Author, as appears in the article.: Alonso-Prieto M; Miró J; Torres-Luna R; Plaza López de Sabando D; Reinoso-Barbero F

Department: Psicologia

URV's Author/s: Miró Martínez, Jordi

Keywords: Video pupilometer Pediatric patient Patient-controlled analgesia Hematology oncology Analgesia nociception index Acute pain pediatric patient patient-controlled analgesia hematology oncology analgesia nociception index acute pain

Abstract: ©Mercedes Alonso-Prieto, Jordi Miró, Raquel Torres-Luna, Diego Plaza López de Sabando, Francisco Reinoso-Barbero. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 30.03.2020. BACKGROUND: Patients with secondary pain due to mucositis after chemotherapy require treatment with morphine. Use of electronic video games (EVGs) has been shown to be an effective method of analgesia in other clinical settings. OBJECTIVE: The main objective of this study was to assess the association between the use of EVGs and the intensity of pain caused by chemotherapy-induced mucositis in pediatric patients with cancer. The secondary objective was to assess the association between changes in pain intensity and sympathetic-parasympathetic balance in this sample of pediatric patients. METHODS: Clinical records were compared between the day prior to the use of EVGs and the day after the use of EVGs. The variables were variations in pupil size measured using the AlgiScan video pupilometer (IDMed, Marseille, France), heart rate variability measured using the Analgesia Nociception Index (ANI) monitor (Mdoloris Medical Systems, Loos, France), intensity of pain measured using the Numerical Rating Scale (score 0-10), and self-administered morphine pump parameters. RESULTS: Twenty patients (11 girls and nine boys; mean age 11.5 years, SD 4.5 years; mean weight 41.5 kg, SD 20.7 kg) who met all the inclusion criteria were recruited. EVGs were played for a mean of 2.3 (SD 1.3) hours per day, resulting in statistically significant changes. After playing EVGs, there was significantly lower daily morphine use (before vs after playing EVGs: 35.9 vs 28.6 µg/kg/day, P=.003), lower demand for additional pain relief medication (17 vs 9.6 boluses in 24 hours, P=.001), lower scores of incidental pain intensity (7.7 vs 5.4, P=.001), lower scores of resting pain (4.8 vs 3.2, P=.01), and higher basal parasympathetic tone as measured using the ANI monitor (61.8 vs 71.9, P=.009). No variation in pupil size was observed with the use of EVGs. CONCLUSIONS: The use of EVGs in pediatric patients with chemotherapy-induced mucositis has a considerable analgesic effect, which is associated physiologically with an increase in parasympathetic vagal tone despite lower consumption of morphine.

Thematic Areas: Saúde coletiva Odontología Medicina ii Medicina i Medical informatics Health informatics Health care sciences & services Engenharias iv Enfermagem Ciência da computação

licence for use: https://creativecommons.org/licenses/by/3.0/es/

ISSN: 1438-8871

Author's mail: jordi.miro@urv.cat

Author identifier: 0000-0002-1998-6653

Record's date: 2023-02-22

Journal volume: 22

Papper version: info:eu-repo/semantics/acceptedVersion

Link to the original source: https://www.jmir.org/2020/3/e16013/

Licence document URL: http://repositori.urv.cat/ca/proteccio-de-dades/

Papper original source: Journal Of Medical Internet Research. 22 (3): e16013-

APA: Alonso-Prieto M; Miró J; Torres-Luna R; Plaza López de Sabando D; Reinoso-Barbero F (2020). The Association Between Pain Relief Using Video Games and an Increase in Vagal Tone in Children With Cancer: Analytic Observational Study With a Quasi-Experimental Pre/Posttest Methodology. Journal Of Medical Internet Research, 22(3), e16013-. DOI: 10.2196/16013

Article's DOI: 10.2196/16013

Entity: Universitat Rovira i Virgili

Journal publication year: 2020

Publication Type: Journal Publications