Appropriate pain and anxiety management of critically-ill patients during bedside procedures remains a big challenge. Clinical Practice Guidelines recommend preemptive analgesia or non-pharmacological interventions, such as relaxation techniques or distraction, to prevent and treat pain during nursing procedures. One of the most painful procedures in the Intensive Care Unit (ICU) is the removal of chest drains in post-cardiac surgical patients. Virtual reality (VR) is a computer-generated simulation of a 360º immersive world in which the patient can receive visual and auditory stimuli that distract them from the real environment. Current research has demonstrated that VR reduced pain and anxiety in intravenous catheter insertions or wound care. The primary objective of the study is to evaluate the effectiveness of VR on pain and anxiety during the removal of chest drains, in post-cardiac surgical patients. The hypothesis is that VR reduces both pain and anxiety, in critically-ill patients, during the removal of chest drains in post-cardiac surgical patients.
This is a prospective, randomized, open-label, prospective study of two parallel groups of patients during the removal of chest drains: Group 1: removal of chest drains according to the usual management protocol. Group 2: removal of chest drains according to the usual management protocol supplemented by the use of virtual reality glasses (VR glasses)
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
NONE
Enrollment
98
Patients will watch a virtual world in VR glasses during the painful procedure. They will be able to choose between 3 VR content based on their preferences.
Patients will not receive distraction during chest drain removal
Hospital Universitari de Bellvitge
L'Hospitalet de Llobregat, Barcelona, Spain
Procedural pain score
Numerical rating scale (NRS). The pain can be scored from 0 to 10 (0=no pain, 10= worst possible pain)
Time frame: Baseline
Procedural pain score
Numerical rating scale (NRS). The pain can be scored from 0 to 10 (0=no pain, 10= worst possible pain)
Time frame: 1 minute after the removal of chest drains
Procedural pain score
Numerical rating scale (NRS). The pain can be scored from 0 to 10 (0=no pain, 10= worst possible pain)
Time frame: 30 minutes after the removal of chest drains
Procedural anxiety score
State-Trait Anxiety Inventory (STAI scale)- trait state. The anxiety can be scored from 0 to 60 (0=no anxiety, 60=worst possible anxiety)
Time frame: Baseline
Procedural anxiety score
State-Trait Anxiety Inventory (STAI scale)- trait state. The anxisety can be scored from 0 to 60 (0=no anxiety, 60=worst possible anxiety)
Time frame: 1 minute after the removal of chest drains
Procedural anxiety score
State-Trait Anxiety Inventory (STAI scale)- trait state. The anxisety can be scored from 0 to 60 (0=no anxiety, 60=worst possible anxiety)
Time frame: 30 minutes after the removal of chest drains
Sociodemographic and clinical factors
Age, gender, past medical history
Time frame: Baseline
Blood pressure
Systolic, Diastolic and mean blood pressure measure in mmHg
Time frame: Baseline
Blood pressure
Systolic, Diastolic and mean blood pressure measure in mmHg
Time frame: 1 minute after the removal of chest drains
Blood pressure
Number of systolic, diastolic and mean blood pressure measure in mmHg
Time frame: 30 minutes after the removal of chest drains
Heart rate
Number in beats per minute
Time frame: Baseline
Heart rate
Number in beats per minute
Time frame: 1minute after the removal of chest drains
Heart rate
Number in beats per minute
Time frame: 30 minutes after the removal of chest drains
Respiratory rate
Number in breaths per minute
Time frame: Baseline
Respiratory rate
Number in breaths per minute
Time frame: 1 minute after the removal of chest drains
Respiratory rate
Number in breaths per minute
Time frame: 30 minutes after the removal of chest drains
Type of cardiac surgery
Type
Time frame: Baseline
Type of chest drains
Mediastinal or pleural drains
Time frame: At baseline
Number of chest drains
Number
Time frame: At baseline
Dose of analgesic drugs
Cumulated dose of analgesia drugs
Time frame: 1 hour before the procedure
Patient satisfaction
Numerical Rating Scale (NRS). Patient's satisfaction will be scored from 0 to 4 (0= unsatisfied, 4=very satisfied).
Time frame: 30 minutes
Adverse events
Type of adverse events experienced by patients
Time frame: 30 minutes
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.