Relieves the pain of dressing changes in pediatric burn patients

Credit: Unsplash/CC0 public domain

According to the American Burn Association, burns affect about 250,000 children in the United States each year. The pain associated with burns extends beyond the injury itself. There is also significant pain when changing the dressing, which can be exacerbated by fear of anticipating this additional pain.

Opioids relieve burns associated with burn pain. They have serious harmful side effects. Previous studies have explored alternative approaches to pain relief for burn patients, with a focus on distractions, such as music, hypnosis, and toys. virtual reality (VR).

In the study published today, the JAMA Network opened Henry Xiang, MD, MPH, Ph.D., MBA and his research team Pediatric Patients I Burned. “Smartphone-based VR games were very effective in reducing the pain reported by patients,” said Dr. Xiang, professor of pediatrics and epidemiology at the National Children’s Hospital and director of the Center for Pediatric Trauma Research. says.

In a pilot study designed as a randomized clinical trial, the research team divided 90 children ages 6 to 17 into three treatment groups: active VR, passive VR, and standard care (toys, tablets, etc.). Most of these patients had two burns and burns from December 2016 to January 2019.

A VR game called “Virtual River Cruise” was designed specifically for research by the Children’s Research Information Solutions and Innovation Division across the country. “Two factors were taken into account in the design of the game,” explains Dr. Xiang out. “The first factor was the in-game snow and the cooling environment. The second factor was cognitive processing to promote active engagement.”

The patient played the game with a smartphone and headset. Patients in the active VR group actively participated in the game during a change of clothes lasting approximately 5-6 minutes. The patient tilted his head to aim at the target because he was quiet while playing the game, said Dr. Xiang. Patients in the passive VR group only watched the match.

Patients, along with their caregivers, reported perceived pain and the subjective experience of play in a post-intervention study. The nurse evaluated the clinical usefulness of the game.

Of the three treatment groups, patients in the active VR group had the lowest overall pain score. Most patients and their caregivers described the game as “fun, engaging and realistic” and reported positive experiences.

The nurses found this game clinically useful in outpatient settings. In the past, computer games were used to change clothes. However, the size of the computer was not clinically practical. “Smartphones are easy to use and most families have smartphones,” says Dr. Xiang.

Given the ease of use of VR games and the proven effectiveness of pain relief when changing burn dressings, Dr. Xiang game You also play at home to relieve this pain. “Paediatric burn patients still need to change their dressings at home after discharge, and these changes can be very painful,” said Dr. Xiang. dr. Xiang is currently leading a research project funded by the Ohio Department of Public Security’s Department of Emergency Medical Services that is assessing the feasibility and effectiveness of VR games to reduce the pain of changing at home. doing.

The current opioid crisis underscores the need to continue exploring non-opioid approaches to manage pain in burn patients. “The direction of future research is to assess whether smartphone-based VR games have opioid-saving effects,” said Dr. Xiang.

Study: Caregivers underestimate pain during burn replacement in children

For more information:
Distraction and standard treatment effectiveness of smartphone active and passive virtual reality for burn injuries in Xiang H, Shen J, Wheeler KK and other pediatric patients. JAMA network opened.. 2021; 4 (6): e2112082.

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National Children’s Hospital

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