A randomized controlled trial comparing immersive virtual reality games versus nitrous oxide for pain reduction in common outpatient procedures in pediatric surgery
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Children often experience anxiety and pain during minor surgical procedures, prompting the search for effective pain management strategies beyond traditional pharmaceutical approaches. This study aims to evaluate the efficacy of virtual reality (VR) as a pain reduction method in pediatric outpatient surgical interventions compared to the standard use of nitrous oxide. The research questions explore pain reduction levels, patient preferences, enjoyment during VR use, and the time limit of the VR application. The study employs a randomized controlled trial design, utilizing VR technology and nitrous oxide in separate groups in 100 children at the age from 6 to 15 undergoing minor surgical procedures. Outcomes are monitored directly after the intervention and two weeks following the procedure. The primary outcome measure is the pain level, assessed using visual face and visual analog scales. Secondary outcomes are the fun and/or fear experienced during the intervention, the willingness to undergo the same procedure again (if necessary), and whether there is a time limit with the VR application compared to nitrous oxide. The study also considers adverse events and safety measures. The study aims to address a significant research gap in pediatric pain management strategies, as it is the first randomized controlled trial designed to compare pain levels using VR versus a control group with nitrous oxide analgosedation in children undergoing minor surgical procedures. Preliminary evidence suggests VR may offer a viable alternative to traditional pain management methods, as VR technology could be an effective distraction and pain management tool for pediatric patients undergoing outpatient surgical procedures. ClinicalTrials.gov NCT05510141. Registered on August 22, 2022. Virtual Reality Games in Pediatric Surgery—Full Text View—ClinicalTrials.gov. The principal investigator, Cordula Scherer act as the Sponsor, Clinic for pediatric surgery, Inselspital, Bern University Hospital, CH 3010 Bern, Switzerland.Keywords:
Outpatient surgery
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Previous research has reported that people sometimes try to concentrate their attention on something else to suppress unwanted thoughts. This strategy is called focused-distraction. The purpose of present study was to investigate the effects of focused-distraction on the frequency of intrusive thoughts. Sixteen participants were asked to suppress their thoughts about targets and perform a memory task at the same time, to simply suppress the thoughts, and to think about anything they like. The results showed that participants tried to focus their attention on the memory task in the suppression with memory task condition, and they experienced less intrusive thoughts in the suppression with memory task condition than in the simple suppression condition. These results suggest that focused-distraction is useful for suppressing unwanted thoughts, and people spontaneously use focused-distraction depending on the situation. The necessity of further investigation regarding focused-distraction is discussed.
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Driver distraction as well as driver failure to monitor the forward roadway are the most common and recognizable accident-contributing factors. This paper presents a review and discussion related driver distraction suggesting that taking eyes off the road is not sufficient to explain distraction-related incidents and accidents. Keywords: Driver distraction; Language: en
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Driver distraction is a major cause of traffic accidents in Korea. Various measures are being introduced to detect and warn driver distraction. The objective of this research is to invcstigate changes in driver's physiological signals due to distraction during driving. Driving simulator experiments have been canicd out to investigate discrepancy in EEG signals among normal driving, DMB watching during driving, and cellular phone use during driving. Based on the discrepancy, combination of EEG signals have been identfied as candidate variables for detecting driver distraction. Statistical analysis has been carried out to verify their statistical significance.
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Research on the effectiveness of distraction as a method of pain control is inconclusive. One mechanism pertains to the motivational relevance of distraction tasks. In this study the motivation to engage in a distraction task during pain was experimentally manipulated. Undergraduate students (N=73) participated in a cold pressor test (CPT) and were randomly assigned to three groups: a distraction-only group performed a tone-detection task during the CPT, a motivated-distraction group performed the same task and received a monetary reward for good task performance, and a control group did not perform the tone-detection task. Results indicated that engagement in the distraction task was better in the motivated-distraction group in comparison with the distraction-only group. Participants in both distraction groups experienced less pain compared to the control group. There were no overall differences in pain intensity between the two distraction groups. The effect of distraction was influenced by the level of catastrophic thinking about pain. For low catastrophizers, both distraction groups reported less pain as compared to the non-distracted control group. This was not the case for high catastrophizers. For high catastrophizers it mattered whether the distraction task was motivationally relevant: high catastrophizers reported less intense pain in the motivated-distraction group, as compared to the non-distracted control group. We conclude that increasing the motivational relevance of the distraction task may increase the effects of distraction, especially for those who catastrophize about pain.
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Driving simulator
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According to the AAA Foundation for Traffic Safety, driver inattention is a major contributor to highway accidents. Driver distraction is one form of inattention and a leading factor in most vehicle crashes and near crashes. Distraction occurs when a driver is delayed in the recognition of information needed to safely accomplish the driving task because some event, activity, object, or person within or outside the vehicle compels or induces the driver attention away from the driving task. Although some indexes of driving performance have measured distraction, they are the results of the distraction and not the distraction itself. We directly and quantitatively employ biological signals to measure the distraction by finding useful biological indexes from candidates of various biological signals. Our experimental results using a driving simulator showed useful indexes derived from EEG and ECG.
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Many incidents and crashes can be attributed to driver distraction, due to increasing use of in-vehicle information systems (IVISs). Although visual and cognitive distraction has been studied extensively, relatively little research has compared the differences of effects between them on driving performance in the field. To fill this gap, twelve participants drove on roads under three distraction conditions: without distraction, with visual distraction, with cognitive distraction. Results revealed that visual distraction leads to higher speed variance and resulted in higher workload. Cognitive distraction made steering less smooth, but improved lane maintenance. Visual distraction was associated with more off-road glances, while increased blink frequency was observed during cognitive distraction. Both distractions caused gaze concentration and slow saccades when drivers looked at the roadway. Overall, visual distraction interferes with driving performance more than cognitive distraction, but they influence vehicle control and gaze behavior in different ways. These results suggest that minimizing visual demand is particularly important in the design of in-vehicle systems and also will be beneficial for the development of distraction countermeasures.
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