Anesthesiology & Pain Medicine >> Research >> Sharar Group

Sharar Group
Harborview Medical Center & UW Medical Center

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PI: Sam R. Sharar, MD

Research Overview

The Sharar lab investigates the efficacy, safety and mechanisms of virtual reality technologies applied as non-pharmacologic analgesic techniques, in both clinical and experimental settings of acute pain.

Non-pharmacologic pain management techniques (e.g., cognitive distraction, hypnosis, biofeedback) are frequently utilized in clinical acute pain settings where pharmacologic analgesic use is impractical, or when standard, safe doses provide inadequate analgesia. One venue in which pharmacologic analgesics often provide insufficient analgesia is the setting of brief, yet painful medical procedures performed in awake (i.e., unanesthetized) patients. A particularly striking example of procedural pain is the aggressive wound care and dressing changes that are performed on a daily basis in children and adults hospitalized for cutaneous burn injuries. Non-pharmacologic analgesic strategies are therefore added to pharmacologic pain treatments in such patients to minimize patient discomfort.

Immersive virtual reality (VR) distraction is a novel non-pharmacologic analgesic technique that uses intense cognitive distraction — creating a user's sense of presence in an interactive virtual environment — to draw patients' attention away from a painful stimulus, thereby reducing their subjective pain experience. The technique has been applied in various clinical settings of procedural pain including wound care, physical therapy, dental care, and minor surgical procedures. In the VR analgesia laboratory we investigate the neuroanatomic and neurophysiologic mechanisms of VR distraction and related VR hypnosis using safe and carefully controlled experimental pain techniques in healthy volunteers, in combination with pharmacologic manipulation of pain-related factors (e.g., opioid receptor blockade, attention, hypnotizeability). Subjective reports (e.g., pain scores, anxiety,) and objective outcome measures (e.g., functional neuroimaging with fMRI) are used to infer analgesic mechanisms and to guide the clinical application of VR technologies — both alone and in combination with pharmacologic analgesic drugs — to maximize overall analgesic effects. For more information on the Virtual Reality Analgesia Program at the University of Washington, see www.vrpain.com.