A 360° virtual reality tool to reduce opioid consumption, pain, and anxiety during dressing changes after burn...

Many patients experience severe pain during dressing change procedures for burn wounds, and require high doses of opioids. Given the risks associated with opioids, pharmacological and non-pharmacological adjuncts are commonly used to reduce pain while minimizing opioid use. One non-pharmacological adjunct is immersive virtual reality (VR). Emerging studies suggest that active VR, which allows users to interact with the virtual world, reduces pain during burn dressing changes. However, it remains unclear whether passive VR, where the viewer remains an observer, is similarly effective, and whether it reduces opioid use.

In this prospective, parallel-cohort, randomized controlled trial, 82 consenting participants received either standard multimodal analgesia (control group), or a passive VR intervention in addition to multimodal analgesia (VR group) during their dressing changes after autograft surgery. The primary outcome was cumulative peri-procedural opioid consumption during the first two dressing changes. Secondary outcomes included numeric pain and anxiety, and participant satisfaction.

There was no statistically significant difference in peri-procedural opioid consumption, or numeric pain or anxiety scores between the groups. Participants exposed to VR reported high levels of acceptability, particularly for anxiety reduction; 37/41 agreed that they would recommend immersive VR technology for patient care, including 31/41 who highly agreed and 6/41 who slightly agreed.

The addition of passive VR to standard multimodal analgesia did not reduce peri-procedural opioid consumption during painful post-autograft dressing changes. High participant and nurse acceptability suggests that passive VR may be feasible and well tolerated, although these findings should be interpreted as acceptability data rather than comparative evidence of analgesic benefit over standard care.