Immersive Psychiatry

Virtual Reality + Ketamine: Immersive Therapy for Anxiety and Pain During Procedures

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In this episode, we will talk about procedures that cause anxiety or pain that have been paired with immersive technology (most often with virtual reality). We will start with a use case that is specific to psychiatry with the combination of virtual reality with ketamine infusions for chronic pain. Then we will go back to when I started exploring the uses of VR with my work using it during dental procedures. In the second half of the episode, we will talk about hospital-based procedural pain and anxiety along with the research for those areas. 

By the end of the episode, you will know about the kinds of software programs used for procedural pain and anxiety

  • Floating 2-D TV screens (aka a void theater, check out Netflix VR if you have a headset)
  • Immersive VR games for pain reduction 
  • Relaxing 360-degree videos
  • Relaxing Immersive VR environments 
  • VR programs with psychological content - Biofeedback with breath or heart rate and guided relaxation. 

    • Links to resources

    Ketamine (disclaimer there are no published papers on what Dr. Omer Liran has done with VR, but this is the closest thing) 

    Combining Ketamine and Virtual Reality Pain Control During Severe Burn Wound Care: One Military and One Civilian Patient

    Dentistry

    The Impact of Virtual Reality Distraction on Pain and Anxiety during Dental Treatment in 4-6 Year-Old Children: a Randomized Controlled Clinical Trial

    Virtual Reality Distraction for Pain Control During Periodontal Scaling and Root Planing Procedures

    Virtual Reality Relaxation to Decrease Dental Anxiety: Immediate Effect Randomized Clinical Trial

    Pediatrics

    Systematic Review and Meta-analysis of Virtual Reality in Pediatrics: Effects on Pain and Anxiety

    Guided relaxation-based virtual reality versus distraction-based virtual reality or passive control for postoperative pain management in children and adolescents undergoing Nuss repair of pectus excavatum: protocol for a prospective, randomized, controlled trial (FOREVR Peds trial)

    Provider-controlled virtual reality experience may adjust for cognitive load during vascular access in pediatric patients

    Virtual reality during pediatric vascular access: A pragmatic, prospective randomized, controlled trial

    • The above study is a negative study that was well designed which is important for the field. VR does not always do better than the standard of care. 

      • Adult medicine use cases

      Randomized, Crossover Study of Immersive Virtual Reality to Decrease Opioid Use During Painful Wound Care Procedures in Adults.

      Modulation of thermal pain-related brain activity with virtual reality: evidence from fMR

      Pain Distraction During Ambulatory Surgery: Virtual Reality and Mobile Devices

      Adjunctive virtual reality for procedural pain management of burn patients during dressing change or physical therapy: A systematic review and meta-analysis of randomized controlled trials


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      Immersive PsychiatryBy Brandon Birckhead, MD, MHDS
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