Cybertherapy in Medicine – Experience at the Universidad Panamericana, IMSS and ISSSTE Mexico

There are many reports of Virtual Reality analysis and clinical applications in Medicine since the end of the last century for many authors. In trauma head injuries [1], during chemotherapy in children [2], in burn wound care [3,4,5], lumbar puncture [6,], breast cancer [7], vein puncture [8], pain distraction [9,10,11,12], dental pain control [13], leg ulcer relief [14], night vision technology with robot control to treat bourn injuries using robot-like arm mounted VR goggles [15]. The first case reports related with VR and medical invasive procedures and surgery in hospitals was in 2004 with our group, beginning with upper gastrointestinal endoscopies and so on, until introduce VR in postoperative care unit of cardiac surgery [16,17]. Pain and anxiety in outpatients and inpatients is a regular symptom in hospitals. For pain are available medications and for anxiety also. Patients in; in-rooms, operating rooms and another different places, get treatments with medical and surgical procedures, and pain and anxiety are the meanly symptom. In this project we try to demonstrate that virtual reality is a complementary tool to reduce pain and anxiety in hospitals during medical procedures including surgical procedures. There are a lot reason and justifications to use VR in hospitals, as follows. Neonatology (0-28 days old), there are newborns staying in unit cares since few days, weeks even months, growing without contact with the external world. The visit unit care is limited to parents in few hours a day. The psychological impact in growth and development in childhood is so hard, where neuro stimulation in a closed environment is a good alternative. In Infants (lower and higher infants) VR have been a good resource to reduce pain and anxiety in oncology. Hunter Hoffman has demonstrated in the benefits of VR during medical rehabilitation in burned childhood. In postoperative cardiac surgery unit care, patients stay 3 days in different critical care units depending of their progress. In these units they stay under the influence of sedative drugs receiving treatments by vein catheters, gastric tube, etc. Their recovery is on beds with different degrees of limited position and the breathing relief is on bed also. In ambulatory surgery (General surgery, endoscopic surgery, urology, dermatology, Orthopedic, angiology, pediatric surgery, obstetrics), patients are awake, minutes, even hours awake during surgical procedures doing nothing in a same position on a surgical table. In the recovery they stay hours waiting for go home or to be hospitalized. Special group of ambulatory surgery, surgeon used night vision technology while patients navigate in VR environment. At the school of medicine from Universidad Panamericana we used night vision on animal models before the application on humans. Gynecology and obstetrics. Women during colposcopy are awake while gynecologist applies local anesthesia into the cervix to perform cervical conization with diathermal loop. The anxiety is present in a same gynecological position. Gastrointestinal endoscopy. Under local anesthesia, neurovegative response is present during and after each upper gastrointestinal exploration of esophagus, stomach and duodenum. Patients present plenty of saliva associated with shortness of. Labor Room. Pregnant patients without complications expected hours to complete cervical dilation in labor room to go into delivery room or operating room. During uterus contractions they increase their respiratory rate. Pediatric. Scholar children stay on bed many days in recovery. In their stay they distract with games and in some times with a TV only. Epidural and Spinal block in anesthesia. This is a relative fast procedure compared with the previous groups where patient in the fetal position they expect catheter installation in their back, place where they can´t see anything and anxiety is present despite local infiltration.