Immersive Virtual Reality May Decrease Pain, Anxiety for Pediatric Venipuncture

A nonpharmacological distraction intervention, such as immersive virtual reality, may reduce pain and anxiety in pediatric patients undergoing venipuncture.

Immersive virtual reality (IVR) intervention may improve pain and anxiety among pediatric patients undergoing venipuncture, according to findings from a randomized clinical trial published in JAMA Network Open.

Researchers recruited 149 pediatric patients who would be undergoing venipuncture from a regional public hospital in Hong Kong for the analysis. The patients had a mean age of 7.21 (SD, 2.45) years; 57.7% were girls; 44.3% had fever; 28.9% had never received a venipuncture before; and 21.5% had used analgesic medication.

Patients were randomly assigned in a 1:1 ratio to receive IVR followed by venipuncture (n=75) or standard care (n=74). The IVR intervention comprised 2 age-appropriate virtual reality scenarios delivered by a smartphone with a disposable headset attachment; both scenarios depicted a cartoon character who would be undergoing venipuncture. The outcomes of interest in this study were pain and anxiety.

The average time for venipuncture was 4.43 (SD, 3.47) minutes among IVR recipients and 6.56 (SD, 7.39) minutes among the standard care recipients.

Given that IVR is becoming more affordable and accessible, it could be used to improve children’s experiences of needle-related or pain- and anxiety-inducing medical procedures.

Compared with the control cohort, the IVR recipients reported lower pain scores immediately and 30 minutes after venipuncture; lower anxiety scores 10 minutes before, immediately after, and 30 minutes after venipuncture. IVR recipients also had a lower heart rate during and immediately after venipuncture and a smaller increase in pain scores (β, -0.78; P <.001) and anxiety scores (β, -0.41; P =.03) immediately after venipuncture, relative to controls.

Stratified by age group, these significant group-by-time interactions were driven by children aged 4 to 7 years (both P =.006) and not by 8 to 12 years (both P =.27). Similarly, the differences in pain and anxiety scores among IVR participants compared with those among controls had larger effect sizes among the younger children than the older children.

Limitations to the study included that participants were not blinded to the study and that the study was conducted at a single site. In addition, study findings may not be generalizable for younger patients in outpatient settings.

“Given that IVR is becoming more affordable and accessible, it could be used to improve children’s experiences of needle-related or pain– and anxiety-inducing medical procedures,” the study authors concluded.

This article originally appeared on Clinical Pain Advisor


Wong CL, Choi KC. Effects of an immersive virtual reality intervention on pain and anxiety among pediatric patients undergoing venipuncture: a randomized clinical trial. JAMA Netw Open. Published online February 16, 2023. doi:10.1001/jamanetworkopen.2023.0001