The use of virtual reality in children undergoing vascular access procedures: a systematic review and meta-analysis

Area of Science:

• Pediatric Anesthesiology
• Medical Technology Integration
• Pain Management Innovations

Background:

• Venous access procedures are a common source of significant pain and fear for pediatric patients and their families.
• Virtual reality (VR) has emerged as a promising tool for procedural support across various medical interventions.
• The efficacy of VR in mitigating pediatric procedural pain and anxiety requires systematic evaluation.

Purpose of the Study:

• To conduct a meta-analysis assessing the impact of virtual reality on pain and fear during vascular access procedures in children aged 4 to 12 years.
• To synthesize evidence from existing studies to quantify the effect of VR interventions on primary (pain) and secondary (fear/anxiety) outcomes.
• To evaluate the quality of included studies using the Jadad scale and Delphi List.

Main Methods:

• A comprehensive literature search was performed across multiple databases (Sciencedirect, Springerlink, CENTRAL, Pubmed, PMC) from December 20-26, 2020.
• Included studies compared VR interventions against standard care for vascular access in children aged 4-12.
• Meta-analysis was conducted to calculate standardized mean differences (SMD) for pain and fear/anxiety, with heterogeneity assessed.

Main Results:

• The meta-analysis included 9 studies (10 study instances) with 930 participants for pain outcomes and 648 participants for fear/anxiety outcomes.
• Virtual reality significantly reduced pain (SMD 2.54, p=0.038) and fear/anxiety (SMD 0.89, p=0.017) compared to standard care.
• Significant heterogeneity was observed across studies for both pain and fear/anxiety outcomes.

Conclusions:

• This meta-analysis provides weak to moderate evidence supporting the use of virtual reality for reducing pain and fear in pediatric vascular access procedures.
• Despite large effect sizes, significant heterogeneity necessitates cautious interpretation of the findings.
• Further research with larger sample sizes and age stratification is recommended to strengthen the evidence base for VR in pediatric procedural care.