Pain in the intensive care unit is a heavy burden for patients who cannot move or speak. A new analysis looked at whether virtual reality could help. Researchers combined data from five studies involving 979 adult ICU patients. They compared those who used head-mounted devices showing 360-degree relaxing nature scenes against those receiving conventional care. The results showed that pain scores were significantly reduced for the group using the virtual reality technology. The difference was clear and consistent across the available data. No serious safety issues or adverse events were reported during these trials. Patients tolerated the technology well without needing to stop the intervention early. This suggests that distraction-focused tools might offer extra relief when patients face brief, high-intensity procedures. However, the evidence comes with a note of caution. Only five studies reported how much pain medication or sedatives were used after patients enrolled. Because the reporting varied so much, researchers could not pool the data to give a single number for how much drugs were saved. The complexity of pain sources in the ICU also makes it hard to draw firm conclusions. Variations in study design and the diversity of virtual reality content add to this uncertainty. While the findings are promising, the certainty of the evidence is currently low. The true impact on ICU pain and the demand for analgesic medications should still be continually validated by more research.
Meta-analysis shows VR reduces pain in adult ICU patients receiving conventional careVirtual reality headsets lower pain scores for adults in the ICU
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Key Takeaway
Consider VR as a potential adjunct for pain management in adult ICU patients based on low-certainty evidence.
This meta-analysis and systematic review examined the use of virtual reality technology or intervention involving head-mounted VR devices delivering 360-degree relaxing nature scenes. The study population consisted of 979 adult ICU patients receiving conventional care. The primary outcome measured was pain levels, while secondary outcomes included analgesic and sedative doses.
The analysis found that pain scores were significantly reduced with a standard mean difference of -0.66 and a 95% confidence interval of -0.93 to -0.40. The p-value was 0.032. However, heterogeneity of reporting precluded pooled estimates of opioid- or sedative-sparing effects. Only 5 studies reported post-enrolment analgesic and sedative doses.
The authors highlight several limitations including the complexity of pain sources in the ICU, variations in study design, and diversity of VR content. Safety data such as adverse events, serious adverse events, discontinuations, and tolerability were not reported. The certainty of the evidence is low.
Practice relevance suggests that nature-based, distraction-focused VR appears to confer additional analgesic benefit for ICU patients, especially around brief high-intensity procedures. The authors emphasize that the true impact on ICU pain and the demand for analgesic medications should still be continually validated.
What this means for you:
Virtual reality with nature scenes reduced pain scores in ICU patients compared to standard care. More on Postoperative Pain
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View Original Abstract ↓
BackgroundPain is common in conscious ICU patients, with over 50% experiencing mild to severe pain from procedures, disease, or routine care. Virtual reality (VR) interventions may help reduce pain, but evidence remains inconsistent, and their effect on analgesic use is unclear. The purpose of this systematic review and meta-analysis is to evaluate the impact of virtual reality technology or intervention on pain levels and analgesic dosage in adult ICU patients.MethodsRelevant literature published from January 2015 to February 2026 in PubMed and eight other electronic databases has been comprehensively searched. The Cochrane Risk of Bias Tool and Joanna Briggs Institute checklist were applied for quality assessment of randomized controlled trials (RCTs) and quasi-experimental studies (QES), respectively. The data analysis was conducted using R studio (4.5.2). The GRADE system was employed to evaluate the certainty of evidence.ResultsThirteen studies involving 979 patients were included. Meta-analysis of seven clinical studies (7 RCTs) demonstrated that head-mounted VR devices delivering 360°relaxing nature scenes significantly reduced pain scores compared to conventional care[I2 = 56.5%, SMD = −0.66, 95% CI (−0.93, −0.40), p = 0.032; low-certainty evidence]. The effect was most pronounced during acute procedural pain, particularly postoperative chest drain removal. Only 5 studies reported post-enrolment analgesic and sedative doses, and heterogeneity of reporting precluded pooled estimates of opioid- or sedative-sparing effects.ConclusionNature-based, distraction-focused VR appears to confer additional analgesic benefit for ICU patients, especially around brief high-intensity procedures. However, given the complexity of pain sources in the ICU, variations in study design, and the diversity of VR content, its true impact on ICU pain and the demand for analgesic medications should still be continually validated.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD420251231605, PROSPERO, registration number: CRD420251231605.
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