scholarly journals Utilising Virtual Reality in Pain Management: A Systematic Review

2021 ◽  
Vol 16 (2) ◽  
pp. 52-71
Author(s):  
Faiz Daud ◽  
Keyword(s):  
Systematic Review ◽  
Chronic Pain ◽  
Virtual Reality ◽  
Pain Management ◽  
Acute Pain ◽  
Burn Injury ◽  
Behavioral Therapy ◽  
Chronic Neck Pain ◽  
Complementary Therapy ◽  
Orthopedic Diseases

Virtual reality (VR) offers patient with a drug free supplement, an alternative or complementary therapy to traditional pain management. VR technology allowing its use in a wide variety of settings in the medicine world. So, we would like to evaluate the current existing evidence supporting VR in pain management. We conducted a systematic review of interventional and observational studies that examined VR applications in pain management between 2010 and 2019. We used Scopus databases, PubMed, Web of Science, Ovid MEDLINE and EBSCOhost to identify the studies using keywords “patient”, “virtual reality”, “medicine” and “pain management”. Data was obtained by two investigators and agreement was reached with the involvement of a third and fourth investigator. Narrative synthesis for all research was done. A total of 451 citations were identified, among which 12 studies met the criteria for inclusion. Studies involve various countries with participant age ranging from 6 to 75 years old. Studies were small, employed different design, instrument and measure for outcome. Studies addressed experimental, acute and chronic pain with four categories of condition which are burn injury, orthopedic diseases and chronic headache. VR was effective during the procedure in experimental and acute pain management. Majority of studies involving VR in painful physical rehabilitation therapy found VR reduced chronic pain and some provide evidence of lasting analgesia effect of VR after therapy. The usage of VR in chronic pain in term of psychological and cognitive behavioral therapy (CBT) showed improvement of positive mood, emotional and motivation that could lead to improvement of quality of life. VR also useful to elicit findings during painful cervical kinematics assessment in chronic neck pain. VR is a promising technology to be applied in managing chronic and acute pain. Some research showed that VR usage is able to provide lasting effect of analgesia even after VR session. However, there is a need for long term, larger sample sizes and well controlled studies to show clinical and cost-effectiveness for this technology to be used in clinical settings.

Monoterpenes as Perspective to Chronic Pain Management: A Systematic Review

2018 ◽  
Vol 19 (8) ◽  
pp. 960-972 ◽  
Author(s):  
Daniele Nascimento Gouveia ◽  
Lícia Tairiny Santos Pina ◽  
Thallita Kelly Rabelo ◽  
Wagner Barbosa da Rocha Santos ◽  
Jullyana Souza Siqueira Quintans ◽  
...  
Keyword(s):  
Systematic Review ◽  
Chronic Pain ◽  
Pain Management ◽  
Chronic Pain Management

scholarly journals The Prevalence and Severity of Chronic Pain in Patients With Chronic Kidney Disease: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 8 ◽  
pp. 205435812199399
Author(s):  
Sara N. Davison ◽  
Sarah Rathwell ◽  
Sunita Ghosh ◽  
Chelsy George ◽  
Ted Pfister ◽  
...  
Keyword(s):  
Systematic Review ◽  
Chronic Kidney Disease ◽  
Chronic Pain ◽  
Pain Management ◽  
Meta Analysis ◽  
Pain Severity ◽  
Chronic Pain Management ◽  
Dialysis Patients ◽  
Severity Scores ◽  
The Mean

