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Anterior shoulder dislocation (ASD) is a common situation in the emergency department (ED). Quick reductions lead to reduced mid and long term complications. No technique is superior to one another. Inhaled nitrous oxide can deal with pain reduction and anxiety but its efficacy is not optimal, with safety issues. Virtual reality hypnosis (VRH), by distracting patients from their pain, may lead to a better muscular relaxation and an easier ASD reduction.
Our first objective is to evaluate the clinical interest of VHR compared to nitrous oxide, in ASD reduction. Our second objective is to evaluate the safety of VRH in ASD reduction.
Patients over 18 years presenting an ASD < 24 hours, will be illegible for enrollment in an open multicenter randomized controlled trial, conducted in the Great East Region in France.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Virtual reality hypnosis (VRH) | Experimental |
| |
| Nitrous oxide (NO) | Active Comparator |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Virtual reality hypnosis | Procedure | VRH offers predefined hypnosis sessions with no need of trained physician or nurse or caregiver mobilization. Consisting of a headset including headphones and a virtual reality screen, VRH allow patients to select a visual and sound environment (e.g.: tropical beach, space, underwater…) into which the hypnotic speech is delivered. That way, the patient's attention is distracted and muscular relaxation is obtained, a major relaxation factor. HRV is simple, quick, and presumably safe. |
| Measure | Description | Time Frame |
|---|---|---|
| Reduction of ASD procedure time | Day 0 |
| Measure | Description | Time Frame |
|---|---|---|
| Achievement of the reduction of ASD procedure | Day 0 | |
| Per-procedure pain | Visual analogue scale | Day 0 |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Stéphane GENNAI | Contact | 03 26 78 87 10 | 0033 | sgennai@chu-reims.fr |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Damien JOLLY | Recruiting | Reims | France |
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|
| Nitrous oxide | Drug | inhalation of NO usually used to help with ASD reduction but inhaled NO has safety and maintenance issues. |
|
| Passage time in the ED |
| Day 0 |
| Patient satisfaction | Likert scale in 5 points | Day 0 |
| Adverse events when using HRV | Day 0 |
| Adverse events when using inhaled NO | Day 0 |
| ID | Term |
|---|---|
| D012783 | Shoulder Dislocation |
| ID | Term |
|---|---|
| D004204 | Joint Dislocations |
| D007592 | Joint Diseases |
| D009140 | Musculoskeletal Diseases |
| D014947 | Wounds and Injuries |
| D000070599 | Shoulder Injuries |
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| ID | Term |
|---|---|
| D009609 | Nitrous Oxide |
| ID | Term |
|---|---|
| D009589 | Nitrogen Oxides |
| D005740 | Gases |
| D007287 | Inorganic Chemicals |
| D017672 | Nitrogen Compounds |
| D010087 | Oxides |
| D017601 | Oxygen Compounds |
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