The effect of virtual reality on procedural pain and anticipatory anxiety in children admitted to emergency room: systematic review and meta-analysis.

Abstract

BACKGROUND: In recent years, the use of virtual reality (VR) as a distraction technique for pain control in paediatric settings has become widespread. Despite the presence of several dedicated systematic reviews in the literature, none focus on the effectiveness of the intervention in the emergency room, a setting that is a source of great stress for children and caregivers. OBJECTIVE: To evaluate the effect of VR on the pain of children undergoing medical procedures in the emergency room. METHODS: Systematic review with meta-analysis of parallel-group randomised controlled clinical trials. Studies were retrieved by querying biomedical databases, online resources and trial registries. VR was compared with standard of care. The primary outcome was pain following the procedure. Risk of bias was assessed with RoB 2. The overall effect size was calculated with a random-effects model. The certainty/quality of the results was assessed with the GRADE approach. RESULTS: Six studies with 433 patients were included. The risk of bias is high for four studies and raises some concerns for two. Compared to standard of care, the use of VR had a small but statistically significant effect on pain (SMD: -0.32, 95% CI: -0.56, -0.09). Heterogeneity between studies was low. CONCLUSION: Virtual reality for pain in children undergoing medical procedures in the emergency room seems effective, but further studies are needed to confirm the results.

Keywords

• virtual reality
• procedural pain
• anticipatory anxiety
• children
• emergency room