Articles: acute-pain.
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Randomized Controlled Trial
Quantifying virtual reality pain modulation in healthy volunteers: A randomized, crossover study.
Virtual reality (VR) is an emerging tool to reduce pain and anxiety during procedures. Although VR's clinical benefits are reported, biometric data quantifying VR's effect on pain tolerance is lacking. We used time-lapse, subjective, and biometric data to evaluate VR's effect on modulating pain. ⋯ Participants with VR were more likely to survive the 4-min ice bath challenge longer and with lower levels of pain perception, supporting VR's effectiveness as a distraction tool during painful procedures. We observed no differences in sympathetic response when comparing VR to no VR.
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J Pain Palliat Care Pharmacother · Sep 2022
Evaluation of Guideline-Recommended Pain Management in Acute Sickle Cell Crisis and Its Effect on Patient Outcomes.
This was a retrospective, multi-site observational cohort of 233 encounters of patients with Sickle Cell Disease (SCD) who received analgesia for acute pain crisis related to SCD from January 1, 2019 to December 31, 2019. Patient encounters were categorized based on whether they received analgesia within guideline directed 60 minutes of emergency department (ED) arrival. The primary outcome was time to a pain score reduction of ≥30% on the numerical rating scale. ⋯ We found that patients with a history of substance use disorder documented in their chart were less likely to receive timely analgesia. Our study indicated that when patients with SCD received analgesia in accordance with guideline recommendations, pain goals were achieved faster with an improvement in outcomes. Providing optimal care can be difficult, but education and standardized policies may help mitigate this gap.
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Ocular surface burns can be caused by chemicals (alkalis and acids) or direct heat. One effect of the burn is damage to the limbal epithelial stem cells of the ocular surface with delayed re-epithelialisation, stem cell failure, and conjunctivalisation of the cornea. Amniotic membrane transplantation (AMT) performed in the acute phase (day 0 to day 7) following an ocular surface burn is claimed to reduce pain and accelerate healing. The surgery involves securing a layer of amniotic membrane (AM) to the eyelid margins as a patch to cover the entire ocular surface. However, there is debate about the severity of an ocular burn that may benefit from AMT and uncertainty of whether AMT improves outcomes. ⋯ There is uncertain evidence to support the treatment of moderate acute ocular surface burns with AMT in addition to standard medical therapy as a means of preventing failure of epithelialisation by day 21, improving visual outcome and reducing corneal neovascularisation, symblepharon formation and time-to-epithelialisation. For severe burns, the available evidence does not indicate any significant benefit of treatment with AMT.
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There is an urgent need for safe and effective nonpharmacologic approaches to treat chronic knee pain in older adults. Although virtual reality (VR) has shown some effectiveness for acute pain, there is limited evidence on the effects of VR on chronic pain particularly with older adult populations. This single application, within-subject pilot study evaluated the feasibility and effectiveness of VR as a clinical treatment for older adults with chronic osteoarthritis knee pain. ⋯ The findings also suggest VR meditation intervention had a positive effect on affect, with a significant large decrease in negative affect scores pre- to post-VR (d = 1.14). The significant moderate to large decreases in pain interference for normal work (d = 0.71), mood (d = 0.53), sleep (d = 0.67), and enjoyment of life (d = 0.72) suggest that older adults may have a higher ability to participate in meaningful daily activities up to 24-48 h after VR meditation. VR appears to be a feasible and effective nonpharmacological tool for older adults to treat chronic overall and knee-specific pain.