2024 FSA Podium and Poster Abstracts

P038: VIRTUAL REALITY AS A PROCEDURAL ANXIOLYTIC AND PAIN ATTENUATOR FOR THE PEDIATRIC AND ADULT POPULATIONS.
Saloni Chadha; Victoria Young; Natalie Nagib; Corey Mumaw; Nicole Greenwood, MD; Lake Erie College of Osteopathic Medicine

Introduction: Therapeutic and operative procedures are often associated with pain and anxiety for adult and pediatric patients. Virtual reality (VR) technology may be a useful distraction strategy that may result in lower anxiety and pain levels in all ages. It is hypothesized that VR modulates nociceptive pathways in brain structures such as the anterior cingulate cortex among other subcortical structures, which may benefit the overall healthcare experience for both children and adults. The use of VR is important as evidence suggests that poor pain management can lead to unfavorable outcomes due to reasons such as immune dysfunction. Pain and anxiety in the medical environment may also result in a lack of compliance and emotional instability. The objective of this study is to explore the effects of VR on procedural and perioperative pain and anxiety of pediatric patients in comparison to adult patients.

Methods: A literature review was conducted using ("virtual reality") AND (("anesthesiology") OR (anesthesia)) as keywords, identifying 495 sources from the PubMed database between 1995-2024. After filters including free full text availability, year 2010-2023, and article type (clinical trial, randomized controlled trials, and systematic review) were applied, 54 sources remained.

Results: Out of 54 sources, 14 sources met inclusion criteria. Out of the 5 randomized control trials that included only pediatric patients (under the age of 18), 1 out of the 3 (33%) that measured pain reported that VR significantly reduced pain, and 2 out of 3 (67%) sources that measured anxiety reported that VR significantly reduced anxiety. Out of the 7 randomized control trials that included adults (over the age of 18), 3 out of the 5 (60%) that measured pain reported that VR significantly reduced pain and 2 out of the 4 (50%) reported that VR significantly reduced anxiety. 2 out of the 14 total sources included both populations, one source included ages above 12 and the other source included ages 15-66, and both of those sources showed significant reduction in pain in the VR groups when compared to the control groups.

Discussion/Conclusion: This literature review indicates that VR technology may be a promising and useful tool to reduce pain and/or anxiety in pediatric and adult patients undergoing a range of medical procedures. A few ways that VR can be used in healthcare is to provide hypnotic analgesia prior to surgery, reduce preoperative anxiety, reduce pain from physical therapy, and reduce dental procedure anxiety. As a non-pharmacological strategy, virtual reality immersive techniques may used as analgesia and may decrease the use of opioid analgesics which are associated with many side effects including abuse potential. Limitations to this literature review include sample size and the standardization of variables. Further research is required to fully quantify and qualify the benefit of VR in modern day pain attenuation and anxiolysis.