Evidence map›Paper›PMID 31136330›Full record

SynthesisAnesthesia and analgesia2019

Systematic Review and Meta-analysis of Virtual Reality in Pediatrics: Effects on Pain and Anxiety.

Robin Eijlers, Elisabeth M W J Utens, Lonneke M Staals, Pieter F A de Nijs, Johan M Berghmans, René M H Wijnen, Manon H J Hillegers, Bram Dierckx, Jeroen S Legerstee

14 registry-linked trialsOpen access · hybridAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Anesthesia and analgesia, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 14 registered trials, which are not on this map. Cited by 232 papers, 25 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
232citing papers in PubMed, 25 pooled it
73.3field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04869293 naunknown statusnot on this mapstarted 2021, after this paper: background citation

Assessment of Analgesia Through Hypnosis With 3D Virtual Reality During Extra-corporeal Lithotripsy (LAHMA)

TypeinterventionalSponsorAssistance Publique - Hôpitaux de ParisRan2021 to 2024Enrolled106ConditionsRenal Calculi, PainArmsHypnosis 3D virtual reality headset
NCT05653934 naunknown statusnot on this mapstarted 2023, after this paper: background citation

Virtual Reality Immersion With 360° Virtual Reality Headset to Reduce Postoperative Anxiety and Pain After Surgery for Colorectal Cancer: a Randomized Controlled Pilot Trial - VIREA Trial

TypeinterventionalSponsorAssistance Publique - Hôpitaux de ParisRan2023 to 2024Enrolled124ConditionsColon Tumor, Malignant, Rectum Tumor, Pain, PostoperativeArmsPre-operative use of virtual reality headset, Standard surgery, Post-operative use of virtual reality headset
NCT05743062 nacompletednot on this mapstarted 2023, after this paper: background citation

Awe Inducing Elements in Virtual Reality Applications: A Prospective Study of Hospitalized Children

TypeinterventionalSponsorStanford UniversityRan2023 to 2023Enrolled202ConditionsAweArmsVirtual Reality, Control
NCT05898100 nacompletednot on this mapstarted 2023, after this paper: background citation

Effects of The Virtual Reality "Dream" Game on Anxiety During Dental Procedures in Children (VR-TOOTH): A Pilot Randomized, Controlled Trial

TypeinterventionalSponsorSt. Justine's HospitalRan2023 to 2024Enrolled25ConditionsDental Anxiety, Dental Phobia, Dental Trauma, Dental DiseasesArmsVirtual Reality Distraction, Dental Clinic's Standard Treatment
NCT06160518 nacompletednot on this mapstarted 2023, after this paper: background citation

Technology and Children's Health: Effect of Virtual Reality on Pain and Clinical Outcomes During Hydrotherapy for Children With Burn

TypeinterventionalSponsorMatrouh UniversityRan2023 to 2023Enrolled60ConditionsBurn, HydrotherapyArmsVirtual reality
NCT06182462 narecruitingnot on this mapstarted 2023, after this paper: background citation

The Effects of A Virtual Reality Game on Anxiety During Dental Procedures in Children (VR-TOOTH): A Randomized, Controlled Trial Protocol

TypeinterventionalSponsorSt. Justine's HospitalRan2023 to 2026Enrolled88ConditionsDental Anxiety, Dental Phobia, Dental Trauma, Dental DiseasesArmsVirtual Reality Distraction, Dental Clinic's Standard Treatment
NCT06446518 nacompletednot on this mapstarted 2022, after this paper: background citation

A Randomized Control Trial for Assessing Virtual Reality for Perioperative Anxiolysis and Postoperative Pain Modulation in Adolescents Undergoing MIRPE Surgery

TypeinterventionalSponsorSemmelweis UniversityRan2022 to 2024Enrolled50ConditionsPectus Excavatum, Pectus DeformityArmsVirtual reality exposure
NCT06515873 naunknown statusnot on this mapstarted 2024, after this paper: background citation

Evaluating the Acceptability of Virtual Reality Headsets During Surgery Under Spinal Anesthesia in Elderly Patients. Seniors' Intraoperative Management Under Locoregional Anesthesia Integrating Virtual Reality (SILVR)

TypeinterventionalSponsorCiusss de L'Est de l'Île de MontréalRan2024 to 2025Enrolled55ConditionsVirtual Reality, Spinal AnesthesiaArmsVirtual Reality Headset
NCT06516003 nacompletednot on this mapstarted 2022, after this paper: background citation

Use of Immersive Virtual Reality for Laceration Repairs in the Pediatric Emergency Department

TypeinterventionalSponsorEastern Virginia Medical SchoolRan2022 to 2023Enrolled91ConditionsLacerationArmsImmersive Virtual Reality Goggles, Standard of Care
NCT06522711 nanot yet recruitingnot on this mapstarted 2024, after this paper: background citation

Virtual Reality as a Strategy for Intra-operatory Anxiolysis and Pharmacological Sparing in Patients Undergoing Breast Surgeries : the V-RAPS Randomized Controlled Trial

TypeinterventionalSponsorCiusss de L'Est de l'Île de MontréalRan2024 to 2026Enrolled100ConditionsVirtual Reality, PropofolArmsVirtual reality headset, Standard of care
NCT07018999 nacompletednot on this mapstarted 2022, after this paper: background citation

