• Evelyn Chan, Michael Hovenden, Emma Ramage, Norman Ling, Jeanette H Pham, Ayesha Rahim, Connie Lam, Linly Liu, Samantha Foster, Ryan Sambell, Kasthoori Jeyachanthiran, Catherine Crock, Amanda Stock, Sandy M Hopper, Simon Cohen, Andrew Davidson, Karin Plummer, Erin Mills, Simon S Craig, Gary Deng, and Paul Leong.
• General Pediatrics, Monash Children's Hospital, Clayton, Victoria, Australia; General Medicine, Royal Children's Hospital, Parkville, Victoria, Australia.
• J. Pediatr. 2019 Jun 1; 209: 160-167.e4.

ObjectiveTo assess the efficacy and safety of a virtual reality distraction for needle pain in 2 common hospital settings: the emergency department (ED) and outpatient pathology (ie, outpatient laboratory). The control was standard of care (SOC) practice.Study DesignIn 2 clinical trials, we randomized children aged 4-11 years undergoing venous needle procedures to virtual reality or SOC at 2 tertiary Australian hospitals. In the first study, we enrolled children in the ED requiring intravenous cannulation or venipuncture. In the second, we enrolled children in outpatient pathology requiring venipuncture. In the ED, 64 children were assigned to virtual reality and 59 to SOC. In pathology, 63 children were assigned to virtual reality and 68 to SOC; 2 children withdrew assent in the SOC arm, leaving 66. The primary endpoint was change from baseline pain between virtual reality and SOC on child-rated Faces Pain Scale-Revised.ResultsIn the ED, there was no change in pain from baseline with SOC, whereas virtual reality produced a significant reduction in pain (between-group difference, -1.78; 95% CI, -3.24 to -0.317; P = .018). In pathology, both groups experienced an increase in pain from baseline, but this was significantly less in the virtual reality group (between-group difference, -1.39; 95% CI, -2.68 to -0.11; P = .034). Across both studies, 10 participants experienced minor adverse events, equally distributed between virtual reality/SOC; none required pharmacotherapy.ConclusionsIn children aged 4-11 years of age undergoing intravenous cannulation or venipuncture, virtual reality was efficacious in decreasing pain and was safe.Trial RegistrationAustralia and New Zealand Clinical Trial Registry: ACTRN12617000285358p.Copyright © 2019 Elsevier Inc. All rights reserved.

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