Feasibility of Mobile Phone-Based Virtual Reality as a Non-pharmacologic Acute Procedural Pain Management Intervention in an Inpatient Burn Center

Burn patients often experience severe procedural pain throughout hospitalization, and poorly controlled pain is a significant predictor of long-term psychological adjustment post-injury. Virtual Reality (VR) presents a promising adjunctive approach to pharmacological analgesics by redirecting patients' attention away from painful stimuli using immersive, multidimensional environments. Recent technological advances have made VR more affordable, portable, and hands-free permitting the head-mounted display to be easily transported with minimal set up, particularly conducive to hospital environments. This proof-of-concept randomized pilot trial compared VR-enhanced distraction to treatment as usual (TAU) during painful procedures (e.g., wound dressing changes) in hospitalized burn patients. Of 51 patients approached, 15 adults enrolled and 100% completed the study. VR was rated as highly enjoyable (M = 77.5/100) and moderately immersive (M = 63.3/100) with minimal side effects. Descriptively, VR participants demonstrated smaller increases in peri-procedural pain and anxiety relative to TAU and reported reduced cognitive pain during the procedure (i.e., time thinking about pain; M = 33.3 vs. 94.0). Within six hours post-procedure, fewer VR participants required pharmacologic analgesia compared to TAU participants (50.0% vs. 71.4%). Preliminary data indicate that portable VR appears to be a highly feasible and acceptable adjunct to traditional pharmacologic interventions for acute procedural pain in an inpatient burn center. Clinicaltrials.gov: NCT04685486.