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Immersive Virtual Reality Versus Video Distraction for the Management of Emergence Delirium in Children: A Randomized
Insights
Immersive virtual reality (VR) distraction significantly reduced emergence delirium (ED) in preschool children undergoing surgery compared to video distraction or standard care. VR offers a promising approach to improve pediatric postoperative outcomes.
Area of Science:
- Pediatric Anesthesiology
- Virtual Reality in Medicine
- Surgical Patient Care
Background:
- Emergence delirium (ED) poses significant challenges in pediatric surgical settings for patients, parents, and healthcare providers.
- Existing interventions for ED often have limitations, necessitating the exploration of novel approaches.
- Parental presence is a common strategy, but its effectiveness can be variable.
Purpose of the Study:
- To evaluate the efficacy of immersive virtual reality (VR) distraction in reducing emergence delirium (ED) in preschool-aged children undergoing elective surgery.
- To compare VR distraction with tablet video distraction plus parental presence and standard care.
- To assess the impact of interventions on postoperative pain and parental separation anxiety.
Main Methods:
- Prospective, randomized, controlled clinical trial involving 90 children aged 4-7 years.
- Three groups: immersive VR distraction, tablet video distraction with parental presence, and standard care.
- Primary endpoints: incidence of ED and Pediatric Anesthesia Emergence Delirium Scale scores; secondary: Parental Separation Anxiety Scale and Faces, Legs, Activity, Cry, Consolability (FLACC) scale.
Main Results:
- Immersive VR distraction significantly reduced ED incidence (6.67%) compared to video distraction (40%) and standard care (60%) (P < .05).
- Children in the VR group showed significantly lower postoperative pain scores (FLACC scale) compared to other groups (P < .05).
- No significant differences in perioperative anxiety were found between the three groups based on Parental Separation Anxiety Scale scores (P = .27).
Conclusions:
- Immersive VR distraction is a highly effective intervention for mitigating emergence delirium in pediatric surgical patients.
- VR technology integration during the perioperative period can lead to improved postoperative outcomes.
- Further research is recommended to validate these findings across diverse surgical contexts and explore broader applications of VR in pediatric healthcare.
Purpose:
Emergence delirium (ED) presents challenges for both parents and health care providers in pediatric surgical settings. This study aims to evaluate the effectiveness of immersive virtual reality (VR) distraction and video distraction combined with parental presence in reducing ED in preschool-aged children undergoing elective surgery.
Design:
A prospective, randomized, controlled clinical trial was conducted with 90 children ages 4 to 7. Participants were randomly assigned to three groups: VR distraction (group V), tablet video distraction with parental presence (group T), and standard care (group C). The primary endpoints were the incidence of ED and Pediatric Anesthesia Emergence Delirium Scale scores, with secondary measures encompassing scores from the Parental Separation Anxiety Scale and the Faces, Legs, Activity, Cry, Consolability (FLACC) scale.
Methods:
Participants were assigned to one of the three intervention groups, and relevant scales were used to assess ED, parental separation anxiety, and postoperative pain. The immersive VR distraction and video distraction with parental presence interventions were compared against standard care.
Findings:
Immersive VR distraction significantly reduced the incidence of ED (6.67% in group V vs 40% in group T and 60% in group C), and the incidence of ED in group V was notably lower than in the other groups (P = .023 vs group T and P = .004 vs group C). Children in group V displayed significantly lower FLACC compared with the other groups as well (P < .05). However, no significant differences between the 3 groups were observed in perioperative anxiety as assessed by the Parental Separation Anxiety Scale scores (P = .27).
Conclusions:
This study underscores the potential of immersive VR distraction as an effective intervention for mitigating ED in pediatric surgical patients. The findings suggest that incorporating VR technology during the perioperative period can positively impact postoperative outcomes. Further research in diverse surgical contexts is recommended to validate these findings and explore the broader applicability of VR distraction in pediatric health care settings.
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