沉浸式虚拟现实技术在创面操作性疼痛管理中的应用进展

doi:10.3761/j.issn.0254-1769.2023.02.017

摘要/Abstract

摘要：

操作性疼痛对患者的生理、心理及伤口愈合具有不良影响，有效缓解换药时的创面操作性疼痛是亟需解决的难题。沉浸式虚拟现实技术可缓解创面操作性疼痛。该文介绍了沉浸式虚拟现实技术的镇痛机制及其在创面操作性疼痛管理中的应用形式，总结了沉浸式虚拟现实技术在创面操作性疼痛管理中的应用优势与效果，并分析了现阶段研究与应用中存在的不足，以期为推动沉浸式虚拟现实技术在创面操作性疼痛管理中的应用提供借鉴。

关键词: 沉浸式虚拟现实技术, 创面操作性疼痛, 伤口, 疼痛管理, 综述, 护理

Abstract:

The wound procedural pain has an important effect on the physiological health，psychological health and wound healing of patients；therefore，effectively relieving the wound procedural pain during dressing change is an urgent problem to be solved. Immersive virtual reality（IVR） technology has a significant effect on wound procedural pain management. This paper introduces the analgesic mechanism of IVR and its application form in wound procedural pain management，including 3 IVR systems based on computer，smartphone and virtual all-in-one machine，summarizes the advantages of IVR technology in wound procedural pain management，and analyzes the shortcomings in the current research and application. The prospect was put forward，in order to promote the application of IVR technology in wound procedural pain management in China.

Key words: Immersive Virtual Reality Technology, Wound Procedural Pain, Wound, Pain Management, Review, Nursing Care

张媛, 郭锦丽. 沉浸式虚拟现实技术在创面操作性疼痛管理中的应用进展[J]. 中华护理杂志, 2023, 58(2): 243-249.

ZHANG Yuan, GUO Jinli. Application progress of immersive virtual reality technology in wound procedural pain management[J]. Chinese Journal of Nursing, 2023, 58(2): 243-249.

