Mosso Vázquez, José Luis
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Mosso Vázquez, José Luis
Official Name
José Luis Mosso Vázquez
Alternative Name
jmosso
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ORCID
Scopus Author ID
57196970146
Researcher ID
JHL-3429-2023

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Pain Distraction During Ambulatory Surgery: Virtual Reality and Mobile Devices

2019 , Mosso Vázquez, José Luis , Mosso Lara, Dejanira , Mosso Lara, José Luis , Miller, Ian , Wiederhold, Mark D. , Wiederhold, Brenda K.

Virtual reality (VR) pain distraction has been applied across medical, surgical, and behavioral healthcare domains, marking a shift in pain attenuation practices. However, there is little research that has been performed to compare the efficacy of traditional head-mounted displays (HMDs) versus portable VR devices. The present study evaluated 44 outpatients in need of lipoma resection. Randomized into two groups—HMD versus mobile phone VR—participants navigated pain distraction virtual environments while undergoing surgery. Vital signs and subjective pain measurements via a visual analog scale were taken before, during, and after the surgery. Results indicate that the HMD group reported greater pain reduction than the Mobile group. Overall, this study points to the efficacy of nonpharmacological pain attenuation practices. Although both systems reduced pain during surgery, the clinically validated VR environments seen in the HMD group were more effective. This study does show that inexpensive solutions can work in surgical settings. Future research should be performed to identify the most effective VR pain distraction systems.

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Pain reduction with VR in indigenous vs urban patients in ambulatory surgery

2019 , Mosso Vázquez, José Luis , Obrador, Gregorio , Moss Lara, Dejanira , Mosso Lara, José Luis , Wiederhold, Brenda K. , Lara Vaca, Verónica , Miller, Ian , Wiederhold, Mark D. , Michael, Aaron , Lange, John , Yu Gillette, Sean

The current report presents comparisons of pain reduction and heart rate response using supplemental virtual reality (VR) pain distraction between 22 indigenous and 22 urban patients during ambulatory surgery. Material and methods. Forty-four (44) patients participated under full informed consent. Half (n = 22) were indigenous peoples and half (n = 22) were urban patients (those residing in Mexico City). For the urban group, a surgeon performed ambulatory surgeries with local anesthesia to remove lesions in soft tissues, such as lipomas, cysts located in the head, neck, back, shoulders, arms, limbs, and abdomen. For the indigenous group, operating rooms, intravenous line, analgesics, and sedatives were not used. Materials included laptop-linked virtual reality, PlayStation, Smartphones and Google Cardboard googles alongside virtual environments such as Enchanted Forest, The Sea, Lake Valley, Jurassic Dinosaur and Coast Space VR. Results. Pain scale indicated 2.92 before, 1.67 during and 0.67 after for indigenous participants, and 5.8 before, 3.32 during and 1.48 after for urban participants. Heart rate responses in indigenous were 80.42(before), 78.5 (during) and 72.42 (after) and urban responses were 74.07 (before), 68.53 (during) and 73.1(after). Discussion. Indigenous patients presented more pain reduction during ambulatory surgery without intravenous lines, analgesics or sedatives and required recovery time or hospitalization. Supplemental VR during medical and surgical procedures is discussed in light of cultural, economic and psychological variables associated with medical care in Mexico. ©2019, Interactive Media Institute. All rights reserved.

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Virtual reality pain mitigation during elective cesarean surgical delivery

2019 , Mosso Vázquez, José Luis , Mosso Lara, Dejanira , Lara Vaca, Verónica , Wiederhold, Brenda K. , Miller, Ian , Rivas, Homero , Wiederhold, Mark D.

We present supplemental virtual reality (VR) relaxation to reduce pain and anxiety during elective cesarean delivery in 4 young women under epidural analgesia. Methodology. Four women voluntarily participated in a VR relaxation group (mean age = 28.5 years) and four women in a control group (mean age = 30.5 years). VR relaxation was initiated for the placement of the epidural block and cesarean procedure until the gynecologist extracted the newborn from the uterus. The mothe's vital signs and pain were measured using physiological monitoring and a visual analog scale before, during and after anesthesia placement and during and after cesarean surgery. Participants viewed an ‘Enchanted Forest’ virtual environment. Three of the four patients’ husbands participated by navigating the virtual environment for his wife using a game controller. Results. Patients presented 91.89 % pain reduction in the VR group—a remarkable result under regional anesthesia. Patients in the control group presented 61 % increases in pain. Conclusions. VR supplemented pain mitigation provides high levels of satisfaction to mothers during elective cesarean delivery and carries no risk for the newborns. The current report highlights an innovative contribution to womens’ healthcare. (PsycInfo Database Record (c) 2021 APA, all rights reserved)

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Virtual reality and minimal analgesia attenuate pain during spine surgery

2019 , Mosso Vázquez, José Luis , Canseco Aguilar, Patricia , Mosso Lara, Dejanira , Miller, Ian , Wiederhold, Brenda , Wiederhold, Mark D.

We present progress with 17 cases of virtual reality (VR) therapy to reduce pain and anxiety during interventional treatment under radiology guidance on patients diagnosed with intense and chronic back pain with narrow channel syndrome and lumbar disc hernias. Methodology. Patients under informed consent fitted with a head mounted display (HMD), to allow them to navigate in VR scenarios, lie in a prone position. The procedure begins using minimal analgesia with an intravenous single dose with fentanyl 50 mcg without sedation. We infiltrate locally with local anesthesia (lidocaine 1%); depending on the interventional procedure involved. The interventional procedures were: discography with discolysis with ozone, caudal blockages, and foramina blocks. During the procedure, patients navigate VR scenarios created at the Virtual Reality Medical Center in San Diego (Dr. Brenda Wiederhold). At the end of the procedure, patients recover for one to two hours before leaving the Surgical Center. Results. No statistically significant increase in pain ratings from baseline through procedure were noted, however, a significant decrease was noted post-operatively. The attenuation of pain due to VR distraction in 17 patients allowed the procedure to be non-sedative (Midazolam was not used). Conclusions. Advantages of VR therapy include a high degree of patient satisfaction, minimal risk without sedatives, such as midazolam, maintenance of patient's conscious awareness, stress reduction in the patient, stress reduction in the anesthesiologist, and cooperation with the patient. The noninvasive VR equipment used is portable, reliable, and led to a a better patient–physician relationship. VR therapy during pain treatment is an excellent option in the pain clinic. Chronic pain treated with anti-inflammatories administered directly to the spine and local ozone is an area in which the use of VR can significantly reduce pain. With this experience we demonstrate the cost benefit advantage that also offers satisfaction to patients while offering savings to health institutions. No complications were presented.

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