The opinions or assertions contained herein are the private views of the author and are not to be construed as official or as reflecting the views of the Department of the Army or the Department of Defense.
Combining Ketamine and Virtual Reality Pain Control During Severe Burn Wound Care: One Military and One Civilian Patient
Version of Record online: 11 APR 2011
Wiley Periodicals, Inc.
Volume 12, Issue 4, pages 673–678, April 2011
How to Cite
Maani, C. V., Hoffman, H. G., Fowler, M., Maiers, A. J., Gaylord, K. M. and DeSocio, P. A. (2011), Combining Ketamine and Virtual Reality Pain Control During Severe Burn Wound Care: One Military and One Civilian Patient. Pain Medicine, 12: 673–678. doi: 10.1111/j.1526-4637.2011.01091.x
- Issue online: 15 APR 2011
- Version of Record online: 11 APR 2011
- Burn Pain;
- Wound Care;
- Virtual Reality
Background. US soldiers injured in Iraq, and civilian burn trauma patients are treated at the US Army Institute of Surgical Research. Burn patients experience extrem pain during wound care, and they typically receive opioid analgesics and anxiolytics for debridement. Virtual Reality (VR) has been applied as an adjunct to opioid analgesics for procedural pain. We describe the first use of ketamine combined with immersive VR to reduce excessive pain during wound care.
Case Report. A 21-year-old male US Army soldier stationed in Iraq, and a 41-year-old civilian male sustained a 13% and 50% total body surface area (TBSA) burn, respectively. Each patient received 40 mg ketamine intraveneous (IV) for wound care. Using a within-subject design, nurses conducted half of a painful segment of wound care treatments with no VR and the other half with immersive VR. Graphic pain rating scores for each of the two treatment conditions served as the dependent variables.
Results. Compared to ketamine + no VR, both patients reported less pain during ketamine + VR for all three pain ratings. Both patients rated wound care during no VR as “no fun at all”, but those same patients rated wound care during virtual reality as either “pretty fun” or “extremely fun”, and rated nausea as either “mild” or “none”.
Conclusions. Results from these first two cases suggest that a moderate dose of ketamine combined with immersive virtual reality distraction may be an effective multimodal analgesic regimen for reducing acute procedural pain during severe burn wound cleanings.