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Pilot Randomized Controlled Trial of Virtual Reality vs. Standard-of-Care During Pediatric Laceration Repair
Ran D Goldman1,2, Amir Behboudi3
1The Pediatric Research in Emergency Therapeutics (PRETx) Program, Division of Pediatric Emergency Medicine, Department of Pediatrics, University of British Columbia, Vancouver, Canada.
Insights
Virtual reality (VR) effectively reduced anxiety and pain in pediatric patients undergoing laceration repair. Children preferred the VR experience over standard care, suggesting its utility as an additional pain management tool.
Area of Science:
- Pediatric Emergency Medicine
- Medical Technology
- Pain Management
Background:
- Virtual Reality (VR) is an emerging immersive technology with documented benefits for reducing anxiety and pain in pediatric hospital settings.
- This study aimed to compare VR with standard of care (SOC) for pain and anxiety management in children undergoing laceration repair in a pediatric Emergency Department (ED).
Observation:
- A prospective randomized controlled trial was conducted in a tertiary pediatric ED involving children aged 6-16 years undergoing laceration repair.
- The intervention group used low-cost VR goggles with a roller coaster application, while the control group received SOC.
- Demographic and procedural characteristics were similar between the VR and SOC groups.
Findings:
- Post-procedure pain and anxiety scores were low and comparable between the VR and SOC groups.
- Children in the VR group rated their experience more positively than those in the SOC group (p=0.01).
- The low-cost VR system was found to be comparable to SOC in terms of comfort and was more enjoyable for children.
Implications:
- Virtual reality may serve as a valuable adjunctive tool for emergency department providers to manage pain and anxiety in children during laceration repairs.
- The positive reception by children suggests VR's potential for improving patient experience in procedural settings.
- Further research could explore the integration of VR into routine pediatric procedural care.
Abstract:
Virtual reality (VR) is an emerging immersive technology with initial documentation of reduction in anxiety and pain when used by children in the hospital setting. The objective of this study was to compare VR to standard of care (SOC) in a pediatric Emergency Department (ED) for pain management and anxiety among children needing a laceration repair procedure. We conducted a prospective randomized controlled trial in a tertiary pediatric ED (NCT03681717) with children 6-16 years of age going through a laceration repair procedure. Intervention was low-cost VR goggles with a free roller coaster application during the procedure or SOC in the ED during the same time (1:1). The primary outcome was post-procedure pain (Faces Pain Scale - Revised (FPS-R)), and secondary outcome was the Venham Situational Anxiety (VSA) score. A total of 32 subjects were in the VR group and 30 in the SOC group. Age, gender, location and length of the laceration, number of sutures needed, use of oral, topical or local anesthetics, time to complete the procedure and time to discharge, were similar between groups. Pain and anxiety as measured after the procedure were very low, and similar between groups. Children rated the VR experience more positively than the SOC (p = 0.01). Using low cost VR system was similar to our tertiary pediatric center SOC comfort level and children enjoyed the VR system more. VR may serve as an additional tool in the armamentarium of ED providers for pain and anxiety reduction during laceration repairs.
