title: The efficacy of an augmented virtual reality system to alleviate pain in children undergoing burns dressing changes: a randomised controlled trial.
abstract: In children, the pain and anxiety associated with acute burn dressing changes can be severe, with drug treatment alone frequently proving to be inadequate. Virtual reality (VR) systems have been successfully trialled in limited numbers of adult and paediatric burn patients. Augmented reality (AR) differs from VR in that it overlays virtual images onto the physical world, instead of creating a complete virtual world. This prospective randomised controlled trial investigated the use of AR as an adjunct to analgesia and sedation in children with acute burns. Forty-two children (30 male and 12 female), with an age range of 3-14 years (median age 9 years) and a total burn surface area ranging from 1 to 16% were randomised into a treatment (AR) arm and a control (basic cognitive therapy) arm after administration of analgesia and/or sedation. Pain scores, pulse rates (PR), respiratory rates (RR) and oxygen saturations (SaO2) were recorded pre-procedurally, at 10 min intervals and post-procedurally. Parents were also asked to grade their child's overall pain score for the dressing change. Mean pain scores were significantly lower (p=0.0060) in the AR group compared to the control group, as were parental pain assessment scores (p=0.015). Respiratory and pulse rates showed significant changes over time within groups, however, these were not significantly different between the two study groups. Oxygen saturation did not differ significantly over time or between the two study groups. This trial shows that augmented reality is a useful adjunct to pharmacological analgesia.
authors.affiliation: Royal Children's Hospital Burns Research Group, University of Queensland, Department of Paediatrics and Child Health, Royal Children's Hospital, Brisbane, Queensland, Australia.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Mott
authors.forename: Sam
authors.initials: S
authors.lastname: Bucolo
authors.forename: Leila
authors.initials: L
authors.lastname: Cuttle
authors.forename: Julie
authors.initials: J
authors.lastname: Mill
authors.forename: Melanie
authors.initials: M
authors.lastname: Hilder
authors.forename: Kate
authors.initials: K
authors.lastname: Miller
authors.forename: Roy M
authors.initials: RM
authors.lastname: Kimble
mesh_terms: D000293:Adolescent; D000701:Analgesics, Opioid / Q000627:therapeutic use; D001458:Bandages; D002056:Burns / Q000150:complications / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D003198:Computer Simulation; D005260:Female; D006801:Humans; D008297:Male; D010146:Pain / Q000523:psychology; D059408:Pain Management; D010147:Pain Measurement / Q000379:methods*; D011446:Prospective Studies; D016896:Treatment Outcome; D014584:User-Computer Interface
chemical_list: D000701:Analgesics, Opioid