The Clinical Utility of Virtual Reality in Inpatient Pain Management Among Patients with Gastrointestinal Disorders

Abstract

Introduction: Improvements in soft ware, design, and cost reduction have made virtual reality (VR) a practical tool for an immersive, multi-sensory experience to distract patients from painful stimuli. While the utility of VR for pain management has been evaluated among few specific conditions, to our knowledge it has not been tested among hospitalized patients with gastrointestinal (GI) disorders. Herein, we evaluated the clinical utility of VR for inpatient pain management and its effect on blood pressure and heart rate in a cohort of hospitalized patients with a variety of GI disorders. Methods: We screened patients admitted to the inpatient medicine service for GI-related illnesses during a 4-month period. We excluded patients with nausea, vomiting, dementia, motion sickness, stroke, seizure, epilepsy, and those in infectious isolation. Patients with at least one self-reported pain score of three or greater during the 24 hours preceding patient screening were selected to participate in the study. Eligible patients viewed a specific VR experience designed to reduce pain using the Samsung Gear Oculus VR goggles (Figure 1). We then compared pre and post intervention pain scores, blood pressure, and heart rate within subjects.Figure 1Results: A total of 13 patients participated in the study (Table 1). There was a statistically significant reduction in self-reported pain scores post VR intervention compared to before the intervention (pre-VR Mean = 3.8462 vs. post-VR Mean = 3.0000; P = 0.0025) corresponding to a 22% pain reduction and an observed effect size of 1.06 (Table 2). When adjusting for patients who reported no pain prior to VR intervention, similar findings were observed with a larger effect size of 1.83 (pre-VR Mean = 5.5556 vs. post-VR Mean = 4.3333; P = 0.0006). We did not observe a statistically significant change in systolic blood pressure, diastolic blood pressure, or mean heart rate (Table 2). Additionally, patients tolerated the intervention well and did not report any adverse effects.Table 1: Patient CharacteristicsTable 2: Physiological OutcomesConclusion: The use of VR for inpatients with GI disorders resulted in significant improvements in patient-reported pain scores, without influencing blood pressure and heart rate. VR is a potentially safe and practical tool to augment pain management in the acute inpatient setting. Further studies are indicated to further validate these findings, determine which subtypes of GI patients would benefit most from VR, and discover if long-term improvements in patient-reported pain scores are possible.