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Virtual Reality as Active Distraction in Laceration Repair: A Game Changer?

Anne O McEvoy1,2, Olivia B Vincent3, Turaj Vazifedan4

  • 1Department of Pediatrics, Eastern Virginia Medical School, Norfolk, VA.

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Immersive virtual reality (VR) goggles significantly reduced pain and fear in children undergoing laceration repair in the pediatric emergency department (PED). VR use also decreased the need for physical holding during the procedure.

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Area of Science:

  • Pediatric Emergency Medicine
  • Pain Management
  • Virtual Reality Applications

Background:

  • Laceration repair in children often involves significant pain and fear.
  • Current standard of care may not adequately address these distress symptoms.
  • Virtual reality (VR) presents a potential non-pharmacological intervention for pain and anxiety management.

Purpose of the Study:

  • To evaluate the effectiveness of immersive virtual reality (VR) goggles in reducing pain and fear scores during laceration repair in a pediatric emergency department (PED).
  • To assess secondary outcomes including procedure duration, need for physical restraint, anxiolytic use, and patient/provider willingness to reuse VR.

Main Methods:

  • An unblinded, randomized controlled trial was conducted with 91 pediatric patients (aged 6-17) undergoing simple laceration repair.
  • Patients were randomized to receive either VR goggles or standard of care.
  • Pain and fear were assessed using validated scales (Wong-Baker Faces Pain Scale, Children's Fear Scale), with additional data collected from guardians and providers.

Main Results:

  • Patients using VR goggles reported significantly lower mean pain scores (2.3 vs. 3.7) and fear scores (2.2 vs. 3.0) compared to the standard care group.
  • The likelihood of requiring physical holding was significantly lower in the VR group (aOR=0.34).
  • Anxiolytic use was reduced in older adolescents (12-17 years) using VR (aOR=0.27), with no significant difference in procedure duration.

Conclusions:

  • Immersive virtual reality goggles are an effective distraction tool for reducing pain and fear during simple laceration repairs in pediatric patients.
  • VR use decreases the need for physical restraint and shows potential for reducing anxiolytic administration in older children.
  • High acceptance rates among patients, parents, and providers suggest VR is a viable adjunct to standard care in the PED.