With more identified drug dependence and abuse nationally is there an alternative to pain relief to break the cycle of addiction? The immediate response to a current inpatient reporting pain in the hospital setting is to prescribe opiates. The national drug overdose death rates involving opioids has increased in the last 10 years from 3.8 to 6.6 deaths per 100,00 Australians with 76% of these deaths attributable to pharmaceutical opioids. All Plastic and Reconstructive surgical patients whether a skin excision, burn or free flap can be exposed to opioids during their presentation to hospital.
A literature review was conducted using search engines Medline and Pubmed. Exclusion criteria included articles in a non-English language, inability to obtain the full text, hypnosis therapy and articles published prior to 2000. Key words included ‘virtual reality’, ‘pain management’, ‘opioid’, ‘distraction techniques’ and ‘future drug therapy’.
Eleven journal articles were identified including seven randomised control trials, two systematic reviews with meta-analysis and two case reports. Eight of the articles were related to management of pain associated with dressing changes in burn patients and the remainder of the articles were comparing post-procedural pain. The eleven articles showed promising results with a reduction in traditional pain management during the immersive virtual reality experience. In paediatric patients there was greater immersion with virtual reality correlating with a greater distraction technique and subsequent reduced requirement of opiates.
There appears to be a reduced requirement of opioid use when the patient is immersed in the virtual reality environment. The use of virtual reality may reduce opioid use and misuse among patients and provide new treatment options for patients who develop chronic pain as consequence of surgical intervention.