参考文献 40

[1]	罗高兴, 彭毅志, 吴军. 成人烧伤疼痛管理指南(2013版)[J]. 中华烧伤杂志, 2013(3):225-231.
	Luo GX, Peng YZ, Wu J. Adult burn pain management guidelines(2013 edition)[J]. Chin J Burns, 2013(3):225-231.
[2]	Sen CK. Human wound and its burden:updated 2020 compendium of estimates[J]. Adv Wound Care(New Rochelle), 2021, 10(5):281-292.
[3]	Krane EJ. The opioid debate-PRO:opioids have an important role in pain management in children[J]. Clin J Pain, 2019, 35(6):468-472. DOI URL
[4]	Li YZ, Deng KS. Application of virtual reality technology in the health field based on the background of big data[J]. J Phys Conf Ser, 2021, 1883(1):012175. DOI URL
[5]	卜晓繁, 谌永毅, 韦迪, 等. 虚拟现实技术在乳腺癌患者症状管理中的应用进展[J]. 中华护理杂志, 2020, 55(6):868-871. DOI
	Bu XF, Chen YY, Wei D, et al. Application progress of virtual reality technology in symptom management of breast cancer patients[J]. Chin J Nurs, 2020, 55(6):868-871.
[6]	金建芬, 陆骏, 俞梦盈, 等. 虚拟现实技术在心脏康复患者中的应用进展[J]. 中华护理杂志, 2021, 56(2):206-211. DOI
	Jin JF, Lu J, Yu MY, et al. Application progress of virtual reality technology in patients’ cardiac rehabilitation[J]. Chin J Nurs, 2021, 56(2):206-211.
[7]	叶磊, 荣芸, 丁洁芳, 等. 基于虚拟现实技术的干预对减轻成人患者术前焦虑效果的Meta分析[J]. 中华护理杂志, 2022, 57(11):1310-1317. DOI
	Ye L, Rong Y, Ding JF, et al. The effect of virtual reality intervention on improving preoperative anxiety in adult patients:a meta analysis[J]. Chin J Nurs, 2022, 57(11):1310-1317.
[8]	He ZH, Yang HM, Dela Rosa RD, et al. The effects of virtual reality technology on reducing pain in wound care:a meta-analysis and systematic review[J]. Int Wound J, 2022, 19(7):1810-1820. DOI URL
[9]	Woo K, Sibbald G, Fogh K, et al. Assessment and management of persistent (chronic) and total wound pain[J]. Int Wound J, 2008, 5(2):205-215. DOI PMID
[10]	Verschooren S, Schindler S, De Raedt R, et al. Switching attention from internal to external information processing:a review of the literature and empirical support of the resource sharing account[J]. Psychon Bull Rev, 2019, 26(2):468-490. DOI PMID
[11]	Rock AK, Truong H, Park YL, et al. Spinal cord stimulation[J]. Neurosurg Clin N Am, 2019, 30(2):169-194. DOI PMID
[12]	Gupta A, Scott K, Dukewich M. Innovative technology using virtual reality in the treatment of pain:does it reduce pain via distraction,or is there more to it?[J]. Pain Med, 2017, 19(1):151-159. DOI URL
[13]	Hoffman HG, Meyer WJ, Maribel R, et al. Feasibility of articulated arm mounted Oculus Rift Virtual Reality goggles for adjunctive pain control during occupational therapy in pediatric burn patients[J]. Cyberpsychology Behav Soc Netw, 2014, 17(6):397-401.
[14]	Matamala-Gomez M, Donegan T, Bottiroli S, et al. Immersive virtual reality and virtual embodiment for pain relief[J]. Front Hum Neurosci, 2019, 13:279. DOI PMID
[15]	Colloca L, Raghuraman N, Wang Y, et al. Virtual reality:physiological and behavioral mechanisms to increase individual pain tolerance limits[J]. Pain, 2020, 161(9):2010-2021. DOI URL
[16]	Lauwens Y, Rafaatpoor F, Corbeel K, et al. Immersive virtual reality as analgesia during dressing changes of hospitalized children and adolescents with burns:a systematic review with meta-analysis[J]. Children (Basel), 2020, 7(11):E194.
[17]	Spittle B, Frutos-Pascual M, Creed C, et al. A review of interaction techniques for immersive environments[J]. IEEE Trans Vis Comput Graph, 2022.
[18]	Kipping B, Rodger S, Miller K, et al. Virtual reality for acute pain reduction in adolescents undergoing burn wound care:a prospective randomized controlled trial[J]. Burns, 2012, 38(5):650-657. DOI URL
[19]	Ding J, He Y, Chen L, et al. Virtual reality distraction decreases pain during daily dressing changes following haemorrhoid surgery[J]. J Int Med Res, 2019, 47(9):4380-4388. DOI PMID
[20]	Esumi R, Yokochi A, Shimaoka M, et al. Virtual reality as a non-pharmacologic analgesic for fasciotomy wound infections in acute compartment syndrome:a case report[J]. J Med Case Rep, 2020, 14(1):46. DOI URL
[21]	Henry X, Shen JB, Wheeler KK, et al. Efficacy of smartphone active and passive virtual reality distraction vs standard care on burn pain among pediatric patients:a randomized clinical trial[J]. JAMA Netw Open, 2021, 4(6):e2112082. DOI URL
