Effectiveness of Virtual Reality on Pain During Peripheral Intravenous Catheterization in the Emergency Room: A Randomized Clinical Trial

The aim of the study was to evaluate the effectiveness of virtual reality in reducing pain and procedure-related distress during peripheral intravenous catheter (PIVC) insertion in children. A 2-arm, randomized, parallel-group clinical trial compared virtual reality with standard care. Children aged 4 to 14 years requiring an elective PIVC were randomly assigned (1:1) to virtual reality with a relaxing ocean film (intervention group) or standard care (control group). The outcomes measured were pain perception (Faces Pain Scale-Revised) and procedure-related distress (Observational Behavioral Distress Scale). A total of 352 children were stratified by age (4-8 and 9-14 years) before randomization into intervention (48.6%, n = 171) and control (51.4%, n = 181) groups. The pain was significantly reduced for children receiving virtual reality across all age groups (relative risk [RR]: 0.57; 95% confidence interval [CI]: 0.45-0.72). This reduction was observed in younger (RR: 0.53; 95% CI: 0.39-0.71) and older children (RR: 0.63; 95% CI: 0.43-0.91). Procedure-related distress decreased across all ages, with more pronounced effects in children aged 8 years and under. In the intervention group, 9% (n = 17) discontinued due to poor tolerance to intravenous catheterization; no other adverse events were reported. Virtual reality decreased pain and alleviated procedure-related distress, with more significant effects for children aged 4 to 8 years.