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Augmented reality game shows no significant effect on persistent opioid use after pediatric surgeryAugmented reality game shows no clear advantage over regular game for pediatric surgery pain

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Key Takeaway
Interpret pilot AR game findings cautiously; no significant effect on pediatric postoperative opioid use.

This pilot randomized controlled trial enrolled 66 opioid-naïve pediatric patients undergoing major surgery, with 80% having oncological procedures. Patients were randomized to receive either an augmented reality scavenging game or a non-AR scavenging game postoperatively, with follow-up to 90 days after hospital discharge.

The primary outcome was persistent opioid use at 90 days postoperatively. The AR group had a rate of 6.1% (2/33) compared to 9.7% (3/33) in the non-AR group, with no statistically significant difference (p=0.667). Secondary outcomes including pain intensity, opioid use, inpatient ambulation, movement, and length of stay showed no statistically significant differences between groups, though specific numbers were not reported.

Safety and tolerability data were not reported. Key limitations include the pilot study design with small sample size of 66 patients, and the overall low rate of persistent opioid use in both groups. The study population was predominantly pediatric oncology patients, limiting generalizability to other surgical populations.

For clinical practice, this pilot RCT does not support the use of augmented reality games to reduce persistent opioid use following pediatric surgery. The findings should be interpreted cautiously due to the small sample size and lack of statistical significance for the primary outcome. Further research with larger sample sizes is needed to determine if AR interventions might have meaningful effects on postoperative outcomes.

Researchers conducted a small pilot study to see if playing an augmented reality (AR) scavenger hunt after major surgery could help children use fewer opioid pain medications. The study involved 66 children who were having major operations, most of which were cancer-related surgeries. They compared the AR game to a regular, non-AR version of the same game.

The main goal was to see if the AR game reduced the rate of children still needing opioids 90 days after leaving the hospital. The study found no significant difference: about 6% of children in the AR group and 10% in the non-AR group were still using opioids at that point. There were also no clear differences in other measures like pain levels, how much they moved, or hospital stay length.

This was a pilot study, which means it was designed to test the idea on a small scale first. With only 66 children, it's too small to draw firm conclusions. The overall rate of children needing opioids long-term was low in both groups. More research with larger groups is needed to know if AR games can be a helpful tool for managing pain after surgery.

What this means for you:
A small study found an AR game did not significantly reduce long-term opioid use in children after surgery compared to a regular game.

Study Details

Study typeRct
Sample sizen = 66
EvidenceLevel 2
PublishedApr 2026
View Original Abstract ↓
INTRODUCTION: Pediatric musculoskeletal and cancer surgeries often lead to significant postoperative pain. Augmented reality (AR), a non-pharmacological approach to pain modulation, has been insufficiently studied for its potential role in reducing opioid use following major surgery in children. METHODS: In this pilot trial, we randomly assigned pediatric patients undergoing major surgery, in a 1:1 ratio, to an AR versus non-AR scavenging game postoperatively. Randomization was stratified according to the study site. The primary endpoint was the rate of persistent opioid use measured at 90 days after hospital discharge. Secondary endpoints included pain intensity, opioid use, inpatient ambulation or "out of bed", movement, length of stay, and adverse events. We considered the trial a success if the rate of opioid use at 90 days postoperatively was significantly lower in the AR arm than in the non-AR arm. RESULTS: A total of 66 patients underwent randomization (n = 33 in each arm). The median age of each group was 12 years old. There were more females (72.7%) in the AR group than in the non-AR group (48.5%). Most patients (80%) had undergone oncological surgeries. The primary endpoint was met in over 95% of the patients. The overall rate of opioid use was low in both groups of patients (AR: 6.1% and non-AR: 9.7%) and did not reach statistical significance (p = 0.667). There were no statistically significant differences in secondary outcomes. CONCLUSION: In conclusion, this pilot study does not support the use of AR aimed at reducing the rate of persistent opioid use following pediatric surgery.
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