Opioids are the most frequently used pain medications by US burn centers to control severe procedural pain during wound care. Concerns for long-term opioid use have prompted the exploration of non-pharmaceutical interventions, such as virtual reality (VR), for procedural pain management. The primary objective of this pilot study was to evaluate the feasibility and efficacy of VR pain alleviation treatment on reducing adult burn patients’ perceived pain during burn dressing changes. Adult patients aged 18-70 years were recruited from the inpatient unit of a single American Burn Association–verified burn center between May 2019 and February 2020 and randomly assigned to one of three arms. Active VR participants played four VR games; passive VR participants were immersed in the same VR environment without the interaction elements; and a standard of care control group. 71 patients were screened for eligibility and 33 were deemed eligible to approach for informed consent, with 14 agreeing to participate in this study. Of these 14 patients, 4 were randomly assigned to the active VR, 4 to the passive VR, and 6 to the control group. Self-reported overall pain was lowest among participant in the active VR (dressing 1= 41.3, dressing 2= 61.0, and dressing 3= 72.7) and highest among participants in the passive VR (dressing 1= 58.3, dressing 2= 74.5, and dressing 3= 89.0) across all three dressing changes. Self-reported worst pain was lowest among the active VR at the first and last dressing (64.3 and 92.2, respectively), but the control group has the lowest self-reported worst pain at the second dressing (71.3). VR is a useful non-pharmacological tool for pain distraction but designing and implementing clinical research studies face many challenges in real-world medical settings. Lessons from this study have important implications for future VR studies by other researchers.

中文翻译：

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成人烧伤敷料更换期间虚拟现实疼痛管理的随机临床试验：经验教训

阿片类药物是美国烧伤中心最常用的止痛药，用于控制伤口护理期间的严重手术疼痛。对长期使用阿片类药物的担忧促使人们探索用于程序性疼痛管理的非药物干预措施，例如虚拟现实 (VR)。该试点研究的主要目的是评估 VR 镇痛治疗在减少烧伤患者更换烧伤敷料期间感知疼痛的可行性和有效性。2019 年 5 月至 2020 年 2 月期间，从美国烧伤协会认证的烧伤中心的住院部招募了 18-70 岁的成年患者，并随机分配到三个组中的一个。活跃的 VR 参与者玩了四款 VR 游戏；被动 VR 参与者沉浸在没有交互元素的相同 VR 环境中；和标准护理对照组。对 71 名患者进行了资格筛选，其中 33 名被认为有资格获得知情同意，其中 14 名同意参加本研究。在这 14 名患者中，4 名被随机分配到主动 VR，4 名分配到被动 VR，6 名分配到对照组。自我报告的整体疼痛在主动 VR 参与者中最低（敷料 1= 41.3，敷料 2= 61.0，敷料 3= 72.7），在被动 VR 参与者中最高（敷料 1= 58.3，敷料 2= 74.5，和敷料 3= 89.0) 在所有三种敷料变化中。在第一次和最后一次敷料时，主动 VR 中自我报告的最严重疼痛最低（分别为 64.3 和 92.2），但对照组在第二次敷料时自我报告的最严重疼痛最低（71.3）。VR 是一种有用的非药理学工具，可用于分散疼痛，但设计和实施临床研究在现实世界的医疗环境中面临许多挑战。这项研究的经验教训对其他研究人员未来的 VR 研究具有重要意义。