Transient reductions in postoperative pain and anxiety using virtual reality in children

Objective: Virtual reality (VR) is a promising method to manage pain. Distraction-based VR (VR-D) is thought to reduce pain by redirecting attention. While VR-D can reduce pain associated with acutely painful procedures, it is unclear if VR-D can reduce pain after surgery. We assessed the ability of a single VR-D session to decrease acute postoperative pain and anxiety and explored if pain catastrophizing and anxiety sensitivity influenced the ability of VR-D to reduce these outcomes in children following surgery. Design: Single-center, prospective, pilot study Setting: Cincinnati Childrens Hospital Medical Center (CCHMC) Subjects: 50 children/adolescents (age 7-21 years) with postoperative pain followed by the Acute Pain Service Methods: Patients received a single VR-D session following surgery. Prior to the VR-D session, patients completed pain catastrophizing (PCS-C) and anxiety sensitivity (CASI) questionnaires. Primary outcome consisted of changes in pain intensity following VR-D (immediately, 15, and 30 minutes). Secondary outcomes included changes in pain unpleasantness and anxiety. Results: VR-D decreased pain intensity immediately and 15-minutes after VR-D. Reductions in pain unpleasantness were observed up to 30 minutes following VR-D. Anxiety was also reduced immediately and at 15-minutes following VR-D. While patients with higher pain catastrophizing had higher baseline pain intensity and unpleasantness, they did not show larger pain reductions following VR-D compared to those with lower pain catastrophizing. Conclusions: VR-D is beneficial in transiently reducing pain intensity, unpleasantness, and anxiety in children with acute postoperative pain. This study informs design of larger, controlled study assessing VR-D for acute postoperative pain and anxiety.