Systematic review and meta-analysis shows nonsignificant pain reduction with XR in children
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Key Takeaway
Note nonsignificant XR pain reduction in children requires further investigation
This systematic review and meta-analysis examined the efficacy of extended reality interventions, specifically virtual reality, for managing acute and postoperative pain in children aged 18 years or younger. The analysis included nine studies, with primary and secondary meta-analyses each comprising six studies. The setting was not reported for these studies. The primary outcome was self-reported pain, while secondary outcomes included observer-reported pain.
The primary meta-analysis showed a standardized mean difference of -0.61 for self-reported pain with a 95% CI of -1.58 to 0.36. The secondary meta-analysis showed a standardized mean difference of -1.04 for observer-reported pain with a 95% CI of -2.18 to 0.11. Both effects were negative, indicating a potential reduction in pain, but neither reached statistical significance. No adverse events, serious adverse events, discontinuations, or tolerability data were reported.
The authors note that the lack of statistical significance indicates that XR interventions require further investigation. Future research should prioritize pain as a primary endpoint and assess the effects of VR type, timing, and age on acute pain using validated measures. The practice relevance is that XR interventions require further investigation in pediatric pain management. Causality was not explicitly distinguished as this was a meta-analysis of previous studies.
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View Original Abstract ↓
BACKGROUND: Acute and postoperative pain in children is often undertreated, with effects on patient comfort and postoperative recovery. Extended reality (XR) interventions offer non-pharmacological pain management by distracting patients from discomfort. While effective for procedural pain, its impact on prolonged pain episodes remains underexplored.
OBJECTIVES: To systematically review and meta-analyze findings from previous studies on the efficacy of XR interventions in managing acute and postoperative pain in children, compared to standard care.
ELIGIBILITY CRITERIA: Studies involving children (≤ 18 years) with acute or postoperative pain were included if they compared XR interventions to standard care. Studies focusing on procedural or chronic pain were excluded.
METHODS: A systematic search was conducted on January 23, 2025, in MEDLINE, EMBASE, Web of Science, CINAHL, and PsycINFO for studies evaluating XR interventions for acute and postoperative pain in children, using validated pain measures. Pain outcomes were extracted for an exploratory meta-analysis, with self-report as the primary and observer-report as the secondary outcome. Two reviewers independently extracted data and assessed study quality using CONSORT and TREND.
RESULTS: From 1793 records, nine studies were included, all evaluating virtual reality (VR) interventions. Seven focused on postoperative pain, two on acute pain. The primary meta-analysis (n = 6) showed a moderate but nonsignificant effect in self-reported pain (SMD = -0.61; 95% CI, -1.58 to 0.36). The secondary meta-analysis (n = 6) for observer-reported pain showed a large but nonsignificant effect (SMD = -1.04; 95% CI, -2.18 to 0.11).
CONCLUSION: This meta-analysis found no significant analgesic effect of VR on acute or postoperative pain in children. However, moderate effect sizes were observed, but the lack of statistical significance indicates that XR interventions require further investigation in pediatric pain management. Future research should prioritize pain as a primary endpoint and assess the effects of VR type, timing, and age on acute pain using validated measures.
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