Pilot Randomized Controlled Trial of Virtual Reality vs. Standard-of-Care During Pediatric Laceration Repair.

Virtual reality (VR) is an emerging immersive technology with initial documentation of reduction in anxiety and pain when used by children in the hospital setting. The objective of this study was to compare VR to standard of care (SOC) in a pediatric Emergency Department (ED) for pain management and anxiety among children needing a laceration repair procedure. We conducted a prospective randomized controlled trial in a tertiary pediatric ED (NCT03681717) with children 6-16 years of age going through a laceration repair procedure. Intervention was low-cost VR goggles with a free roller coaster application during the procedure or SOC in the ED during the same time (1:1). The primary outcome was post-procedure pain (Faces Pain Scale - Revised (FPS-R)), and secondary outcome was the Venham Situational Anxiety (VSA) score. A total of 32 subjects were in the VR group and 30 in the SOC group. Age, gender, location and length of the laceration, number of sutures needed, use of oral, topical or local anesthetics, time to complete the procedure and time to discharge, were similar between groups. Pain and anxiety as measured after the procedure were very low, and similar between groups. Children rated the VR experience more positively than the SOC (p = 0.01). Using low cost VR system was similar to our tertiary pediatric center SOC comfort level and children enjoyed the VR system more. VR may serve as an additional tool in the armamentarium of ED providers for pain and anxiety reduction during laceration repairs.