虚拟现实传递的疼痛心理学治疗可用于癌症相关神经性疼痛的可行性：一项飞行员随机对照试验

最近，已将虚拟现实传递的心理疗法作为急性和慢性疼痛的非药物管理进行了研究。但是，没有任何虚拟现实疼痛疗法软件可满足神经性疼痛的癌症患者的需求。我们创建了一个定制的虚拟现实疼痛疗法软件计划，以帮助癌症患者管理神经性疼痛，结合了可视化和进行性肌肉放松技术，同时最大程度地降低了这一脆弱患者人群的网络治Cybersickness的风险。这项随机对照试验研究评估了该疼痛疗法软件计划的可行性，可接受性，招聘率和Cybersickness的风险。临床结果包括阿片类药物消耗，疼痛严重程度，疼痛干扰和全球生活质量评分是次要目标。在87名合格的神经性疼痛患者中，招募了39例（47％），分配给干预措施（20例患者，虚拟现实疼痛疗法软件计划）或对照（19例患者，观看虚拟现实视频）。在3个月的随访之前（全部在对照组）之前，有四名患者退出了。预先存在的头晕（Spearmanρ0.37，p = 0.02）和预先存在的恶心（Spearmanρ0.81，p <0.001）与两组网络核电的风险显着相关。干预组中的患者报告的网络智能较少，并且耐受性并完成了所有治疗课程。在1个月和3个月的随访中，干预组有趋势降低：口服吗啡同等的每日剂量阿片类药物消耗（-8 mg和-4 mg; vs.对照组分别为0 mg和15 mg）；修改后的简短疼痛清单严重程度（-0.4，-0.8; vs.控制0.4，-0.3）;和疼痛干扰（-0.9，-1.8; vs.控制-0.2，-0.3）分数。欧洲研究和治疗癌症生活质量问卷C30的全球生活质量量表在1到3个月之间没有显着变化（干预：-5，-8；对照：3，4）。这项新创建的虚拟现实传递的疼痛疗法软件计划被证明是可行的，对于神经性疼痛的癌症患者是可行的，并且可以接受。这些结果将有助于设计确定的多中心随机对照试验。

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.