The treatment of postoperative pain after severe trauma is poorly understood, and it can lead to chronic pain, opiate drug addiction and elevated health care costs. The proposed project will be a randomized controlled trial to evaluate an innovative methodology for delivering clinical hypnosis (virtual reality hypnosis) for pain control as well as a more time-honored delivery system that uses audio recordings. The goal will be to reduce postoperative pain in a sample of patients hospitalized for the care of severe orthopedic trauma. 300 patients admitted to a major regional trauma center will be randomly assigned to groups that receive virtual reality hypnosis (VRH), standard audio hypnosis (via CD or MP3 player) or standard control. The orthopedic trauma will involve long bone or pelvic fractures. The VRH intervention will involve immersive virtual reality technology, which allows the patient to enter a three-dimensional, illusory world designed to capture attention and create a sense of presence. Patients will receive this intervention 1-2 times prior to their surgery and then 2-5 times in the days following the operation. Outcome measures will involve patient ratings of pain, anxiety, sleep quality, medication intake, long-term health related quality of life, emotional adjustment and length of hospitalization. It is hypothesized that both the VRH and audio hypnosis intervention will create reductions in patient pain reports. Orthopedic trauma pain has been poorly studied, and so has non pharmacologic approaches to reducing pain and complications from surgery. The proposed study will test a unique intervention with a population that has seldom been studied, and the findings could be applied to countless patients and procedures.
This proposal will test innovative and low-risk approaches to reducing postoperative trauma pain that are designed to reduce pain, anxiety and other complications after surgery. The findings have the potential not only to reduce pain and suffering in patients who have suffered severe orthopedic trauma but could be applicable to the millions of people who have surgery every year. The potential for reducing addictive opiate-based medication and health care costs are both potential outcomes from the project.
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