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Virtual reality helps relieve procedural pain

23 Sep 2020

Patients undergoing medical procedures appear to benefit from virtual reality (VR)-based interventions in terms of alleviating pain, as shown in a study.

Researchers conducted a systematic review and meta-analysis of studies evaluating the utility of VR-based psychological interventions compared to treatment as usual (eg, analgesics alone, standard distraction) or another active comparator in patients of any age undergoing a painful procedure delivered in a medical setting.

Twenty-seven trials were included in the meta-analysis, with a total of 1,452 patients (659 in the VR group and 793 in the control group). Fourteen trials had parallel design and 13 had crossover design. Most of them were conducted for burns, while a few were for pain and distress related with needle procedures (eg, during intravenous port access placement or phlebotomy), dental treatment, and chemotherapy.

Pooled data revealed that compared with usual care, VR-based interventions reduced pain intensity both real-time (nine trials; Hedges' g, 0.95, 95 percent confidence interval [CI], 0.32–1.57) and retrospectively (22 trials; g, 0.87, 95 percent CI, 0.54–1.21).

Results were similar for secondary outcomes of cognitive (eight trials; g, 0.82, 95 percent CI, 0.39–1.26) and affective (14 trials; g, 0.55, 95 percent CI, 0.34–0.77) pain components.

There was marked heterogeneity, which was similarly high in sensitivity analyses. Risk of bias was low in few trials, and there was evidence of publication bias. Adverse events were rare.

Despite the positive results, the meta-analysis only amounts to establishing proof-of-concept, according to the researchers. Larger, prospectively registered and transparently reported phase III trials are needed before conclusions can be made about the clinical effectiveness of VR-based interventions, along with its potential for real-world implementation at a wider scale.

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Pearl Toh, 5 days ago
The combination therapy comprising carfilzomib, cyclophosphamide and dexamethasone (KCd) is effective, with a tolerable safety profile, in an Asian cohort with high-risk multiple myeloma (MM) — thus providing a more economical alternative as a potential upfront regimen in resource-limited settings, according to leading experts during a myeloma education webinar.
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