Houston, Texas, USA : Can virtual reality help reduce the pain of medical procedures?
When I was a child, I dreaded seeing the doctor. Before a visit, my heart beat faster, my vision went blurry and I would feel light-headed. This was because most visits involved needles, and I hate needles.
Does this experience sound familiar? It’s estimated over 60% of children have a fear of needles. For some, this fear can lead to anxiety and, in extreme cases, aichmophobia (a fear of all sharp objects).
If we could find a way to break the association of a doctor’s visit with pain and fear, it would be a huge relief for children—and their parents!
Thankfully, with modern tech, we’re already on our way.
Health service with a smile
Dr. Evelyn Chan has seen many children who were anxious and distressed about having a needle. Her experiences as a paediatric doctor inspired her to create Smileyscope—a virtual reality (VR) adventure to entertain and distract children from painful procedures like needles.
Evelyn says, “I knew there had to be a better way to manage children’s anxiety and pain during needle procedures. We started asking children what they would like to see, think and experience during needles.”
Virtual reality is an ideal solution as it allows children to “virtually escape the scary procedure room”, she says.
When children put on the Smileyscope VR headset, they go on an underwater adventure. Children blow bubbles, feed fish and search for other exciting sea creatures.
Smileyscope is easy to use, consisting of a smartphone and Google Daydream VR headset. Doctors can choose from short, medium or long experiences for different procedures.
Smileyscope is being used in 20 hospitals across Australia and the United States, including the St John of God hospitals in Perth.
Monash Children’s Hospital and the Royal Children’s Hospital in Melbourne led the world’s largest paediatric needle VR trial. The effectiveness of Smileyscope was tested with 252 patients aged 4 to 11 years. Compared to current practices, Smileyscope reduced pain and anxiety.
Smileyscope was designed specifically for needles, yet Evelyn reports clinicians are using it in creative ways, including for wound dressings, suturing and before anaesthesia/surgery.
Monash Medical Imaging has also found Smileyscope helps with medical imaging. Using Smileyscope significantly improved children’s cooperation and anxiety before MRI scans.
Virtual reality experiences are safe with little to no side effects. One possible side effect is nausea, which can be fixed by removing the headset.
But what is it about these experiences that make them so effective in healthcare?
A welcome distraction
Those cute pictures of puppies on your dentist’s ceiling have an important purpose. You feel less pain when distracted.
Pain is not just a physical sensation. Your mind influences the feeling of pain. If you focus on pain, it will feel more intense, but if your mind is distracted, it will feel less intense.
Virtual reality offers a more immersive distraction than pictures, television or toys. Wearing a VR headset also prevents patients from watching the procedure.
VR in medicine
Evelyn says Smileyscope is growing. “We are creating more VR content for different procedures, to help prepare, educate and support children through their entire healthcare journey.”
“We’re working together with talented and passionate clinicians, families, researchers, software engineers and digital artists to do this work.”
As VR becomes cheaper and more accessible, it is becoming a popular tool in medicine, including treating phobias, anxiety, pain and more.
Soon your visit to the doctor could include a virtual trip to a relaxing beach.
A second study found that virtual reality can be used to manage pain at a pediatric hospital.
Virtual reality can be used to manage pain at a pediatric hospital
Virtual reality has emerged into popular culture with an ever-widening array of applications including clinical use in a pediatric healthcare center. Children undergo necessary yet painful and distressing medical procedures every day, but very few non-pharmaceutical interventions have been found to successfully manage the pain and anxiety associated with these procedures. Investigators at Children’s Hospital Los Angeles have conducted a study to determine if virtual reality (VR) can be effectively used for pain management during blood draw. Their findings showed that VR significantly reduced patients’ and parents’ perception of acute pain, anxiety and general distress during the procedure. The results of the study are published in the Journal of Pediatric Psychology.
“Given the immersive and engaging nature of the VR experience, this technology has the capacity to act as a preventative intervention transforming the blood draw experience into a less distressing and potentially pain-free medical procedure, particularly for patients with more anxiety about having their blood drawn,” said Jeffrey I. Gold, PhD, the director of the Pediatric Pain Management Clinic at Children’s Hospital Los Angeles.
While previous research supported the effectiveness of distraction during painful procedures, specifically needle pain, the investigators hypothesized that the new VR technology, an arguably more powerful and immersive intervention could be even more effective at reducing pain and anxiety.
Gold and study co-author Nicole E. Mahrer, PhD, of the Department of Anesthesiology Critical Care Medicine at CHLA, theorize that ‘VR analgesia’ or pain control originates from the neurobiological interplay of the parts of the brain that regulate the visual, auditory, and touch sensory experience to produce an analgesic effect.
For the study, they recruited patients, ages 10 to 21 years, the patient’s caregiver and the phlebotomist in the outpatient blood draw clinic, and randomized them to receive either standard of care, which typically includes a topical anesthetic cream or spray and a movie playing in the room, or standard of care plus the virtual reality game when undergoing routine blood draw. Looking at pre-procedural and post-procedural standardized measures of pain, anxiety and satisfaction, researchers found that VR is feasible, tolerated, and well-liked by patients, their parents and the phlebotomists.
“VR, especially immersive VR, draws heavily on the limited cognitive resource of attention by drawing the user’s attention away from the hospital environment and the medical procedures and into the virtual world,” said Gold who is also a professor of Anesthesiology, Pediatrics, and Psychiatry & Behavioral Sciences at the Keck School of Medicine of USC.
Given the significant concerns about problematic opioid use, evidence-based support for non-pharmaceutical inventions may lead to use of VR for pain management during certain medical procedures and a decreased need for narcotics.
“Ultimately, the aim of future VR investigations should be to develop flexible VR environments to target specific acute and chronic pain conditions,” added Gold.
Citation for second study : Jeffrey I. Gold et al, Is Virtual Reality Ready for Prime Time in the Medical Space? A Randomized Control Trial of Pediatric Virtual Reality for Acute Procedural Pain Management, Journal of Pediatric Psychology.