title: The efficacy of playing a virtual reality game in modulating pain for children with acute burn injuries: a randomized controlled trial [ISRCTN87413556].
abstract: BACKGROUND
  The management of burn injuries is reported as painful, distressing and a cause of anxiety in children and their parents. Child's and parents' pain and anxiety, often contributes to extended time required for burns management procedures, in particular the process of changing dressings. The traditional method of pharmacologic analgesia is often insufficient to cover the burnt child's pain, and it can have deleterious side effects 12. Intervention with Virtual Reality (VR) games is based on distraction or interruption in the way current thoughts, including pain, are processed by the brain. Research on adults supports the hypothesis that virtual reality has a positive influence on burns pain modulation.
  
  
  METHODS
  This study investigates whether playing a virtual reality game, decreases procedural pain in children aged 5-18 years with acute burn injuries. The paper reports on the findings of a pilot study, a randomised trial, in which seven children acted as their own controls though a series of 11 trials. Outcomes were pain measured using the self-report Faces Scale and findings of interviews with parent/carer and nurses.
  
  
  RESULTS
  The average pain scores (from the Faces Scale) for pharmacological analgesia only was, 4.1 (SD 2.9), while VR coupled with pharmacological analgesia, the average pain score was 1.3 (SD 1.8)
  
  
  CONCLUSIONS
  The study provides strong evidence supporting VR based games in providing analgesia with minimal side effects and little impact on the physical hospital environment, as well as its reusability and versatility, suggesting another option in the management of children's acute pain.
authors.affiliation: Centre of Allied Health Evidence, University of South Australia, Adelaide, Australia. debashish.das@unisa.edu.au <debashish.das@unisa.edu.au>
authors.forename: Debashish A
authors.initials: DA
authors.lastname: Das
authors.forename: Karen A
authors.initials: KA
authors.lastname: Grimmer
authors.forename: Anthony L
authors.initials: AL
authors.lastname: Sparnon
authors.forename: Sarah E
authors.initials: SE
authors.lastname: McRae
authors.forename: Bruce H
authors.initials: BH
authors.lastname: Thomas
mesh_terms: D000293:Adolescent; D000700:Analgesics / Q000627:therapeutic use; D001007:Anxiety / Q000209:etiology / Q000523:psychology; D002056:Burns / Q000150:complications / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D010146:Pain / Q000209:etiology; D059408:Pain Management; D010147:Pain Measurement; D016896:Treatment Outcome; D014584:User-Computer Interface; D018910:Video Games
chemical_list: D000700:Analgesics
references.citation: Curr Probl Pediatr. 1985 May;15(5):1-67
references.pmid: 2861066
references.citation: J Consult Clin Psychol. 1984 Oct;52(5):729-38
references.pmid: 6501658
references.citation: Pain. 1989 Aug;38(2):123-35
references.pmid: 2674861
references.citation: Oncol Nurs Forum. 1990 May-Jun;17(3):361-7
references.pmid: 2342970
references.citation: J Pain Symptom Manage. 1990 Dec;5(6):350-6
references.pmid: 2269802
references.citation: J Pain Symptom Manage. 1995 Aug;10(6):456-63
references.pmid: 7561228
references.citation: Cancer Surv. 1994;21:211-31
references.pmid: 8564995
references.citation: Int J Trauma Nurs. 1996 Jul-Sep;2(3):68-73
references.pmid: 9079333
references.citation: Pain. 2000 Mar;85(1-2):305-9
references.pmid: 10692634
references.citation: Clin J Pain. 2000 Sep;16(3):244-50
references.pmid: 11014398
references.citation: Clin J Pain. 2001 Sep;17(3):229-35
references.pmid: 11587113
references.citation: Oncol Nurs Forum. 2002 Jan-Feb;29(1):E8-E15
references.pmid: 11845217
references.citation: Crit Care Nurs Clin North Am. 2001 Jun;13(2):233-42
references.pmid: 11866405
references.citation: Pediatrics. 2003 Jul;112(1 Pt 1):116-23
references.pmid: 12837876
references.citation: Cyberpsychol Behav. 2003 Jun;6(3):301-7
references.pmid: 12855087
references.citation: Cyberpsychol Behav. 2003 Dec;6(6):633-8
references.pmid: 14756928
references.citation: Cyberpsychol Behav. 2003 Dec;6(6):657-61
references.pmid: 14756933
references.citation: Pain. 1983 Mar;15(3):271-82
references.pmid: 6134266
references.citation: Neurosci Lett. 1986 Feb 28;64(2):221-5
references.pmid: 3960401