虚拟现实对儿童骨折治疗后克氏针取出过程中疼痛和压力的影响：一项随机临床试验。

IF 8.6 1区医学 Q1 SURGERY

British Journal of Surgery Pub Date : 2025-05-31 DOI:10.1093/bjs/znaf075

Kathrin Kelly,Juliane Pretzsch,Lena Altenburger,Julia Siebert,Alexander Tzabazis,Judith Lindert,Reinhard Vonthein,Ludger Tüshaus

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引用次数: 0

摘要

背景：儿童在上肢骨折治疗后取出克氏针是不愉快的。这项研究的目的是评估虚拟现实（VR）分心是否能改善儿童的疼痛和整体体验。方法在一个骨折门诊进行一项随机对照试验，其中6-15岁的儿童（6-15岁）在三个年龄层中以1:1的比例随机分配到额外的VR或标准护理。疼痛知觉由中立观察者和患者及其监护人分别使用Wong-Baker面部疼痛评定量表进行评估。进一步的测量包括面部/腿部/活动/哭泣/安慰（FLACC）疼痛量表，改进的耶鲁疼痛焦虑量表（mYPAS），问卷调查以及客观数据，如心率变异性和血压。结果共纳入146例患者。与对照组相比，VR组在Wong-Baker面部疼痛评定量表上的疼痛明显减轻（OR 0.23 (95% ci . 0.12至0.43)）。观察人员对VR组中43%的患者和对照组中74%的患者的疼痛评分为>2。观察量表（FLACC疼痛量表和mYPAS）在取丝过程中也显示疼痛减轻（OR分别为0.36 （95% ci . 0.19至0.24）和0.29 (95% ci . 0.16至0.52)）。VR组和对照组在取下k线后（分别为59%和69%）和2周后（分别为58%和70%）疼痛评分>2的差异较小。VR组患儿在拔线后和拔线后2周对疼痛刺激的意识较弱。结论vr牵引可有效减轻儿童k线拔除术中的疼痛。虚拟现实正向影响儿童的程序记忆。注册号drks00020229(德国注册克里尼斯彻学生(DRKS；即德国临床试验注册)；注册日期2019年12月10日)。

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Effect of virtual reality on pain and stress in children during Kirschner-wire removal after fracture treatment: a randomized clinical trial.

BACKGROUND Removal of Kirschner wires (K-wires) after fracture treatment in the upper limb is unpleasant for children. The aim of this study was to evaluate whether virtual reality (VR) distraction could improve pain and the overall experience for children. METHODS An RCT was performed in a single outpatient fracture clinic, where children (aged 6-15 years) were randomized 1 : 1, in three age strata, to additional VR or standard of care. Pain perception was assessed using the Wong-Baker Faces Pain Rating Scale by neutral observers and later by the patients and their guardians. Further measures included the Face/Legs/Activity/Cry/Consolability (FLACC) Pain Scale, the modified Yale Pain Anxiety Scale (mYPAS), and questionnaires, as well as objective data, such as heart rate variability and blood pressure. RESULTS A total of 146 patients were recruited into the trial. The VR group showed significantly less pain on the Wong-Baker Faces Pain Rating Scale (OR 0.23 (95% c.i. 0.12 to 0.43)) compared with the control group. Observers rated the pain >2 for 43% of patients in the VR group and 74% of patients in the control group. Observer scales (the FLACC Pain Scale and the mYPAS) during K-wire removal also indicated less pain (OR 0.36 (95% c.i. 0.19 to 0.24) and 0.29 (95% c.i. 0.16 to 0.52) respectively). The difference in pain rated >2 between the VR and control group was smaller directly after (59% versus 69% respectively) and 2 weeks after (58% versus 70% respectively) K-wire removal. Children in the VR group were less aware of the painful stimulus directly after and 2 weeks after wire extraction. CONCLUSION VR distraction effectively reduces pain during K-wire removal in children. VR positively impacts the procedural memory of children. REGISTRATION NUMBER DRKS00020229 (Deutsches Register Klinischer Studien (DRKS; that is the German Clinical Trials Register); date of registration 10 December 2019).

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来源期刊

British Journal of Surgery 医学-外科

CiteScore

12.70

自引率

7.30%

发文量

1102

审稿时长

1.5 months

期刊介绍： The British Journal of Surgery (BJS), incorporating the European Journal of Surgery, stands as Europe's leading peer-reviewed surgical journal. It serves as an invaluable platform for presenting high-quality clinical and laboratory-based research across a wide range of surgical topics. In addition to providing a comprehensive coverage of traditional surgical practices, BJS also showcases emerging areas in the field, such as minimally invasive therapy and interventional radiology. While the journal appeals to general surgeons, it also holds relevance for specialty surgeons and professionals working in closely related fields. By presenting cutting-edge research and advancements, BJS aims to revolutionize the way surgical knowledge is shared and contribute to the ongoing progress of the surgical community.