Evaluating simulator sickness and acceptability of virtual reality prototype in pain management in hospitalized patients

Aim: Acute and chronic noncancer pain is a common healthcare problem locally and globally, and remains under treated and poorly controlled. We created a virtual reality (VR)-based prototype with customization of content to our local population. Materials & methods: This was an open-label, single center, single-arm study to examine the safety, acceptability and tolerability of the use of VR as an adjunctive tool for pain relief in hospitalized patients. The participants rated their baseline and post-VR pain and anxiety scores. Results & conclusion: All 50 patients completed the VR sessions with good tolerability and safety. Preliminary exploration of pain reduction indicated a positive effect (for pain and anxiety visual analog scale scores; p < 0.001). We believe VR is a potentially beneficial tool for use in pain management.

Implementing Battlefield Acupuncture Through a Large Medical System: Overcoming Barriers

Introduction: Developing a new and innovative acupuncture technique to deal with acute and chronic pain is a considerable undertaking in itself as many barriers must be overcome. Designing the technique and gaining acceptance is even more daunting and challenging across a large system of medical facilities such as the Department of Defense and the Veterans Administration. Such was the case of Battlefield Acupuncture (BFA), a 5-needle placement in each external ear into specific auricular points to treat acute and chronic pain. Discussion: This technique geared for military deployment is rapid, safe, and easily reproducible without side effects because it uses a choice acupuncture microsystem, namely the ear. Acquiring acupuncture practical skills is the prerequisite before designing the technique and then taking into consideration, neurophysiology data, and actual clinical experience to finally focus development is demanding. Conclusions: The benefits of BFA that was promulgated in a Joint Incentive Fund for $5.4 million resulted in thousands of trained health care providers and eventually many clinical trials to help validate the technique. Process improvement data were beneficial and important for its sustainment. There are 5 steps recommended for overcoming the barriers.

Traumatic osteoarthritis-induced persistent mechanical hyperalgesia in a rat model of anterior cruciate ligament transection plus a medial meniscectomy

Background

Osteoarthritis (OA) is a degenerative joint disease characterized by progressive cartilage degeneration, subchondral bone changes, osteophyte formation, and synovitis. A major symptom is pain that is triggered by peripheral and central changes within the pain pathways. Some surgery-induced joint instability rat models of OA were described to mimic traumatic OA. Several behavioral tests were developed to access OA-induced pain. However, follow-up in most studies usually only occurred for about 4 weeks. Since traumatic OA is a chronic disease which gradually develops after trauma, the pattern of pain might differ between early and late stages after the trauma.

Purpose

To observe the time-dependent development of hypersensitivity after traumatic OA and to determine the best timing and methods to investigate traumatic OA-induced pain.

Methods

Anterior cruciate ligament transection plus medial meniscectomy was used to induce traumatic OA in Sprague-Dawley rats. Traumatic OA-induced pain was evaluated using four different behavioral tests for 15 weeks.

Results

A significant difference in mechanical hypersensitivity developed throughout the observational period. It was worst in the first 3 weeks after the operation, then became less significant after 5 weeks but persisted. There were no differences in thermal hyperalgesia or motor coordination.

Conclusion

Traumatic OA induced mechanical hyperalgesia but did not cause thermal hyperalgesia or influence motor coordination. Furthermore, to investigate chronic pain induced by OA, the observational period should be at least 5 weeks after the intervention. These findings may help in further research and improve our understanding of traumatic OA-induced pain mechanisms.