Immersive Virtual Reality Exposure for Reducing Preoperative Anxiety in Children

TypeinterventionalSponsorHong Kong Children's HospitalRan2022 to 2024Enrolled114ConditionsAnxiety State, Satisfaction, ComplianceArmsImmersive virtual reality operating theatre tour
NCT07173231 nanot yet recruitingnot on this mapstarted 2025, after this paper: background citation

Comparisons Between Virtual Reality and Hypno-Virtual Reality for Procedural Pain and Anxiety During a Diagnostic Hysteroscopy: A Pilot Randomized Controlled Trial

TypeinterventionalSponsorSt. Justine's HospitalRan2025 to 2026Enrolled45ConditionsHysteroscopy, Anxiety, PainArmsImmersive Virtual Reality Distraction (IVR), Hypno-Virtual Reality Distraction (HVR), Usual Care Group
NCT07737886 nanot yet recruitingnot on this mapstarted 2026, after this paper: background citation

Feasibility, Acceptability, and Preliminary Effects of Virtual Reality for Pain, Anxiety and Recovery Enhancement of Children Post-Scoliosis Surgical Repair: A Pilot Randomized Controlled Parallel Trial (VR-SPINE)

TypeinterventionalSponsorSt. Justine's HospitalRan2026 to 2028Enrolled24ConditionsScoliosis PatientsArmsVirtual Reality, Standard medical treatment
NCT07780331 narecruitingnot on this mapstarted 2025, after this paper: background citation

The Effect of Using Virtual Reality Glasses and Gaming Cards on Fear, Anxiety, and Physiological Parameters in Children Administered Inhaler Medication

TypeinterventionalSponsorBandırma Onyedi Eylül UniversityRan2025 to 2026Enrolled150ConditionsRespiratory Tract Diseases, Pediatric Disorders, Anxiety, FearArmsVirtual Reality Goggles (VR BOX), Interactive Distraction Cards (DistrACTION® Cards), Standard Clinical Care
3 · Its place in the literature

Who cites it

232 citing papers in PubMed, 25 syntheses or guidelines pooled it, 563 citations in OpenAlex.

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  13. Distraction Therapies for Office-Based Otolaryngology Procedures Performed on the Upper Airway.Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery · 2025
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172 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 2 institutions in 2 countries.

Robin EijlersFrom the Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Center-Sophia Children's Hospital, Rotterdam, the Netherlands.
Elisabeth M W J UtensFrom the Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Center-Sophia Children's Hospital, Rotterdam, the Netherlands.
Lonneke M StaalsDepartment of Anesthesiology, Erasmus Medical Center-Sophia Children's Hospital, Rotterdam, the Netherlands.
Pieter F A de NijsFrom the Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Center-Sophia Children's Hospital, Rotterdam, the Netherlands.
Johan M BerghmansFrom the Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Center-Sophia Children's Hospital, Rotterdam, the Netherlands.
René M H WijnenIntensive Care and Department of Pediatric Surgery, Erasmus Medical Center-Sophia Children's Hospital, Rotterdam, the Netherlands.
Manon H J HillegersFrom the Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Center-Sophia Children's Hospital, Rotterdam, the Netherlands.
Bram DierckxFrom the Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Center-Sophia Children's Hospital, Rotterdam, the Netherlands.
Jeroen S LegersteeFrom the Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Center-Sophia Children's Hospital, Rotterdam, the Netherlands.
Erasmus MC - Sophia Children’s Hospital · NLZNA Middelheim Hospital · BE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMedical procedures often evoke pain and anxiety in pediatric patients. Virtual reality (VR) is a relatively new intervention that can be used to provide distraction during, or to prepare patients for, medical procedures. This meta-analysis is the first to collate evidence on the effectiveness of VR on reducing pain and anxiety in pediatric patients undergoing medical procedures.

methodsOn April 25, 2018, we searched EMBASE, MEDLINE, CENTRAL, PubMed, Web of Science, and PsycINFO with the keywords "VR," "children," and "adolescents." Studies that applied VR in a somatic setting with participants ≤21 years of age were included. VR was defined as a fully immersive 3-dimensional environment displayed in surround stereoscopic vision on a head-mounted display (HMD). We evaluated pain and anxiety outcomes during medical procedures in VR and standard care conditions.

resultsWe identified 2889 citations, of which 17 met our inclusion criteria. VR was applied as distraction (n = 16) during venous access, dental, burn, or oncological care or as exposure (n = 1) before elective surgery under general anesthesia. The effect of VR was mostly studied in patients receiving burn care (n = 6). The overall weighted standardized mean difference (SMD) for VR was 1.30 (95% CI, 0.68-1.91) on patient-reported pain (based on 14 studies) and 1.32 (95% CI, 0.21-2.44) on patient-reported anxiety (based on 7 studies). The effect of VR on pediatric pain was also significant when observed by caregivers (SMD = 2.08; 95% CI, 0.55-3.61) or professionals (SMD = 3.02; 95% CI, 0.79-2.25). For anxiety, limited observer data were available.

conclusionsVR research in pediatrics has mainly focused on distraction. Large effect sizes indicate that VR is an effective distraction intervention to reduce pain and anxiety in pediatric patients undergoing a wide variety of medical procedures. However, further research on the effect of VR exposure as a preparation tool for medical procedures is needed because of the paucity of research into this field.

Indexed as

Pain ManagementVirtual RealityAdolescentAdultAnxietyChildChild, PreschoolHumansPublication BiasYoung Adult

Identifiers

PMID31136330
PMCPMC6791566
OpenAlexW2947250242

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

and 8 more above

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.