A randomized controlled trial on virtual reality distraction during venous cannulation in young children

Abstract

Background and Objectives: Pain management in children is often inadequate, and the single most common painful procedure in children who are hospitalized is needle procedures. Virtual reality (VR) has been shown to decrease anxiety and pain in children undergoing painful procedures primarily in children from the age of 7 years. Our aim for this study is to investigate patient satisfaction and pain reduction by using a three-dimensional VR interactive game as a distraction in 4-7 years old children during venous cannulation.Methods: In this randomized clinical trial, we enrolled 106 children aged 4-7 years who were scheduled for venous cannulation. Patients assigned to the control group were adherent to standard of care, including topical numbing cream, positioning, and distraction in this group by games of choice on a tablet/smartphone. In the study group, children were adherent to standard of care and were distracted by an interactive VR game. Primary outcomes were patient satisfaction and the procedural pain assessed by using Wong-Baker Faces Pain Rating Scale; secondary outcomes were the procedural time and any adverse events. Results:We found an overall high level of patient satisfaction with our regime of topical numbing cream, positioning, and distraction. The primary outcome of pain during the procedure was median 20 mm (IQR 0-40) and 20 mm (IQR 0-55) (Wong-Baker 0-100 mm) in the VR group and the control group, respectively (difference: 0 mm, 95% CI: 0-20, p = .19). No significant difference was found in procedural times. The number of adverse effects was low, with no significant difference between the two groups.Conclusions: VR distraction is an acceptable form of distraction for children 4-7 years old when combined with topical numbing cream and positioning during preoperative venous cannulation. No difference was found between VR-and smartphone/tablet distraction.

Is Virtual Reality a Game Changer in Pediatrics' Acute Pain Perception?

“…Moreover, the VR goggle group had better reported scores (less reported pain) according to children (n=89, 4 to 10 years old), parents and observers reports when compared to distraction from a kaleidoscope [42]. Finally, when immersive VR was compared to tablets, no author observed a lower efficacy for VR entertainment, but a similar capacity in self-reported pain mitigation in youngest children (106 children, aged 4 to 7 years old) with no consequences in procedure's time and adverse reactions, and a better efficacy of VR in older subjects (80 kids aged 7-12 years) during phlebotomy [44,45].…”