Immersive virtual reality (VR)
Pain has been declared the “fifth vital sign”, signifying its importance to patients and health care providers. A common therapeutic goal in American hospitals is to ensure that patients have a pain score of 4 or less (out of ten) after surgery .
Unfortunately, all pharmaceutical pain treatments have potential side-effects. The aggressive treatment of postoperative pain with standard pain killers may lead to a range of complications, including gastro-intestinal side-effects (nausea, vomiting, constipation), over-sedation, hematological problems (bleeding or thrombosis), and even death from respiratory depression. Non-pharmacological approaches to the treatment of pain, such as hypnotherapy, acupuncture and music, are therefore an attractive option.
A recent study of immersive Virtual Reality (VR) published in the journal Anesthesia & Analgesia (Dec 2007) adds to the evidence that this technology can be useful in the treatment of pain.
Nine volunteers had a standardized painful thermal (heat) stimulus applied to the back of the foot while receiving one of four different treatments: (1) hydromorphone (Dilaudid), (2) VR, (3) both hydromorphone and VR, or (4) no analgesia. Each volunteer experienced, during separate sessions, all four of the treatments. Hydromorphone is an opioid (morphine-like drug) commonly used in the US to treat postoperative pain.
VR goggles immersed the subjects in SnowWorld, (developed by the Human Interface Technology group at the University of Washington) a 3D virtual environment featuring an icy canyon in which the participant “shoots” snowballs at penguins and snowmen.
Pain scores were lower in those who received hydromorphone or VR, and lowest in those who got both. Volunteers also underwent functional MRI imaging (fMRI) which revealed in the treated subjects less activity in five areas of the brain known to be associated with the experience of pain. VR was also more fun!
VR distracts from the perception of pain. Reading a book or talking to a friend probably accomplishes the same effect, but VR appears to be a much more powerful distraction. The VR experience gives the participant the feeling of being “inside” the environment, thanks to the high-resolution, wide field-of-view head-mounted display, 3D sound effects, head-tracking and user interaction with the environment. VR may cause motion sickness in some participants.
This technology has already been used successfully in clinical environments, such as the dressing of burn wounds, and other painful procedures. Undoubtedly we will see more use of this as an accompaniment to conventional drug treatment as the technology matures and moves out of the experimental realm.
What you can do about it:
Take your Nintendo or Playstation with you to hospital!