Immersive Virtual Reality as Analgesia During Dressing Changes of Hospitalized Children and Adolescents with Burns: A Systematic Review with Meta-Analysis

Abstract

Children and adolescents with severe burns require dressing changes, associated with pain. As immersive virtual reality (VR) gained prominence as non-pharmacological adjuvant analgesia, we conducted a systematic review and meta-analysis on the efficacy of full immersive VR on pain experienced during dressing changes in hospitalized children and adolescents with severe burns. This exercise included quality and risk of bias assessment. The systematic reviewsearch resulted in eight studies and 142 patients. This exercise included quality and risk of bias assessment. Due to missing data, four studies were excluded from the meta-analysis. Fixed effects meta-analysis of the four included studies (n = 104) revealed a large effect size (ES) (SMD=0.94; 95% CI=0.62, 1.27; Z=5.70; p<0.00001) for adjuvant full immersive VR compared to standard care. In conclusion, adjuvant full immersive VR significantly reduces pain experienced during dressing changes in children and adolescents with burns. We therefore recommend implementing full immersive VR as an adjuvant in this specific setting and population. However, this requires further research into the hygienic use of VR appliances in health institutions. Furthermore, due to the high cost of the hardware, a cost-benefit analysis is required. Finally, research should also verify the long term physical and psychological benefits of VR.

Effect of Virtual Reality on Distraction of Children Attention during Dressing of Second Degree Burns

“…These resul similar to results of Lauwens et el (2020) who reported that most of their study children are from 6-12 years old. (23) The results of the current study illustrated that more than half of studied children were males. It may be due to males may be active and having physical activities more than females.…”

Efficacy of opioids and non-opioid analgesics in the treatment of post procedure pain of burned patients: a narrative review

“… 27 However, due to the high intensity of pain and exposure to multiple painful procedures, non-pharmacological therapies that contribute to analgesia should be considered, such as virtual reality. In this regard, Lauwens et al 28 found that virtual reality had an outstanding effect in reducing pain in pediatric patients when compared to traditional care (n = 104) ( p < 0.00001).…”