Analgesic Use of Virtual Reality for Burn Dressing Changes in Low- and Middle-income Countries: A Feasibility Study.

Abstract

The paucity of pain management options in resource-limited settings is a significant and systemically unaddressed problem. To improve global health equity, it is important to bridge this gap in care without introducing the peril of opioid dependence. We present a proof-of-concept case series wherein virtual reality (VR) was successfully used to manage discomfort in patients undergoing burn dressing changes in sub-Saharan Africa. Nine patients presenting with burn injuries of variable severity underwent routine stabilization and dressing as part of standard-of-care treatment. During dressing changes, a VR intervention consisting of the Dream Flight interactive game displayed on an Oculus Quest 2 headset was offered to patients. Patient mood scores were collected before VR initiation and at the conclusion of the dressing change by a translator using the Youth Feelings Scale. There were no adverse events associated with use of the VR headset and no patients elected to terminate the VR during their procedure. Patients and physicians subjectively reported satisfaction with the device's utility in the procedure. Before VR initiation, the 95% confidence interval for patient mood score was 4.89 ± 1.725. After VR initiation, the 95% confidence interval for patient mood score was 8.78 ± 1.40. Our results of this proof-of-concept case series to suggest both feasibility of use and positive influence on patient discomfort and periprocedural satisfaction. We propose that VR should be explored as an analgesic alternative and/or adjunct to narcotics in resource-limited countries, particularly for high-pain, low-duration procedures.