With the drive to find alternate ways to manage pain and anxiety during procedures, is there a place for immersive virtual reality (VR)?
In recent years, medicine has turned to alternate ways to alleviate the pain and anxiety that many children experience during medical procedures. When children must undergo peripheral intravenous catheter placement, does the use of an immersive virtual reality experience perform better than standard care with pain and anxiety management?1
Investigators performed a randomized clinical trail from April 2017 to July 2019 in patients aged 10 to 21 years who received peripheral intravenous (IV) catheter placement in 2 clinical settings: radiology department and an infusion center at an urban pediatric academic medical center. Clinicians, caregivers, and patients completed questionnaires before and after the placement, which asked about patient pain, anxiety, and sensitivity to anxiety. Patients were randomized to get standard care, which involved simple distraction techniques such as coloring as well as the application of a numbing cream, or a virtual reality intervention.
There were a total of 107 patients who completed the clinical trial: 54 in the standard care arm and 53 who received the virtual reality intervention. Those who had the virtual reality intervention had significantly lower average post- peripheral IV catheter scores than standard care when clinician-reported (2.04 points [95% CI, 1.37-2.71 points] vs 3.34 points [95% CI, 2.69-3.99 points]; P = .002) and patient-reported (1.85 points [95% CI, 1.28-2.41 points] vs 3.14 points [95% CI, 2.59-3.68 points]; P < .001). Similarly, there were significantly lower average peripheral IV catheter placement pain scores when patient-reported (1.34 points [95% CI, 0.63-2.05 points] vs 2.54 points [95% CI, 1.78-3.30 points]; P = .002), caregiver-reported (1.87 points [95% CI, 0.99-2.76 points] vs 3.01 points [95% CI. 1.98-4.03 points]; P = .04), and clinician-reported (2.05 points [95% CI, 1.47-2.63 points] vs 3.59 points [95% CI, 2.97-4.22 points]; P < .001).
Patients who had a virtual reality intervention experienced significantly less anxiety and pain than those who were given standard care. The use of a variety of viewpoints (patient, caregiver, and clinician) provided a large array of data on pain and anxiety, more than would have been possible in a study that only looked at patient reporting.
1. Gold J, SooHoo M, Laikin A, Lane A, Klein M. Effect of an immersive virtual reality intervention on pain and anxiety associated with peripheral intravenous catheter placement in the pediatric setting. JAMA Netw Open. 2021;4(8):e2122569. doi:10.1001/jamanetworkopen.2021.22569