Guided Relaxation–Based Virtual Reality for Acute Postoperative Pain and Anxiety in a Pediatric Population: Pilot Observational Study

Abstract

Background Distraction-based therapies, such as virtual reality (VR), have been used to reduce pain during acutely painful procedures. However, distraction alone cannot produce prolonged pain reduction to manage sustained postoperative pain. Therefore, the integration of VR with other pain-reducing therapies, like guided relaxation, may enhance its clinical impact. Objective The goal of this pilot study was to assess the impact of a single guided relaxation–based VR (VR-GR) session on postoperative pain and anxiety reduction in children. We also explored the influence of pain catastrophizing and anxiety sensitivity on this association. Methods A total of 51 children and adolescents (7-21 years) with postoperative pain and followed by the Acute Pain Service at Cincinnati Children’s Hospital were recruited over an 8-month period to undergo a single VR-GR session. Prior to VR, the patients completed 2 questionnaires: Pain Catastrophizing Scale for Children (PCS-C) and the Child Anxiety Sensitivity Index (CASI). The primary outcome was a change in pain intensity following the VR-GR session (immediately, 15 minutes, and 30 minutes). The secondary outcomes included changes in pain unpleasantness and anxiety. Results The VR-GR decreased pain intensity immediately (P<.001) and at 30 minutes (P=.04) after the VR session, but not at 15 minutes (P=.16) postsession. Reductions in pain unpleasantness were observed at all time intervals (P<.001 at all intervals). Anxiety was reduced immediately (P=.02) but not at 15 minutes (P=.08) or 30 minutes (P=.30) following VR-GR. Patients with higher CASI scores reported greater reductions in pain intensity (P=.04) and unpleasantness (P=.01) following VR-GR. Pain catastrophizing was not associated with changes in pain and anxiety. Conclusions A single, short VR-GR session showed transient reductions in pain intensity, pain unpleasantness, and anxiety in children and adolescents with acute postoperative pain. The results call for a future randomized controlled trial to assess the efficacy of VR-GR. Trial Registration ClinicalTrials.gov NCT04556747; https://clinicaltrials.gov/ct2/show/NCT04556747

Virtual Reality Reduces Fear and Anxiety During Pediatric Orthopaedic Cast Room Procedures: A Randomized Controlled Trial

“…Our results align with the results from a similar study conducted in Canada, demonstrating that VR technology is a helpful distraction tool for reducing anxiety for pediatric patients undergoing cast removals 10. Our results add to the overall body of knowledge that VR can be used as an effective distraction tool in a variety of settings that include not only pediatric orthopaedic clinics, but also during needle procedures,3,7,8 in pediatric oncology,5 for postoperative care in the Acute Pain Service,9 and for burn wound patients in concurrence with pharmacologic analgesics 4. For pediatric patients undergoing a blood draw, VR has shown to decrease fear, anxiety, and pain outcomes in pediatric patients aged 5 to 12 years old 6.…”

“…V irtual Reality (VR) is an immersive technology that has been used by hospitals for training and educational purposes but more recently, has been adapted for use in the clinical setting as a distraction tool for patients. [1][2][3][4][5][6][7][8][9][10][11] Distraction plays an important role in clinical care and increasing patient satisfaction, especially for pediatric patients undergoing stressful procedures. VR has shown to decrease pain and anxiety for children in various clinical settings such as anesthesia, 1 burn wound care, 4 and oncology.…”

Development of a Virtual Reality Nursing Assistance System to Positively Enhance Rectal Medication Adherence in Children

“…he main purpose of the VR animation game developed in this study is to provide children with positive enhancement in their adherence to rectal drug delivery. Previous studies have shown that the use of VR sensory stimulation distracts children from invasive procedures and reduces pain, anxiety, and fear during medical procedures 9,12,13 . However, after passively receiving treatment, children still did not understand the reason behind the procedure and continued to feel anxious and fearful the next time they faced an invasive procedure.…”

Penggunaan Virtual Reality Dalam Penurunan Kecemasan Pada Anak Dengan Hospitalisasi

“…Selain itu ada alat VR yang diaplikasikan dengan menggunakan headphone dan handheld controller dimana pasien berinteraksi dengan lingkungan di dalam VR melalui headphone dan mengontrolnya melalui tangan. Ada pula VR yang diaplikasikan menggunakan kacamata dan headset dan menghasilkan gambar virtual berupa padang rumput Alpine dimana penggunanya dipandu untuk belajar bernafas pelan dan rileks (Olbrecht et al, 2021).…”