虚拟现实能止痛
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【DavidShi译文】十年前，人们已经研究了分心（即分散注意力，译者注）的技术，并成功应用于临床以苏缓一些治疗引起的疼痛。人们猜想在感受疼痛过程中存在着一个重要的心理学因素，对有害刺激的关注程度影响着感受疼痛，这成了应用分心技术的依据。
分心技术的根据是：病人注意力是有限的，以致病人减少了对刺激的注意力，从而减少了刺激本身。人们认为最佳分心技术包括针对不同感觉（视觉、听觉和运动觉）的最适注意程度、积极的情绪和病人的参与，以与有害刺激信号相竞争。
人们开发出的高级分心术（The advanced distraction techniques，ADTs) 利用了三维图像结合动态声音刺激。这样，比起传统的分心方法，如看电影或玩简单的电脑游戏来，高级分心术显得更理想。
高级分心术模拟了现实生活环境，有着无穷多的选择。例如，现在人们能选择飞行、驾车、下坡滑雪、勘查建筑物和很多其他的活动。
该研究回顾了受同行评议的高级分心术和疼痛的出版物，以确定此类技术止疼的临床效果和重要性。结果提示，高级分心术能显著地减轻内科治疗相关的疼痛。在临床上，止痛技术应用于非常多的病例中，尤其在极度疼痛的病例中。人们发现，在使用止痛技术过程中，病人的焦虑程度降低了，同时几乎没有“模拟器疾病”（simulator sickness）之类的副作用。
虽然有人在继续研究高级分心术的技术和疗效，人们更关注它的心理学方面的研究。人们发现在确定使用者参与程度时，一些个性品质（如专注和分裂）是重要因素，它们可能调节了应用技术的效果。例如，在一些病人中，视觉头盔产生的视野变小和察觉不到医生的活动和失控，这些增强此类病人的焦虑和疼痛感；在另外一些病人中，此项技术是积极有效的，他们看不到也觉察不了医生的活动。
总而言之，高级分心术是很有效的止痛技术，能减少止痛剂的使用。通过加强方法学和心理学的研究，人们将扩大这个新的研究领域。
来源：巴塞罗那大学
【英文原文】
Virtual realities against pain
For over a decade, the technique of distraction has been researched and successfully applied in clinical practice in order to reduce pain associated with certain medical procedures. The use of distraction is based on the assumption that there is an important psychological element in the perception of pain, with the amount of attention given to the harmful stimulus affecting the perception of the pain.
Distraction techniques are based on the patient's limited capacity for attention, resulting in a reduction in the patient's attention to the stimulus and therefore a reduction in the stimulus itself. It was assumed that the ideal distractor would require an optimum amount of attention involving various senses (visual, auditory and kinaesthetic), an active emotional involvement, and participation from the patient to compete with the signals of the harmful stimuli.
The advanced distraction techniques (ADTs) recently developed use 3D images combined with dynamic audio stimuli, making the techniques more likely to meet the requirements of an ideal distractor than the traditional distraction methods such as watching a film or playing a simple computer game.
The ADTs simulate real-life situations, and the possibilities are infinite. For example, until now users could choose between taking a flight, driving, downhill skiing, exploring buildings and many more activities.
In this study, peer-reviewed publications on ADTs and pain have been reviewed to determine the clinical effectiveness and importance of using these techniques as analgesic. The results suggest that the ADTs can significantly reduce the pain associated with medical treatment. The use of analgesic was clinically revealing in most cases, especially in patients with very high or unbearable levels of pain. It was found that levels of anxiety were reduced during the exposure, and the side effects, such as "simulator sickness", were hardly observed at all.
Although some studies continue to focus mainly on the technological aspects and the effectiveness of ADTs, greater consideration is being given to psychological aspects. Several personality traits (such as absorption and dissociation) have been identified as important factors for determining the level of involvement of the users, possibly modulating the effectiveness of technological progress. For example, some patients perceive a reduction in their visual field (due to the video helmet) and a loss of awareness of the activities of the medical practitioner, as well as a loss of control, leading to an increase in anxiety and pain; other patients see it as positive that they cannot see and perceive what the medical practitioner is doing.
We can conclude that ADTs are very useful as analgesic, and can reduce the amount of analgesic administered. This new field of study can begin to move forward beyond its current initial phase by placing more emphasis on methodology and psychological aspects.
Source : Universitat Autonoma de Barcelona