Background: Chronic pain is a common and distressing symptom reported by patients with chronic kidney disease (CKD). Clinical practice and research in this area do not appear to be advancing sufficiently to address the issue of chronic pain management in patients with CKD. Objectives: To determine the prevalence and severity of chronic pain in patients with CKD. Design: Systematic review and meta-analysis. Setting: Interventional and observational studies presenting data from 2000 or later. Exclusion criteria included acute kidney injury or studies that limited the study population to a specific cause, symptom, and/or comorbidity. Patients: Adults with glomerular filtration rate (GFR) category 3 to 5 CKD including dialysis patients and those managed conservatively without dialysis. Measurements: Data extracted included title, first author, design, country, year of data collection, publication year, mean age, stage of CKD, prevalence of pain, and severity of pain. Methods: Databases searched included MEDLINE, CINAHL, EMBASE, and Cochrane Library, last searched on February 3, 2020. Two reviewers independently screened all titles and abstracts, assessed potentially relevant articles, and extracted data. We estimated pooled prevalence of overall chronic pain, musculoskeletal pain, bone/joint pain, muscle pain/soreness, and neuropathic pain and the I2 statistic was computed to measure heterogeneity. Random effects models were used to account for variations in study design and sample populations and a double arcsine transformation was used in the model calculations to account for potential overweighting of studies reporting either very high or very low prevalence measurements. Pain severity scores were calibrated to a score out of 10, to compare across studies. Weighted mean severity scores and 95% confidence intervals were reported. Results: Sixty-eight studies representing 16 558 patients from 26 countries were included. The mean prevalence of chronic pain in hemodialysis patients was 60.5%, and the mean prevalence of moderate or severe pain was 43.6%. Although limited, pain prevalence data for peritoneal dialysis patients (35.9%), those managed conservatively without dialysis (59.8%), those following withdrawal of dialysis (39.2%), and patients with earlier GFR category of CKD (61.2%) suggest similarly high prevalence rates. Limitations: Studies lacked a consistent approach to defining the chronicity and nature of pain. There was also variability in the measures used to determine pain severity, limiting the ability to compare findings across populations. Furthermore, most studies reported mean severity scores for the entire cohort, rather than reporting the prevalence (numerator and denominator) for each of the pain severity categories (mild, moderate, and severe). Mean severity scores for a population do not allow for “responder analyses” nor allow for an understanding of clinically relevant pain. Conclusions: Chronic pain is common and often severe across diverse CKD populations providing a strong imperative to establish chronic pain management as a clinical and research priority. Future research needs to move toward a better understanding of the determinants of chronic pain and to evaluating the effectiveness of pain management strategies with particular attention to the patient outcomes such as overall symptom burden, physical function, and quality of life. The current variability in the outcome measures used to assess pain limits the ability to pool data or make comparisons among studies, which will hinder future evaluations of the efficacy and effectiveness of treatments. Recommendations for measuring and reporting pain in future CKD studies are provided. Trial registration: PROSPERO Registration number CRD42020166965

Pharmacist‐led intervention on chronic pain management: A systematic review and meta‐analysis

2021 ◽  
Author(s):  
Parbati Thapa ◽  
Shaun Wen Huey Lee ◽  
Bhuvan KC ◽  
Juman Abdulelah Dujaili ◽  
Mohamed Izham Mohamed Ibrahim ◽  
...  
Keyword(s):  
Systematic Review ◽  
Chronic Pain ◽  
Pain Management ◽  
Meta Analysis ◽  
Chronic Pain Management

scholarly journals The Effectiveness of Virtual Reality in Managing Acute Pain and Anxiety for Medical Inpatients: Systematic Review

10.2196/17980 ◽  
2020 ◽  
Vol 22 (11) ◽  
pp. e17980
Author(s):  
Vinayak Smith ◽  
Ritesh Rikain Warty ◽  
Joel Arun Sursas ◽  
Olivia Payne ◽  
Amrish Nair ◽  
...  
Keyword(s):  
Systematic Review ◽  
Virtual Reality ◽  
Side Effects ◽  
Acute Pain ◽  
Clinical Setting ◽  
Reality Therapy ◽  
Autonomic Arousal ◽  
Inpatient Setting ◽  
Virtual Reality Therapy ◽  
Head Mounted Display

