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Using Virtual Reality Exposure Therapy in Pain Management: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

  • Qiangru Huang
    Affiliations
    Department of Breast Surgery, Xiangya Hospital of Central South University, Changsha, China

    School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
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  • Junqing Lin
    Affiliations
    Department of Orthopaedic Surgery, Shanghai Jiaotong University Affiliated, Sixth People’s Hospital, Shanghai, China
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  • Rui Han
    Affiliations
    Department of Pain, Third Xiangya Hospital of Central South University, Changsha, China
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  • Cheng Peng
    Correspondence
    Cheng Peng, MD, PhD, Department of Burn and Plastic Surgery, Department of Anesthesiology, Third Xiangya Hospital of Central South University, 138 Tongzipo Rd, Changsha, Hunan, China 410013.
    Affiliations
    Department of Burn and Plastic Surgery, Third Xiangya Hospital of Central South University, Changsha, China

    Department of Anesthesiology, Third Xiangya Hospital of Central South University, Changsha, China
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  • Aji Huang
    Correspondence
    Correspondence: Aji Huang, MD, PhD, Department of Breast Surgery, Xiangya Hospital of Central South University, 87 Xiangya Rd, Changsha, Hunan, China 410008.
    Affiliations
    Department of Breast Surgery, Xiangya Hospital of Central South University, Changsha, China

    Clinical Research Center for Breast Cancer in Hunan Province, Changsha, China
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Published:October 08, 2021DOI:https://doi.org/10.1016/j.jval.2021.04.1285

      Abstract

      Objectives

      This study aimed to assess the effectiveness of virtual reality (VR) in managing different types of pain in different age groups and to provide evidence for the clinical application of new alternative strategy for pain management.

      Methods

      Electronic databases, including the Cochrane Library, PubMed, EMBASE, and the Web of Science, were searched for studies published up to October 2020. Randomized controlled trials that reported on VR for pain management were included.

      Results

      A total of 31 randomized controlled trials were included. As for the pain intensity, the increase of visual analog scale score in the VR group was 1.62 scores less than that in the control group. In juvenile patients, the VR group had 1.79 scores lower than that in control group. For adult patients, the VR group had 1.34 scores lower than that in control group. As for other pain-related indicators, the VR group had lower levels of anxiety, lower pain unpleasantness, lower pulse rate, and shorter duration of dressing change and spent less time thinking about pain. Nevertheless, there was no statistical difference in pain tolerance. VR can effectively alleviate acute pain. In terms of chronic low back pain and cancer-related pain, there was no statistical difference between VR therapy and standard therapy.

      Conclusions

      VR is a feasible alternative therapy for both juveniles and adults in pain management, and it has a greater potential for juveniles. VR can effectively alleviate acute pain. Nevertheless, VR showed little effectiveness in increasing pain tolerance, which may explain in part the ineffectiveness of VR therapy in pain management for chronic pain.

      Keywords

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