Virtual Reality Technology for Hospital Pain Management

The use of virtual reality (VR) technology was superior to standard controlled distraction therapy for the management of pain in hospitalized patients, according to a study reported in JMIR Mental Health.¹ Both interventions produced significant reductions in pain after a single treatment, with more patients reporting improvement in the VR group.  

Study participants were divided into 2 groups of 50 patients aged 18 years or older, recruited at separate times from the Inpatient Specialty Program at Cedars Sinai Medical Center in Los Angeles, California, for each of the 2 protocols. Mean baseline pain scores were equal in both groups: 5.4 points on a patient-rated scale of 0, indicating no pain, to 10, indicating “the worst pain of your life”.

In the first 3 months of the trial, group 1 was subjected to a 3-dimensional VR pain distraction experience, using a Samsung Gear Oculus headset and Samsung Galaxy S7 phone (chosen because of its high-quality images and easy commercial availability). The patients were shown a medium-intensity pain distraction video game, “Pain RelieVR,” transporting them into an immersive fantasy world. The 15-minute program was designed specifically for patients who are bedbound and have limited movement.

The second cohort, evaluated during the next 3 months, was provided a two-dimensional experience that involved watching a high-definition video of nature scenes accompanied by a relaxing audio track of Native American music.

Sixty-five percent of patients treated with VR technology reported experiencing pain relief compared with 40% given the audiovisual distraction treatment (P =.01). Patients exposed to VR had their pain scores reduced by 24% (P <.001) after the intervention, whereas the control group that was shown a two-dimensional video reported a mean reduction of 13.2% (P <.001). The researchers evaluated the between-group difference, using an η² parameter to assess “how much of the variation in the sample can be explained by the interaction;” calculated η² was 0.07, indicating a role for VR in reducing pain scores.

The investigators observed that the current study was unique, in that it assessed the efficacy of VR in reducing pain from a broad range of causes (eg, resulting from surgery, orthopedic, cardiac, or neurological causes), vs a specific type of pain. In addition, VR technology was found to be both safe and practical for the range of patients treated in the study.

Pain among hospitalized patients is extremely common. A large-scale study of pain in hospital wards from 2004 reported that 43% of hospitalized patients experience pain, of which 20% was categorized as “severe,” and 12% as “unbearable.”² The researchers concluded that VR therapy offers significant potential as an adjunctive pain management tool in hospital settings.

Limitations

Although multivariable regression analysis was used in the current study, the protocol  was not a randomized controlled trial.

One of the main limitations to the study was that it evaluated the effect of a single intervention, which was of short duration, and included a single visualization. In addition, the effects of VR on pain re-occurrence after the initial intervention, pharmacologic treatments for pain, or length of hospital stay were not evaluated.

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References

1. Tashjian VC, Mosadeghi S, Howard AR, et al. Virtual reality for management of pain in hospitalized patients: results of a controlled trial. JMIR Ment Health 2017;4:e9.
2. Dix P, Sandhar B, Murdoch J, et al.  Pain on medical wards in a district general hospital. Br J Anaesth 2004;92: 235-237.