A Randomized Controlled Trial of Commercially Available Virtual Reality for Intravenous Cannulation-Related Distress in Children

Abstract

Objective: To assess whether commercially available virtual reality (VR)-based distraction reduces distress when added to standard of care (SOC) for children undergoing intravenous insertion (IVI) in the pediatric emergency department.

Study design: Children aged 6-17 years requiring IVI were recruited for a two-arm randomized controlled trial. The primary outcome was child distress, measured using the Observational Scale of Behavioral Distress-Revised (score range 0-23.5). Secondary outcomes included children's procedural pain (verbal Numerical Rating Scale, score range 0-10) and fear (Children's Fear Scale, score range 0-4).

Results: Mean (SD) children age was 11.1 years (2.9) and 54% (45/82) were female. Mean (SD) preprocedural Observational Scale of Behavioral Distress-Revised scores were similarly low in both the VR [0.39 (0.70)] and SOC arms [0.18 (0.49)] (P = .16). Use of VR during IVI was not associated with lower mean (SD) total procedural distress [1.1 (1.5)] vs SOC [0.7 (1.4)] (P = .08), mean (SD) procedural pain intensity [3.0 (2.9)] vs SOC [2.1 (2.3)] (P = .14), or mean (SD) Children's Fear Scale score [0.97 (1.33)] vs SOC [0.97 (1.15)]. Technical issues with the VR equipment were reported in 26% (10/39) of cases.

Conclusions: VR distraction therapy employing commercially available software was not associated with reduction in procedural distress, pain or fear, above that provided with SOC, for children undergoing IVI in the pediatric emergency department. Given no differences and frequency of technical issues, other forms of distraction may be more appropriate in this setting.

Trial registration: Clinicaltrials.gov Identifier: NCT04291404.

Keywords: distraction; pain; pediatrics; technology.