 92.3%). Significant reduction in pain (NRS median pre-VR simulation 4.5 (IQR 3–7) vs. median post-VR simulation 3 (IQR 2–5), p < 0.001), and anxiety levels (NRS median pre-VR simulation 4 (IQR 2–5) vs. median post-VR simulation 2 (IQR 0–3), p < 0.001) was achieved, yielding moderate to large effect sizes (Cohen’s d estimate for pain reduction = 0.59 (95% CI 0.19—0.98), for anxiety level on NRS = 0.75 (95% CI 0.34—1.15). With medium immersion and good tolerability of the VR simulation, user satisfaction was high. Conclusions Virtual reality analgesia for pain and anxiety reduction in the busy setting of an ED is feasible, effective, with high user satisfaction. Further randomized controlled studies are needed to better characterize its impact on pain perception and resource utilization. |
| first_indexed | 2024-12-12T08:03:22Z |
| format | Article |
| id | doaj.art-a12b0348ac874db599f64a4273bd271c |
| institution | Directory Open Access Journal |
| issn | 1471-227X |
| language | English |
| last_indexed | 2024-12-12T08:03:22Z |
| publishDate | 2022-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Emergency Medicine |
| spelling | doaj.art-a12b0348ac874db599f64a4273bd271c2022-12-22T00:32:04ZengBMCBMC Emergency Medicine1471-227X2022-06-0122111310.1186/s12873-022-00671-zVirtual Reality for Pain Relief in the Emergency Room (VIPER) – a prospective, interventional feasibility studyT. Birrenbach0F. Bühlmann1A. K. Exadaktylos2W. E. Hautz3M. Müller4T. C. Sauter5Department of Emergency Medicine, Inselspital, University Hospital BernDepartment of Emergency Medicine, Inselspital, University Hospital BernDepartment of Emergency Medicine, Inselspital, University Hospital BernDepartment of Emergency Medicine, Inselspital, University Hospital BernDepartment of Emergency Medicine, Inselspital, University Hospital BernDepartment of Emergency Medicine, Inselspital, University Hospital BernAbstract Background Pain is one of the most common, yet challenging problems leading to emergency department (ED) presentation, despite the availability of a wide range of pharmacological therapies. Virtual reality (VR) simulations are well studied in a wide variety of clinical settings, including acute and chronic pain management, as well as anxiety disorders. However, studies in the busy environment of an adult ED are scarce. The aim of this study is to explore the feasibility and effectiveness of a VR simulation for pain and anxiety control in a convenience sample of adult ED patients presenting with traumatic and non-traumatic pain triaged 2–5 (i.e., urgent to non-urgent) with a pain rating of ≥ 3 on a numeric rating scale (NRS 0–10). Methods Prospective within-subject, repeated measures interventional feasibility pilot study at a Swiss University ED. The intervention consisted of a virtual reality simulation in addition to usual care. Pain and anxiety levels were measured using a verbally administered numeric rating scale (NRS) before and after the intervention. Information on patient experience was collected using established rating scales. Results Fifty-two patients were enrolled. The most common pain localisations were extremities (n = 15, 28.8%) and abdomen (n = 12, 23.1%). About one third of patients presented with trauma-associated pain (n = 16, 30.8%). Duration of pain was mainly acute (< 24 h) (n = 16, 30.8%) or subacute (> 24 h) (n = 32, 61.5%). The majority of patients were triage category 3, i.e. semi-urgent (n = 48, 92.3%). Significant reduction in pain (NRS median pre-VR simulation 4.5 (IQR 3–7) vs. median post-VR simulation 3 (IQR 2–5), p < 0.001), and anxiety levels (NRS median pre-VR simulation 4 (IQR 2–5) vs. median post-VR simulation 2 (IQR 0–3), p < 0.001) was achieved, yielding moderate to large effect sizes (Cohen’s d estimate for pain reduction = 0.59 (95% CI 0.19—0.98), for anxiety level on NRS = 0.75 (95% CI 0.34—1.15). With medium immersion and good tolerability of the VR simulation, user satisfaction was high. Conclusions Virtual reality analgesia for pain and anxiety reduction in the busy setting of an ED is feasible, effective, with high user satisfaction. Further randomized controlled studies are needed to better characterize its impact on pain perception and resource utilization.https://doi.org/10.1186/s12873-022-00671-zPain managementAnxietyVirtual reality simulationEmergency departmente-HealthTelemedicine |
| spellingShingle | T. Birrenbach F. Bühlmann A. K. Exadaktylos W. E. Hautz M. Müller T. C. Sauter Virtual Reality for Pain Relief in the Emergency Room (VIPER) – a prospective, interventional feasibility study BMC Emergency Medicine Pain management Anxiety Virtual reality simulation Emergency department e-Health Telemedicine |
| title | Virtual Reality for Pain Relief in the Emergency Room (VIPER) – a prospective, interventional feasibility study |
| title_full | Virtual Reality for Pain Relief in the Emergency Room (VIPER) – a prospective, interventional feasibility study |
| title_fullStr | Virtual Reality for Pain Relief in the Emergency Room (VIPER) – a prospective, interventional feasibility study |
| title_full_unstemmed | Virtual Reality for Pain Relief in the Emergency Room (VIPER) – a prospective, interventional feasibility study |
| title_short | Virtual Reality for Pain Relief in the Emergency Room (VIPER) – a prospective, interventional feasibility study |
| title_sort | virtual reality for pain relief in the emergency room viper a prospective interventional feasibility study |
| topic | Pain management Anxiety Virtual reality simulation Emergency department e-Health Telemedicine |
| url | https://doi.org/10.1186/s12873-022-00671-z |
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