title: Effectiveness of virtual reality for pediatric pain distraction during i.v. placement.
abstract: The objective of this study was to test the efficacy and suitability of virtual reality (VR) as a pain distraction for pediatric intravenous (i.v.) placement. Twenty children (12 boys, 8 girls) requiring i.v. placement for a magnetic resonance imaging/computed tomography (MRI/CT) scan were randomly assigned to two conditions: (1) VR distraction using Street Luge (5DT), presented via a head-mounted display, or (2) standard of care (topical anesthetic) with no distraction. Children, their parents, and nurses completed self-report questionnaires that assessed numerous health-related outcomes. Responses from the Faces Pain Scale-Revised indicated a fourfold increase in affective pain within the control condition; by contrast, no significant differences were detected within the VR condition. Significant associations between multiple measures of anticipatory anxiety, affective pain, i.v. pain intensity, and measures of past procedural pain provided support for the complex interplay of a multimodal assessment of pain perception. There was also a sufficient amount of evidence supporting the efficacy of Street Luge as a pediatric pain distraction tool during i.v. placement: an adequate level of presence, no simulator sickness, and significantly more child-, parent-, and nurse-reported satisfaction with pain management. VR pain distraction was positively endorsed by all reporters and is a promising tool for decreasing pain, and anxiety in children undergoing acute medical interventions. However, further research with larger sample sizes and other routine medical procedures is warranted.
authors.affiliation: Clinical Anesthesiology & Pediatrics, USC Keck School of Medicine, Childrens Hospital Los Angeles, Los Angeles, California 90027-6062, USA. jgold@chla.usc.edu
authors.forename: Jeffrey I
authors.initials: JI
authors.lastname: Gold
authors.forename: Seok Hyeon
authors.initials: SH
authors.lastname: Kim
authors.forename: Alexis J
authors.initials: AJ
authors.lastname: Kant
authors.forename: Michael H
authors.initials: MH
authors.lastname: Joseph
authors.forename: Albert Skip
authors.initials: AS
authors.lastname: Rizzo
mesh_terms: D001288:Attention; D002408:Catheters, Indwelling / Q000009:adverse effects; D002648:Child; D003198:Computer Simulation; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous / Q000009:adverse effects; D008297:Male; D010146:Pain / Q000209:etiology / Q000517:prevention & control* / Q000523:psychology; D010147:Pain Measurement; D017288:Pain Threshold; D016896:Treatment Outcome; D014584:User-Computer Interface; D018910:Video Games