• Vanessa A Olbrecht, Keith T O'Conor, Sara E Williams, Chloe O Boehmer, Gilbert W Marchant, Susan M Glynn, Kristie J Geisler, Hannah M Pickerill, Lili Ding, Gang Yang, and Christopher D King.
• Cincinnati Children's Hospital Medical Center.
• Pain Med. 2021 Nov 26; 22 (11): 2426-2435.

ObjectiveVirtual reality is a promising method to manage pain. Distraction-based virtual reality (VR-D) is thought to reduce pain by redirecting attention. Although VR-D can reduce pain associated with acutely painful procedures, it is unclear whether VR-D can reduce pain after surgery. We assessed the ability of a single VR-D session to decrease postoperative pain and anxiety and explored whether pain catastrophizing and anxiety sensitivity influenced these outcomes in children after surgery.DesignSingle-center, prospective, pilot study.SettingCincinnati Children's Hospital Medical Center (CCHMC).SubjectsFifty children (7-21 years of age) with postoperative pain followed by the Acute Pain Service.MethodsPatients received one VR-D session after surgery. Before the session, patients completed pain catastrophizing (Pain Catastrophizing Scale for Children) and anxiety sensitivity (Child Anxiety Sensitivity Index) questionnaires. The primary outcome consisted of changes in pain intensity after VR-D (immediately, 15 minutes, and 30 minutes). Secondary outcomes included changes in pain unpleasantness and anxiety.ResultsVR-D use was associated with a decrease in pain intensity immediately and 15 minutes after VR-D. Reductions in pain unpleasantness were observed up to 30 minutes after VR-D. VR-D was also associated with a reduction in anxiety immediately and at 15 minutes. Although patients with higher pain catastrophizing had higher baseline pain intensity and unpleasantness, they did not show larger pain reductions after VR-D than those with lower pain catastrophizing.ConclusionsVR-D may be beneficial in transiently reducing pain intensity, unpleasantness, and anxiety in children with postoperative pain. This study informs the design of a larger, randomized, controlled study assessing VR-D for acute postoperative pain and anxiety management.© The Author(s) 2021. Published by Oxford University Press on behalf of the American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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