Virtual Reality Analgesia for Procedural Cancer Pain

虚拟现实镇痛治疗手术性癌症疼痛

• 批准号: 6937746
• 负责人: SAM R SHARAR
• 金额: $ 20万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-08-16 至 2007-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6937746
• 关键词: DVD /CD ROM; adolescence (12-20); alternative medicine; analgesia; bioengineering /biomedical engineering; body movement; clinical research; computer human interaction; computer program /software; computer simulation; computer system design /evaluation; computer system hardware; human middle age (35-64); human subject; neoplasm /cancer therapy; pain; patient oriented research; pediatrics; therapy adverse effect; videotape /videodisc

DESCRIPTION (provided by applicant) The consistent provision of effective pain relief with minimal side effects is a major therapeutic goal in cancer therapy. However, it often remains an elusive goal in patients, particularly in children, undergoing repeated oncologic procedures such as lumbar puncture and bone marrow aspiration. Pharmacologic techniques of sedation and analgesia are utilized in most clinical settings, but their widespread use is limited by associated economic costs and side effects (e.g., safety risk, discomfort, and inconvenience). Alternative and complementary, non-pharmacologic analgesic techniques have been adopted in some cancer settings, but their mechanisms, efficacy, and specific indications have been incompletely investigated. Based on the general principal of cognitive distraction, immersive virtual reality (VR) is an innovative non-pharmacologic analgesic technique. Our research group has demonstrated its preliminary efficacy in non-cancer settings of acute procedural pain in adults and children, and is exploring the mechanisms and determinants of its analgesic effects. For example, analgesic efficacy appears dependent on the degree of 'presence' (or immersion) the user feels in the virtual world, a sensation that is strongly influenced by the user's interaction with, and movement within the environment. In the current proposal, we shall build on this knowledge and focus on the application of VR analgesia to procedural cancer pain in a series of preclinical studies. The broad, long-term objectives of this project are: (1) to design and fabricate VR hardware and software that incorporate multisensory input to maximize user 'presence' in the virtual environment (and hence analgesia), in subjects in whom body position is fixed (e.g., for lumbar puncture) and whose movement or motion is severely restricted (i.e., 'Movement-Restricted Virtual Reality' -- MRVR); (2) to assess the analgesic efficacy and side effects of MRVR relative to standard clinical VR (where motion is tolerated and encouraged) and to 2-D video distraction (a currently available distraction therapy) in adult and adolescent subjects experiencing controlled, analog (thermal) pain; and (3) to collect and interpret these preliminary data in order to design future controlled clinical trials of MRVR in adults and children during painful oncologic procedures.

描述（由申请人提供） 持续提供有效的疼痛缓解和最小的副作用是癌症治疗的主要治疗目标。然而，对于接受腰椎穿刺和骨髓抽吸等重复肿瘤手术的患者，尤其是儿童来说，这通常仍然是一个难以捉摸的目标。镇静和镇痛的药理学技术在大多数临床环境中得到应用，但其广泛使用受到相关的经济成本和副作用（例如安全风险、不适和不便）的限制。一些癌症环境中已采用替代和补充的非药物镇痛技术，但其机制、功效和具体适应症尚未完全研究。基于认知分散的一般原理，沉浸式虚拟现实（VR）是一种创新的非药物镇痛技术。我们的研究小组已证明其对成人和儿童急性手术性疼痛的非癌症环境的初步疗效，并正在探索其镇痛作用的机制和决定因素。例如，镇痛功效似乎取决于用户在虚拟世界中感受到的“存在”（或沉浸）程度，这种感觉受到用户与环境的交互以及在环境中的移动的强烈影响。在当前的提案中，我们将基于这些知识，在一系列临床前研究中重点关注 VR 镇痛在手术性癌症疼痛中的应用。该项目的广泛、长期目标是：(1) 设计和制造包含多感官输入的 VR 硬件和软件，以最大限度地提高用户在虚拟环境中的“临场感”（从而实现镇痛），对于身体位置受到影响的受试者而言。固定的（例如腰椎穿刺）并且其运动或动作受到严格限制（即“运动受限虚拟现实”--MRVR）； (2) 评估 MRVR 相对于标准临床 VR（容忍和鼓励运动）和 2D 视频分散注意力（当前可用的分散注意力疗法）在经历受控模拟的成人和青少年受试者中的镇痛功效和副作用。热）痛； (3) 收集和解释这些初步数据，以便设计未来在成人和儿童疼痛肿瘤手术过程中进行 MRVR 的对照临床试验。