Pain control during burn wound care : virtual reality with analgesia vs analgesia alone

Abstract

Wound care of burn injuries can be a very painful procedure and analgesia provided is often inadequate. This evidence-based dissertation focuses on the research question; 'Is virtual reality with analgesia more effective than analgesia alone in reducing pain during wound care of patients with burns?' The PICO elements of this question are; P- Patients with burns undergoing wound care, I- Virtual reality with analgesia, C- Analgesia alone, O- Reduced pain. A literature review was conducted based on this framework. The main sources used to obtain literature were PubMed, Advanced Google Scholar, Mendeley and multiple databases accessed through HyDi. Studies were considered relevant if they were peerreviewed, in English and published within the last 10 years. Studies of lower levels of evidence and those using virtual reality to induce hypnosis were not included. Critical appraisal was guided by the Critical Review Form for Quantitative Studies, AMSTAR and CASP tools. A total of 310 hits were obtained from this search, 6 of which were selected to answer the PICO question. These included one systematic review, four RCTs and one non-randomised controlled trial. Virtual reality tended to lower pain in most patients. It was most effective in patients with long wound care sessions and in those experiencing the highest levels of pain. Although virtual reality seems to be effective in adjunction to analgesia, there is a need for further research before this technology can be implemented. The main recommendations provided in this dissertation include the encouragement of further research in this area of study and increasing awareness of alternative methods for pain control among health care professionals.