[22]	Mosadeghi S, Reid MW, Martinez B, et al. Feasibility of an immersive virtual reality intervention for hospitalized patients:an observational cohort study[J]. JMIR Ment Health, 2016, 3(2):e28. DOI URL
[23]	Da SA, Brandão M, et al. Virtual reality in pain relief during chronic wound dressing change[J]. Rev Esc Enferm USP, 2021, 55:e20200513. DOI URL
[24]	吴玉洁, 吴利平, 林光燕, 等. 虚拟现实技术在儿童感染伤口换药中的应用[J]. 解放军护理杂志, 2020, 37(11):17-20.
	Wu YJ, Wu LP, Lin GY, et al. Application of virtual reality in wound dressing changes for the children with infected wounds[J]. Nurs J Chin PLA, 2020, 37(11):17-20.
[25]	周春兰, 刘颖, 甄莉, 等. 慢性伤口患者基础疼痛及换药相关疼痛的调查分析[J]. 护理学杂志, 2016, 31(18):25-29.
	Zhou CL, Liu Y, Zhen L, et al. An investigation of baseline pain and dressing change-related pain among patients with chronic wounds[J]. J Nurs Sci, 2016, 31(18):25-29.
[26]	Hoffman HG, Doctor JN, Patterson DR, et al. Virtual reality as an adjunctive pain control during burn wound care in adolescent patients[J]. Pain, 2000, 85(1/2):305-309. DOI URL
[27]	崇武, 徐凤莹, 车晓艳. 虚拟现实技术在男性包皮患者术后换药疼痛影响的临床研究[J]. 中华男科学杂志, 2019, 25(10):942-944.
	Chong W, Xu FY, Che XY. Clinical study on the effect of virtual reality technology on pain caused by dressing change in male prepuce patients after operation[J]. Natl J Androl, 2019, 25(10):942-944.
[28]	Hoffman HG, Rodriguez RA, Gonzalez M, et al. Immersive virtual reality as an adjunctive non-opioid analgesic for pre-dominantly Latin American children with large severe burn wounds during burn wound cleaning in the intensive care unit:a pilot study[J]. Front Hum Neurosci, 2019, 13:262. DOI PMID
[29]	Patterson DR, Drever S, Soltani M, et al. A comparison of interactive immersive virtual reality and still nature pictures as distraction-based analgesia in burn wound care[J]. Burns, 2022,S0305-4179(22)00024-9.
[30]	Furness PJ, Phelan I, Babiker NT, et al. Reducing pain during wound dressings in burn care using virtual reality:a study of perceived impact and usability with patients and nurses[J]. J Burn Care Res, 2019, 40(6):878-885. DOI PMID
[31]	Luo HX, Cao C, Zhong J, et al. Adjunctive virtual reality for procedural pain management of burn patients during dressing change or physical therapy:a systematic review and meta-analysis of randomized controlled trials[J]. Wound Repair Regen, 2019, 27(1):90-101. DOI URL
[32]	陈琛, 陆巍. 虚拟现实疗法干预创面操作性疼痛效果的Meta分析[J]. 护理研究, 2018, 32(4):541-547.
	Chen C, Lu W. Meta analysis of effect of virtual reality therapy on operative pain of wound[J]. Chin Nurs Res, 2018, 32(4):541-547.
[33]	李晓庆, 李德丽, 殷欣, 等. 虚拟现实技术在减轻儿童操作性疼痛中的应用进展[J]. 中华护理杂志, 2021, 56(10):1589-1594. DOI
	Li XQ, Li DL, Yin X, et al. Application progress of virtual rea-lity in children with procedural pain[J]. Chin J Nurs, 2021, 56(10):1589-1594.
[34]	Hua Y, Qiu R, Yao WY, et al. The effect of virtual reality distraction on pain relief during dressing changes in children with chronic wounds on lower limbs[J]. Pain Manag Nurs, 2015, 16(5):685-691. DOI PMID
[35]	Corder G, Castro DC, Bruchas MR, et al. Endogenous and exogenous opioids in pain[J]. Annu Rev Neurosci, 2018, 41:453-473. DOI PMID
[36]	McSherry T, Atterbury M, Gartner S, et al. Randomized,cros-sover study of immersive virtual reality to decrease opioid use during painful wound care procedures in adults[J]. J Burn Care Res, 2018, 39(2):278-285. DOI PMID
[37]	Smith KL, Yang W, Luana C. Impact of virtual reality technology on pain and anxiety in pediatric burn patients:a systematic review and meta-analysis[J]. Front Virtual Real, 2021:160.
[38]	Hoffman HG, Patterson DR, Rodriguez RA, et al. Virtual reality analgesia for children with large severe burn wounds during burn wound debridement[J]. Front Virtual Real, 2020, 1:602299. DOI URL
[39]	Faber AW, Patterson DR, Bremer M. Repeated use of immersive virtual reality therapy to control pain during wound dressing changes in pediatric and adult burn patients[J]. J Burn Care Res, 2013, 34(5):563-568. DOI PMID
[40]	Das DA, Grimmer KA, Sparnon AL, et al. The efficacy of play-ing a virtual reality game in modulating pain for children with acute burn injuries:a randomized controlled trial[J]. BMC Pediatr, 2005, 5(1):1. DOI URL