虚拟现实传递的心理治疗方法已近期被研究为急慢性疼痛的非药物管理方案。但是，尚不存在适合神经病理性疼痛的癌症患者需求的虚拟现实疼痛治疗软件。我们开发了一个定制的虚拟现实疼痛治疗软件计划，帮助癌症患者通过引导想象和渐进性肌肉放松技术来管理神经病理性疼痛，同时在这个易感人群中尽可能减少产生晕动症的风险。这项随机对照试验评估了这种疼痛治疗软件计划的可行性、可接受性、招募率和晕动症的风险，临床结果包括阿片类药物消耗、疼痛严重程度、疼痛干扰和全局生活质量评分属于次要目标。在87位符合条件的神经病理性疼痛癌症患者中，招募了39位（47%），分配到干预组（20名患者，虚拟现实疼痛治疗软件计划）或对照组（19名患者，观看虚拟现实视频）。在3个月的跟踪调查前，有4名患者退出（均为对照组）。先前的头晕（Spearman ρ 0.37，p = 0.02）和先前的恶心（Spearman ρ 0.81，p < 0.001）在两组中均与晕动症的风险显著相关。干预组的患者报告有较少的晕动症，而且耐受并完成了所有的治疗课程。在1个和3个月的跟踪调查中，干预组在口服吗啡当量日剂量减少（-8 mg和-4 mg；对照组：0 mg和+15 mg）；改编版疼痛调查问卷疼痛严重程度（-0.4, -0.8 vs 对照组 0.4, -0.3）和疼痛干扰（-0.9, -1.8 vs 对照组 -0.2, -0.3）评分上有减少趋势。欧洲研究与治疗癌症生活质量评估问卷-C30的全球生活质量子量表在1个和3个月时，在两组之间没有显著变化（干预组：-5，-8 vs 对照组：+3，+4）。这个新开发的虚拟现实疼痛治疗软件计划被证明适合癌症患者使用，有其可行性和可接受性。这些结果将有助于设计一个确定性的多中心随机对照试验。©2023作者。麻醉出版社代表麻醉医师协会出版。

Virtual reality-delivered psychological therapies have recently been investigated as non-pharmacological management for acute and chronic pain. However, no virtual reality pain therapy software existed that met the needs of cancer patients with neuropathic pain. We created a bespoke virtual reality-delivered pain therapy software programme to help cancer patients manage neuropathic pain incorporating guided visualisation and progressive muscle relaxation techniques, whilst minimising the risk of cybersickness in this vulnerable patient population. This randomised controlled pilot study evaluated the feasibility, acceptability, recruitment rates and risk of cybersickness of this pain therapy software programme. Clinical outcomes including opioid consumption, pain severity, pain interference and global quality of life scores were secondary aims. Of 87 eligible cancer patients with neuropathic pain, 39 were recruited (47%), allocated to either the intervention (20 patients, virtual reality pain therapy software programme) or control (19 patients, viewing virtual reality videos). Four patients withdrew before the 3-month follow-up (all in the control group). Pre-existing dizziness (Spearman ρ 0.37, p = 0.02) and pre-existing nausea (Spearman ρ 0.81, p < 0.001) were significantly associated with risk of cybersickness in both groups. Patients in the intervention group reported less cybersickness, as well as tolerated and completed all therapy sessions. At 1- and 3-month follow-up, there were trends in the intervention group towards reductions in: oral morphine equivalent daily dose opioid consumption (-8 mg and -4 mg; vs. control: 0 mg and +15 mg respectively); modified Brief Pain Inventory pain severity (-0.4, -0.8; vs. control +0.4, -0.3); and pain interference (-0.9, -1.8; vs. control -0.2, -0.3) scores. The global quality of life subscale from the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-C30 was not significantly changed between groups at 1 and 3 months (intervention: -5, -8; vs. control: +3, +4). This newly created virtual reality-delivered pain therapy software programme was shown to be feasible and acceptable to cancer patients with neuropathic pain. These results will aid the design of a definitive multicentre randomised controlled trial.© 2023 The Authors. Anaesthesia published by John Wiley & Sons Ltd on behalf of Association of Anaesthetists.