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.

Public Health Relevance

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.

Agency
National Institute of Health (NIH)
Institute
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Type
Research Project (R01)
Project #
2R01AR054115-06A1
Application #
8575651
Study Section
Behavioral Medicine, Interventions and Outcomes Study Section (BMIO)
Program Officer
Serrate-Sztein, Susana
Project Start
2006-07-01
Project End
2018-06-30
Budget Start
2013-07-01
Budget End
2014-06-30
Support Year
6
Fiscal Year
2013
Total Cost
$476,829
Indirect Cost
$156,808
Name
University of Washington
Department
Physical Medicine & Rehab
Type
Schools of Medicine
DUNS #
605799469
City
Seattle
State
WA
Country
United States
Zip Code
98195
Jensen, Mark P; Patterson, David R (2014) Hypnotic approaches for chronic pain management: clinical implications of recent research findings. Am Psychol 69:167-77
Hoffman, Hunter G; Meyer 3rd, Walter J; Ramirez, Maribel et al. (2014) Feasibility of articulated arm mounted Oculus Rift Virtual Reality goggles for adjunctive pain control during occupational therapy in pediatric burn patients. Cyberpsychol Behav Soc Netw 17:397-401
Faber, Albertus W; Patterson, David R; Bremer, Marco (2013) Repeated use of immersive virtual reality therapy to control pain during wound dressing changes in pediatric and adult burn patients. J Burn Care Res 34:563-8
Hoffman, Hunter G; Chambers, Gloria T; Meyer 3rd, Walter J et al. (2011) Virtual reality as an adjunctive non-pharmacologic analgesic for acute burn pain during medical procedures. Ann Behav Med 41:183-91
Maani, Christopher V; Hoffman, Hunter G; Fowler, Marcie et al. (2011) Combining ketamine and virtual reality pain control during severe burn wound care: one military and one civilian patient. Pain Med 12:673-8
Maani, Christopher V; Hoffman, Hunter G; Morrow, Michelle et al. (2011) Virtual reality pain control during burn wound debridement of combat-related burn injuries using robot-like arm mounted VR goggles. J Trauma 71:S125-30
Patterson, David R; Jensen, Mark P; Wiechman, Shelley A et al. (2010) Virtual reality hypnosis for pain associated with recovery from physical trauma. Int J Clin Exp Hypn 58:288-300
Askay, Shelley Wiechman; Patterson, David R; Sharar, Sam R (2009) VIRTUAL REALITY HYPNOSIS. Contemp Hypn 26:40-47
Askay, Shelley Wiechman; Bombardier, Charles H; Patterson, David R (2009) Effect of acute and chronic alcohol abuse on pain management in a trauma center. Expert Rev Neurother 9:271-7
Stoelb, Brenda L; Molton, Ivan R; Jensen, Mark P et al. (2009) THE EFFICACY OF HYPNOTIC ANALGESIA IN ADULTS: A REVIEW OF THE LITERATURE. Contemp Hypn 26:24-39

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