2019
Systematic Review and Meta-analysis of Virtual Reality in Pediatrics
Publication
Publication
Effects on Pain and Anxiety
Anesthesia and Analgesia , Volume 129 - Issue 5 p. 1344- 1353
BACKGROUND: Medical procedures often evoke pain and anxiety in pediatric patients. Virtual reality (VR) is a relatively new intervention that can be used to provide distraction during, or to prepare
patients for, medical procedures. This meta-analysis is the first to collate evidence on the effectiveness of VR on reducing pain and anxiety in pediatric patients undergoing medical procedures.
METHODS: On April 25, 2018, we searched EMBASE, MEDLINE, CENTRAL, PubMed, Web of
Science, and PsycINFO with the keywords “VR,” “children,” and “adolescents.” Studies that
applied VR in a somatic setting with participants ≤21 years of age were included. VR was defined
as a fully immersive 3-dimensional environment displayed in surround stereoscopic vision on a
head-mounted display (HMD). We evaluated pain and anxiety outcomes during medical procedures in VR and standard care conditions.
RESULTS: We identified 2889 citations, of which 17 met our inclusion criteria. VR was applied
as distraction (n = 16) during venous access, dental, burn, or oncological care or as exposure
(n = 1) before elective surgery under general anesthesia. The effect of VR was mostly studied in
patients receiving burn care (n = 6). The overall weighted standardized mean difference (SMD) for
VR was 1.30 (95% CI, 0.68–1.91) on patient-reported pain (based on 14 studies) and 1.32 (95%
CI, 0.21–2.44) on patient-reported anxiety (based on 7 studies). The effect of VR on pediatric pain
was also significant when observed by caregivers (SMD = 2.08; 95% CI, 0.55–3.61) or professionals (SMD = 3.02; 95% CI, 0.79–2.25). For anxiety, limited observer data were available.
CONCLUSIONS: VR research in pediatrics has mainly focused on distraction. Large effect sizes
indicate that VR is an effective distraction intervention to reduce pain and anxiety in pediatric
patients undergoing a wide variety of medical procedures. However, further research on the
effect of VR exposure as a preparation tool for medical procedures is needed because of the
paucity of research into this field. (Anesth Analg 2019;129:1344–53)
Additional Metadata | |
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doi.org/10.1213/ane.0000000000004165, hdl.handle.net/1765/120500 | |
Anesthesia and Analgesia | |
Organisation | Pediatric Psychiatry |
Eijlers, R., Utens, E., Staals, L., de Nijs, P., Berghmans, J., Wijnen, R., … Legerstee, J. (2019). Systematic Review and Meta-analysis of Virtual Reality in Pediatrics. Anesthesia and Analgesia, 129(5), 1344–1353. doi:10.1213/ane.0000000000004165 |