Abstract：
BACKGROUND: Virtual reality (VR) is a promising tool in a multimodal analgesic approach; however, evidence regarding virtual reality for postsurgical pain is limited. This study investigates the initial effectiveness and feasibility of self-administered virtual reality in postsurgical pain management.
METHODS: Patients reporting a postsurgical pain score ≥4 were randomized for control or VR, stratified for 3 interventions with varying levels of immersion and interaction. Subjects were instructed to use virtual reality as add-on treatment at least 3 times a day for 10 minutes on days 2 till 4 postoperatively. Primary outcome was the mean daily pain intensity. Results of pain scores were related to patient and intervention characteristics, to explore which characteristics interact with virtual reality effects. Secondary outcomes were analgesic use, anxiety, stress, and feasibility.
RESULTS: One hundred patients were included in the analyses: 37 in the control group and 63 for VR. VR did not demonstrate a significant effect on self-reported pain scores (P = .43), nor were specific patient or intervention characteristics associated with greater VR effects. Analgesic usage did not differ between groups. However, there was a trend toward greater cumulative percentages of patients achieving a 30% pain reduction, and significantly lower daily experienced stress (P = .01) and anxiety (P = .03) levels in VR intervention groups. VR was used less than prescribed, mainly because of illness and pain. Adverse events included disorientation, nausea, and fatigue.
CONCLUSIONS: This explorative study did not demonstrate initial effectiveness of VR as add-on pain treatment regarding pain and analgesic use; however, VR positively affected stress and anxiety. VR is safe and suitable for a wide target audience, and feasibility differed between interventions. Personalizing and improving VR technology may enhance its effectiveness.
METHODS: Patients reporting a postsurgical pain score ≥4 were randomized for control or VR, stratified for 3 interventions with varying levels of immersion and interaction. Subjects were instructed to use virtual reality as add-on treatment at least 3 times a day for 10 minutes on days 2 till 4 postoperatively. Primary outcome was the mean daily pain intensity. Results of pain scores were related to patient and intervention characteristics, to explore which characteristics interact with virtual reality effects. Secondary outcomes were analgesic use, anxiety, stress, and feasibility.
RESULTS: One hundred patients were included in the analyses: 37 in the control group and 63 for VR. VR did not demonstrate a significant effect on self-reported pain scores (P = .43), nor were specific patient or intervention characteristics associated with greater VR effects. Analgesic usage did not differ between groups. However, there was a trend toward greater cumulative percentages of patients achieving a 30% pain reduction, and significantly lower daily experienced stress (P = .01) and anxiety (P = .03) levels in VR intervention groups. VR was used less than prescribed, mainly because of illness and pain. Adverse events included disorientation, nausea, and fatigue.
CONCLUSIONS: This explorative study did not demonstrate initial effectiveness of VR as add-on pain treatment regarding pain and analgesic use; however, VR positively affected stress and anxiety. VR is safe and suitable for a wide target audience, and feasibility differed between interventions. Personalizing and improving VR technology may enhance its effectiveness.
摘要：
背景：虚拟现实（VR）是多模式镇痛方法中的一种有前途的工具；但是，关于手术后疼痛的虚拟现实的证据是有限的。这项研究调查了自我管理的虚拟现实在术后疼痛管理中的初始有效性和可行性。
方法：报告术后疼痛评分≥4的患者随机分为对照或VR，分层为3种干预措施，具有不同的沉浸和互动水平。指导受试者在术后第2天至第4天每天至少3次使用虚拟现实作为附加治疗,持续10分钟。主要结果是平均每日疼痛强度。疼痛评分结果与患者及干预特点相关,探索哪些特征与虚拟现实效果相互作用。次要结果是镇痛药使用，焦虑,压力，和可行性。
结果：100例患者被纳入分析：对照组37例，VR63例。VR对自我报告的疼痛评分没有显着影响（P=0.43），特定患者或干预特征也与更大的VR效果相关。两组之间的镇痛用法没有差异。然而,有一种趋势是增加患者的累积百分比，达到30%的疼痛减少，VR干预组的每日压力（P=0.01）和焦虑（P=0.03）水平显着降低。VR的使用少于规定，主要是因为疾病和疼痛。不良事件包括迷失方向，恶心,和疲劳。
结论：这项探索性研究并未证明VR作为疼痛和镇痛药使用的附加疼痛治疗的初始有效性；然而，VR对压力和焦虑有积极影响。VR是安全的，适合广泛的目标受众，干预措施之间的可行性不同。个性化和改进VR技术可能会增强其有效性。
方法：报告术后疼痛评分≥4的患者随机分为对照或VR，分层为3种干预措施，具有不同的沉浸和互动水平。指导受试者在术后第2天至第4天每天至少3次使用虚拟现实作为附加治疗,持续10分钟。主要结果是平均每日疼痛强度。疼痛评分结果与患者及干预特点相关,探索哪些特征与虚拟现实效果相互作用。次要结果是镇痛药使用，焦虑,压力，和可行性。
结果：100例患者被纳入分析：对照组37例，VR63例。VR对自我报告的疼痛评分没有显着影响（P=0.43），特定患者或干预特征也与更大的VR效果相关。两组之间的镇痛用法没有差异。然而,有一种趋势是增加患者的累积百分比，达到30%的疼痛减少，VR干预组的每日压力（P=0.01）和焦虑（P=0.03）水平显着降低。VR的使用少于规定，主要是因为疾病和疼痛。不良事件包括迷失方向，恶心,和疲劳。
结论：这项探索性研究并未证明VR作为疼痛和镇痛药使用的附加疼痛治疗的初始有效性；然而，VR对压力和焦虑有积极影响。VR是安全的，适合广泛的目标受众，干预措施之间的可行性不同。个性化和改进VR技术可能会增强其有效性。