Background Virtual reality is increasingly being utilized by clinicians to facilitate analgesia and anxiolysis within an inpatient setting. There is however, a lack of a clinically relevant review to guide its use for this purpose. Objective To systematically review the current evidence for the efficacy of virtual reality as an analgesic in the management of acute pain and anxiolysis in an inpatient setting. Methods A comprehensive search was conducted up to and including January 2019 on PubMed, Ovid Medline, EMBASE, and Cochrane Database of Systematic reviews according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Search terms included virtual reality, vr, and pain. Primary articles with a focus on acute pain in the clinical setting were considered for the review. Primary outcome measures included degree of analgesia afforded by virtual reality therapy, degree of anxiolysis afforded by virtual reality therapy, effect of virtual reality on physiological parameters, side effects precipitated by virtual reality, virtual reality content type, and type of equipment utilized. Results Eighteen studies were deemed eligible for inclusion in this systematic review; 67% (12/18) of studies demonstrated significant reductions in pain with the utilization of virtual reality; 44% (8/18) of studies assessed the effects of virtual reality on procedural anxiety, with 50% (4/8) of these demonstrating significant reductions; 28% (5/18) of studies screened for side effects with incidence rates of 0.5% to 8%; 39% (7/18) of studies evaluated the effects of virtual reality on autonomic arousal as a biomarker of pain, with 29% (2/7) demonstrating significant changes; 100% (18/18) of studies utilized a head mounted display to deliver virtual reality therapy, with 50% being in active form (participants interacting with the environment) and 50% being in passive form (participants observing the content only). Conclusions Available evidence suggests that virtual reality therapy can be applied to facilitate analgesia for acute pain in a variety of inpatient settings. Its effects, however, are likely to vary by patient population and indication. This highlights the need for individualized pilot testing of virtual reality therapy’s effects for each specific clinical use case rather than generalizing its use for the broad indication of facilitating analgesia. In addition, virtual reality therapy has the added potential of concurrently providing procedural anxiolysis, thereby improving patient experience and cooperation, while being associated with a low incidence of side effects (nausea, vomiting, eye strain, and dizziness). Furthermore, findings indicated a head mounted display should be utilized to deliver virtual reality therapy in a clinical setting with a slight preference for active over passive virtual reality for analgesia. There, however, appears to be insufficient evidence to substantiate the effect of virtual reality on autonomic arousal, and this should be considered at best to be for investigational uses, at present.

scholarly journals Efficacy and Safety of Intranasal Ketamine for Acute Pain Management in the Emergency Setting: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 10 (17) ◽  
pp. 3978
Author(s):  
Yee Sin Seak ◽  
Junainah Nor ◽  
Tuan Hairulnizam Tuan Kamauzaman ◽  
Ariff Arithra ◽  
Md Asiful Islam
Keyword(s):  
Systematic Review ◽  
Pain Management ◽  
Acute Pain ◽  
Meta Analysis ◽  
Emergency Setting ◽  
Efficacy And Safety ◽  
Acute Pain Management ◽  
Significant Difference ◽  
Mean Differences ◽  
Randomised Controlled

Due to overcrowding, personnel shortages, or problematic intravenous (IV) cannulation, acute pain management is often sub-optimal in emergency departments (EDs). The objective of this systematic review and meta-analysis was to evaluate the efficacy and safety of intranasal (IN) ketamine for adult acute pain in the emergency setting. We searched and identified studies up to 21 May 2021 via PubMed, Scopus, Web of Science, Cochrane Database, and Google Scholar. The random-effects model with 95% confidence intervals (CIs) was used to estimate mean differences (MDs) and odds ratios (ORs). The I2 statistic and Cochran’s Q test were used to determine heterogeneity. The protocol was registered in PROSPERO (CRD42020213391). Seven randomised controlled trials were included with a total of 1760 patients. There was no significant difference in pain scores comparing IN ketamine with IV analgesics or placebo at 5 (MD 0.94, p = 0.26), 15 (MD 0.15, p = 0.74), 25 (MD 0.24, p = 0.62), 30 (MD −0.05, p = 0.87), and 60 (MD −0.42, p = 0.53) minutes. There was also no significant difference in the need for rescue analgesics between IN ketamine and IV analgesics (OR 1.66, 95% CI: 0.57−4.86, p = 0.35, I2 = 70%). Only mild adverse effects were observed in patients who received IN ketamine. Our results suggest that IN ketamine is non-inferior to IV analgesics and may have a role in acute pain management among adults in the ED.

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